The topic of cleft lip and/or palate is widely researched in literature. However no research to date has focused on mothers' experiences raising twins when one twin is born with a cleft lip and/or palate. This qualitative study aims to explore the unigue experiences of these mothers. The epistemological foundations of this study are postmodern, social constructionist and systemic. In accordance with a gualitative methodology data was collected in the form of the participants' personal written stories. This was done from a post-modern paradigm, from a systemic perspective. Themes that were extracted from the stories according to thematic content analysis, not only reflect the experiences of mothers raising twins when one twin is born with a cleft lip and/or palate, they also provide an in-depth understanding of these mothers' experiences and unique situations. Recommendations for future research are offered. / Psychology / M.A. (Clinical Psychology)

English, Afrikaans and Zulu summaries / Orientation: The study researched physical disability apropos of employment. The attitudes of able-bodied persons towards persons with disabilities (PWD) culminate in the exclusion of the latter from the workplace. Aspects of this topic have been addressed by researchers abroad and in Africa using samples of limited size. Research aim: The general aim of the research was twofold. Firstly, it set out to uncover the causes of exclusion of persons with physical disabilities from employment in the South African open labour market, and secondly, to identify interventions that could assuage this situation. Research methodology: A convergent mixed methods research strategy was adopted, with responses of employers forming the quantitative strand and those of persons with physical disabilities (PWPD) forming the qualitative strand. A customer survey questionnaire was developed and validated for the sample of 342 employers, while interview schedules were used for 312 PWPD. Statistical procedures included factor analysis, chi-square tests and structural equation modelling. Main findings: Meta-inferences were formulated relating to the mixed methods research. The overarching message conveyed discord in respect of several dimensions, between the perceptions of employers, those of persons with physical disabilities and the theory. Employers are receptive to employing persons with disabilities but conflicted about their management, competence and accommodation. They are reportedly unfamiliar with disability matters, and cannot locate qualified candidates, while disability policies are not commonplace. Key national interventions encompass incentives for employers to hire PWD, tax concessions and amendment of the BBBEE scorecard points system. Important interventions at organisational level entail training in disability matters across the board, as well as disability-related policies. At individual level, PWPD need training in job-seeking techniques, effective avenues to secure work, accommodation and assistive technology, and skills. To extend the mixed methods research, industrial sectors were compared and latent constructs sought in separate analyses. Main contributions: Different perspectives gleaned from employers in various sectors, PWPD, disability advocacy organisations and associated groups; expansion of the literature on disability employment; structural equation modelling that produced latent constructs which underlie the causes of exclusion of PWPD from employment and enhance understanding of those aspects with a direct bearing on employers’ receptivity to hiring PWPD. The findings could catalyse national and organisational policy frameworks to promote inclusion in the workplace. Public policy makers could utilise the findings to devise strategies that would motivate employers to hire PWPD. Organisational policies, with practical guidelines, should be formulated relating to recruitment of PWPD and disability training for staff. The different types of disabilities and job categories in which employers would be willing to appoint PWD were ascertained. / Oriëntering: Die studie het ondersoek ingestel na liggaamlike ongeskiktheid ten opsigte van indiensneming. Die houdings van nie-gestremde persone teenoor persone met gestremdhede veroorsaak dat laasgenoemde van die werksplek uitgesluit word. Fasette van hierdie onderwerp is deur navorsers oorsee en in Afrika ondersoek met behulp van steekproewe van beperkte grootte. Navorsingsdoelwit: Die algemene doelwit van die navorsing was tweeledig. Dit het eerstens ten doel gehad om die oorsake van indiensnemingsuitsluiting van persone met liggaamlike gestremdhede in die Suid-Afrikaanse arbeidsmark te bepaal, en tweedens, om ingrypings te identifiseer wat hierdie situasie kan verbeter. Navorsingsmetodologie: ’n Konvergerende gemengdemetode-navorsingstrategie is ingespan, met