Magister Psychologiae - MPsych / Globally, and especially in Sub-Saharan Africa the advent of HIV and AIDS has created new inequalities within already challenged health care systems. Chronic illnesses have often been associated with increased prevalence of psychological symptoms. Both national and international studies have found a strong association between psychiatric morbidity and HIV and AIDS. Furthermore, studies have found that social support contributes to positive adjustment of individuals infected with HIV and provides a buffer against the effects of anxiety. The aim of this study was therefore to examine anxiety and social support in adults diagnosed with HIV or AIDS at a public health clinic in the Western Cape. The objectives in relation to the aim were: (1) To determine the prevalence of anxiety in adults diagnosed with HIV or AIDS. (2) To determine the degree of social support, as a component of quality of life,in adults diagnosed with HIV or AIDS. (3) To examine the relationship between anxiety and social support in adults diagnosed with HIV or AIDS. The broad theoretical framework that guides this study is the bio-psycho-social model. A cross-sectional design was used in which 70 participants were recruited using a purposive sampling method. Participants were assessed using well-validated self-administered questionnaires: Hospital Anxiety and Depression Scale(HADS) and Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q). Data were analysed using the Statistical Package for the Social Sciences (SPSS) version 17.1. Correlational and inferential statistics were conducted. The findings of this study indicated that participants in this study had higher levels of anxiety (28%) when compared to the general population (15.8%). Participants in this study, indicated a 59% enjoyment and satisfaction with social support, which indicates satisfaction with social support some of the time. There was however no significant relationship between anxiety and social support in this study. HIV intervention efforts should include screening HIV positive individuals for the presence of psychiatric symptoms. Interventions should also include encouraging HIV positive individuals to maintain and expand their social networks.

Chronic pain in children and adolescents is common; approximately 5% of children and adolescents report chronic pain along with moderate to high pain-related disability. Chronic pain is a subjective experience and can best be explained by a bio-psycho-social approach, which suggests reciprocal relations between different levels of this multidimensional phenomenon. The different dimensions of chronic pain need to be considered for a comprehensive assessment. Due to the subjective nature of pain, the child’s self-report is usually considered the best available and most valid estimate of the pain experience. A reliable and multidimensional assessment is an indispensable requirement for treatment planning. To date, questionnaires in German language are available to assess a wide range of relevant parameters in pediatric chronic pain. However, so far, no validated self-report tool exists to assess sensory and affective pain perception in children. These two parameters are of relevance since they describe aspects of the biological as well as the psychological dimension of chronic pain. Furthermore, a comprehensive diagnostic approach combining parameters from the three dimensions of chronic pain does not yet exist for children and adolescents. Such a comprehensive approach could be used for sample descriptions and standardized comparisons across different populations; it could serve as an approach for treatment planning or to classify outcome. This doctoral thesis is aimed at further developing the available diagnostic measures for older children and adolescents with chronic pain based on the above mentioned gaps in pediatric pain assessment. Research was performed on three patient samples. Sample 1 includes data from a prospective assessment at the German Pediatric Pain Centre from August 2008 to March 2009 (N(1)=139). Sample 2 includes retrospective data from patients who were treated at the German Pediatric Pain Centre from July 2005 to June 2010 (N(2)=1242). Sample 3 consists of pediatric pain patients who started an intensive interdisciplinary inpatient treatment between November 2009 and July 2011 (N(3)=83). In a first study, a tool to assess sensory and affective pain perception, the Pain Perception Scale for Adolescents, was adapted and validated in an adolescent clinical sample (Sample 1). The Pain Perception Scale for Adolescents allows pain patients to provide a valid and reliable self-report of parameters for both the biological and psychological dimensions of pain. In a second study, this tool was applied to a further sample of adolescents with migraine and tension-type headache (subsample of Sample 2). It was demonstrated that, contrary to the official headache classification guidelines, the sensory pain perception in this sample did not differentiate between migraine and tension-type headache. To develop a multidimensional assessment approach, in a third study, an adult classification system (Chronic Pain Grading) was applied to a sample of pediatric pain patients (Sample 2). This approach proved useful as a valid measure for a brief operationalization of pain problem severity, including pain intensity and pain-related disability only, and as an outcome measure. However, it displayed major shortcomings with regards to treatment stratification. To further develop an approach for treatment stratification and treatment planning, a fourth study focused on developing a new multidimensional approach for subgroup classification (subsample of Sample 2). The stability of subgroups was demonstrated in a cross-validation with an independent sample (Sample 1). Furthermore, the identified subgroups displayed distinct treatment outcomes after a standardized treatment program (Sample 3). In conclusion, this doctoral thesis offers an addition to diagnostic measures for older children and adolescents with chronic pain by adding the Pain Perception Scale for Adolescents and by proving the validity of the Chronic Pain Grading for the application in this patient group. These tools allow a valid description of adolescents’ subjective pain experience. Results from this doctoral thesis also indicate that the findings from adults cannot be readily transferred to children and adolescents. The final output of this doctoral thesis is a bio-psycho-social classification approach that identifies subgroups of adolescents with chronic pain with treatment relevant differences. This is a first step toward the development of subgroup-specific treatment.

This review aimed to evaluate orthotic treatments for children and adolescents with pectus carinatum, primarily focusing on patient satisfaction with the treatment. Secondary outcomes of interest were adherence and psychological and social factors following the treatment period. A literature search was performed in the databases CINHAL, Medline, Web of Science and Scopus. Following predetermined eligibility criteria, articles were included and excluded. Next, criticala ppraisal was performed for the included articles. Following this, relevant data were extracted, analysed, and presented to aid in answering the research questions. Six articles with 402 patients were included in the final review. Patient satisfaction was good or improved following the treatment period, and the combined non-adherence rate for the included orthosis was 37.7 %. Patients adhering to the treatment protocol showed increased self-esteem and decreased interference with social activity following orthotic correction. Moreover, they displayed significantly higher patient satisfaction than patient's non-adherent to the treatment protocol. The findings were displayed and discussed in the Bio-Psycho-Social model. Due to their connection, patient satisfaction and adherence were placed together in the middle and surrounded bypsychological and social factors. The model displayed that a combination of many aspects determines patient satisfaction and adherence, demonstrating that treatment is complex and challenging. In conclusion, adherence was deemed one of the most important aspects to achieve high patient satisfaction. Moreover, due to psychological and social factors, a patient-centred approach with professional collaboration is necessary to achieve successful outcomes. To make reliable conclusions, research of higher quality with long follow-up periods including standardised patient satisfaction and adherence measures is needed.

Magister Psychologiae - MPsych / This study utilised secondary data from a larger study that looked at individuals that are already infected by HIV which is entitled Implicative personal dilemmas and cognitive conflicts in health decision making in HIV positive adults and adults with AIDS. The primary aim of