werkgewers se response as die kwantitatiewe been en dié van persone met liggaamlike gestremdhede, as die kwalitatiewe been. ʼn Kliëntetevredenheidsvraelys is vir die steekproef van 342 werkgewers ontwikkel en geldig verklaar, terwyl onderhoudskedules vir 312 persone met liggaamlike gestremdhede gebruik is. Statistiese prosedures het faktorontleding, chi-kwadraattoetse en strukturele-vergelyking-modellering ingesluit. Belangrikste bevindinge: Meta-inferensies met betrekking tot die gemengdemetode-navorsing is geformuleer. Die oorkoepelende boodskap was een van verdeeldheid oor verskeie dimensies; tussen werkgewers se persepsies, dié van persone met liggaamlike gestremdhede en die teorie. Werkgewers is ontvanklik vir indiensneming van persone met gestremdhede, maar het verskil oor die bestuur, bevoegdheid en akkommodering van sulke persone. Hulle is blykbaar nie bekend met ongeskiktheidsaangeleenthede nie en kan nie gekwalifiseerde kandidate vind terwyl ongeskiktheidsbeleide nie alledaags is nie. Deurslaggewende nasionale ingrypings behels aansporings vir werkgewers om persone met liggaamlike gestremdhede in diens te neem, belastingvergunnings en aanpassing van die BGSEB-telkaartpuntestelsel. Belangrike ingrypings op organisasievlak behels algemene opleiding in ongeskiktheidsake, sowel as beleide oor ongeskiktheidskwessies. Op individuele vlak benodig persone met liggaamlike gestremdhede opleiding in werksoektegnieke, doeltreffende metodes om werk te verseker, akkommodasie en ondersteunende tegnologie, en vaardighede. Om die gemengdemetodes-navorsing uit te brei, is nywerheidsektore vergelyk en latente konsepte in afsonderlike ontledings gesoek. Hoofbydraes: Verskillende perspektiewe wat van werkgewers in verskeie sektore verkry is, persone met liggaamlike gestremdhede, gestremdheidvoorspraakorganisasies en verwante groepe; uitbreiding van die literatuur oor ongeskiktheidsindiensneming; strukturele-vergelyking-modellering wat aanleiding gegee het tot latente konsepte onderliggend tot die oorsake van indiensneminguitsluiting van persone met liggaamlike gestremdhede en bevorderlik vir begrip van daardie aspekte wat ʼn direkte invloed op werkgewers se ontvanklikheid rakende indiensneming van persone met liggaamlike gestremdhede het. Die bevindinge kan nasionale en organisasiebeleidsraamwerke kataliseer om insluiting in die werksplek te bevorder. Openbarebeleidbepalers kan die navorsingsresultate gebruik om strategieë te beraam wat werkgewers sal motiveer om persone met liggaamlike gestremdhede aan te stel. Organisasiebeleide, met praktiese riglyne, moet geformuleer word ten opsigte van werwing van persone met liggaamlike gestremdhede en ongeskiktheidsopleiding vir personeel. Die verskillende soorte gestremdhede en werkskategorieë waar werknemers bereid sal wees om persone met liggaamlike gestremdhede in diens te neem, is vasgestel. / Isimo nokuqondiswe kukho (orientation) Ucwaningo lucwaninge ngokukhubazeka ngomzimba maqondana nokuhambisana nokuqashwa Imibono yabantu abangakhubazekile maqondana nabantu abakhubazekile ngokubizwa ngokuthi yi-persons with disabilities (PWD) ibangela ukuthi abantu abakhubazekile bakhishelwe eceleni maqondana nemisebenzi. Izingxenye zalesi sihloko kubhekwane nazo ngabanye abacwaningi baphesheya kanye nase-Afrka ngokusebenzisa amasampuli amancane. Inhloso yocwaningo: Inhloso enabile yocwaningo ikabili. Okokuqala, ukuthola izimbangela zokukhishelwa eceleni kwabantu abakhubazekile ekuqashweni eNingizimu Afrika nasemakethe evulekile yezemisebenzi, kanti eyesibili, ukuphawula ngezinto ezingabawusizo ukululamisa lesi simo. Imetodoloji (indlela) yocwaningo: Kusetshenziswe isu elihlangene lezindlela zocwaningo okuyi-mixed methods research, kanti izimpendulo zabaqashi zibumbe ingxenye ye-quantitative strand, kanti ezalabo bantu abakhubazekile ngomzimba (PWPD) zona zibumbe ingxenye ye-qualitative strand. Kwenziwe i-survey yamakhastama yase iqinisekiswa ukwenzela isampuli yaqabashi abangu 342, kanti isheduli yama-interview yenziwe kubantu abakhubazekile ngomzimba (PWPD) abangu 312). Inqubo yamastatistiki ibandakanye uhlaziyo lwe-factor analysis, i-chi-square tests kanye ne-structural equation modelling. Okukhulu okutholakele: Isiphetho ngokujulile i-meta-inferences yenziwe maqondana nezindlela ezixubene zocwaningo. Umlayezo omkhulu owaboniswa ukubhimba maqondana nezinto ezehlukene, phakathi kwemibono yabaqashi, kanye nabantu abakhubazekile ngemizimba kanye nethiyori. Abaqashi bazimisele ukuqasha abantu abakhubazekile kodwa banemibono engqubuzanayo ngokuphathwa kwabo, amakhono kanye nokubabonelela. Abanalwazi ngezinto eziphathelene nokukhubazeka, kanti abakwazi ukuthola amakhandideyiti afundele imisebenzi, kanti imigomo ngokukhubazeka ayikho kahle. Okukhulu okumele kwenziwe ukungenela kwizwe lonke kubandakanya izikhuthazi kubaqashi ukuqasha abantu abakhubazekile, izibonelelo ngentela, kanye nokuchitshiyelwa kwenqubo yamaphoyinti e-BBBEE. Ukungenela okubalulekile ezinhlanganweni kubandakanya uqeqesho ngezinto eziphathelene nobukhubazeki kuyo yonke imikhakha kanye nemigomo ehambelana nokukhubazeka. Kumkhakha wabantu ziqu, abantu abakhubazekile ngemizimba badinga uqeqesho ngamathekniki okufuna imisebenzi, imikhakha efanele yokuthola imisebenzi, izibonelelo, kanye namatheknoloji osizo kanye namakhono. Ukunweba izindlela ezehlukene zocwaningo, kwaqhathaniswa amasektha ezimboni, kwasekufunwa ama-latent construct ngohlaziyo olwehlukene. / Industrial and Organisational Psychology / D. Com. (Industrial and Organisational Psychology)

Thèse de doctorat présenté en vue de l'obtention du doctorat en psychologie - recherche intervention, option psychologie clinique (Ph.D) / La gestion des réactions de stress post-traumatique dans les premiers jours suivant l’exposition à un événement traumatique (ÉT) au travail reste un défi pour les organisations de premiers répondants et répondantes d’urgence tels que les services médicaux d’urgence (SMU) dans lesquels travaillent les paramédics et les répartitrices et répartiteurs médicaux d’urgence (RMU). Ces travailleurs et travailleuses sont particulièrement exposés à des situations traumatiques imprévisibles et récurrentes, qui les rendent plus à risque de vivre de la détresse et des difficultés d’adaptation. Les recherches doivent se poursuivre pour savoir comment intervenir auprès de ces personnes, car à l’heure actuelle aucune intervention n’a démontré une efficacité suffisante. L’approche des Premiers Soins Psychologiques (PSP), informée par les données probantes, vise à réduire la détresse initiale et promouvoir des stratégies d’adaptation chez les individus exposés à un ÉT. Elle peut être délivrée par des paires aidantes et pairs aidants précocement, en accord avec des directives internationales. Cette approche est encore peu étudiée par la recherche scientifique. L’objectif de cette thèse est d’identifier comment l’approche des PSP peut s’intégrer auprès de paramédics et RMU. Une première étude a été menée auprès de 11 paires aidantes et pairs aidants afin d’explorer qualitativement les facteurs qui peuvent influencer l’adhésion dans le temps des bénéficiaires et des paires aidantes et pairs aidants dans leur participation à l’intervention des PSP, grâce à des entretiens semi-structurés individuels. Quatre thèmes et 11 sous- thèmes influençant l’adhésion ont été identifiés : (1) perceptions et attitudes individuelles des paires aidantes et pairs aidants et des bénéficiaires à l’égard des PSP ; (2) impacts perçus sur les paires aidantes et pairs aidants et les bénéficiaires ; (3) soutien organisationnel aux PSP et (4) congruence avec la culture professionnelle. Les résultats de cette étude suggèrent qu’il est possible d’agir sur divers facteurs au niveau individuel, organisationnel et culturel pour améliorer l’adhésion et qu’il faut surveiller les facteurs pouvant nuire à l’intervention des PSP dans le temps. Une seconde étude qualitative a exploré la perception des bénéficiaires (n=13) de l’intervention des PSP. Les résultats semblent indiquer que l’intervention des PSP permet de répondre aux besoins immédiats des travailleurs et travailleuses en accord avec les cinq principes essentiels d’une intervention précoce de Hobfoll (Hobfoll et al., 2007). L’intervention des PSP favoriserait également l’adaptation et le rétablissement après un ÉT, en contribuant à réduire la stigmatisation de la santé mentale, à augmenter les comportements de recherche d’aide et à diminuer les impacts négatifs organisationnels. Enfin, des éléments spécifiques à l’intervention ont été identifiés comme favorisant l’appréciation de l’intervention. L’identification de ces composantes nous donne des pistes d’amélioration de l’intervention afin de guider au mieux les organisations dans l’implantation et la mise en œuvre des PSP. Ces résultats qualitatifs peuvent également contribuer à informer de futures études quantitatives quant aux directions à prendre pour tester l’efficacité des PSP. Les résultats issus de ces deux articles ont permis de contribuer au développement de la littérature scientifique sur la pertinence et la façon dont peut s’intégrer l’intervention des PSP dans les organisations de premiers répondants et répondantes d’urgence en agissant sur divers facteurs au niveau individuel, organisationnel et culturel et ainsi améliorer l’adhésion dans le temps. Ils mettent aussi en lumière les bénéfices possibles des PSP et offrent des pistes concrètes d’amélioration pour les organisations qui souhaitent implanter ou bonifier la mise en œuvre des PSP comme intervention post-traumatique précoce auprès de leur personnel. / Managing post-traumatic stress reactions during the first days following exposure to a traumatic event (TE) at work remains a challenge for first responder organizations such as emergency medical services (EMS) (p.ex. paramedics and emergency medical dispatchers). These workers are particularly exposed to unpredictable and recurring traumatic situations, which puts them at increased risk for distress and adjustment difficulties. More research is needed to determine how to intervene with these people as no intervention has yet been shown to be sufficiently effective. The evidence informed Psychological First Aid (PFA) approach aims to reduce initial distress and promote coping strategies in individuals exposed to a TE. It can be early delivered by peer helpers, congruently with international guidelines. This approach is still largely unexplored in the scientific literature. The purpose of this thesis is to identify how the PFA approach can be integrated among paramedics and emergency medical dispatchers. The first paper was conducted with 11 peer helpers to qualitatively explore factors that may influence adherence over time of recipients and peer helpers in their participation in the PFA intervention, through individual semi-structured interviews. Four themes and 11 subthemes influencing adherence were identified: (1) individual perceptions and attitudes of peer helpers and recipients about PFA intervention; (2) perceived impacts on peer helpers and recipients; (3) organizational support to PFA intervention; and (4) congruence with the occupational culture. The results of this study suggest that a variety of factors can be acted upon to improve adherence and that factors that may interfere with PFA involvement over time should be monitored. A second paper explored recipients’ (n=13) perceptions of the PFA intervention. The results of the thematic analysis suggest that the PFA intervention addresses the immediate needs of workers in accordance with Hobfoll’s five essential principles of early intervention (Hobfoll et al., 2007). This intervention would also promote adjustment and recovery after a TE, regarding the reduction of stigma, the increase of help-seeking behaviours, and the decrease of organizational difficulties. Finally, specific components regarding the intervention or the provider were identified as promoting appreciation of the PFA intervention. The identification of these components provides us with avenues for intervention improvement to best guide first responder organizations in the implementation and delivery of PFA. These qualitative findings also help to inform future quantitative studies as to which directions to take to test the effectiveness of this intervention. The results of these two articles have contributed to the development of the scientific literature on whether and how to integrate the PFA intervention in first responder organizations. They highlighted the possible benefits of such an intervention and offered concrete avenues for improvement for organizations wishing to implement or improve the implementation of PFA as an early post-traumatic intervention for their personnel.

This thesis analyzes how compulsory heterosexuality is present in Polish legislation on women* and trans* people’s reproductive and sexual rights. The aim of this study is to increase an understanding of how compulsory heterosexuality’s presence in legislation regarding reproductive and sexual rights can consequently affect women* and trans* people in practice. By the means of qualitative content analysis and the operationalization of compulsory heterosexuality through the lens of queer feminism, this thesis analyzes three Polish legislations on reproductive and sexual rights, namely the Constitution of Poland, the Family Planning, Human Embryo Protection and Conditions of Permissibility of Abortion Act, and the Family and Guardianship Code. Adrienne Rich’s theory of compulsory heterosexuality suggests that heterosexuality is not natural, but a violent institution enforced in society through e.g. law. This thesis found that compulsory heterosexuality was present in all three legislations, and presented itself through: erasure of women* and trans* people, denial of their sexuality, idealization of heterosexuality, rape and violence, control of their bodies, robbing of their children, punishment for being LGBTQIA+, diminishing their aspirations, restricting their self-fulfillment to parenthood and marriage, keeping them from seeking reproductive care, erasure of their traditions, objectification, and dismissive language. Possible consequences identified were: invalidation and invisibilization of queer and trans* people, increased oppression, the social norm being a negative bias against LGBTQIA+ people, criminalization of LGBTQIA+ people, more deaths at the hands of the law, more parentless children, making women* and trans* people question their body or intuition, and an increase in illegal unsafe abortions or abortion tourism.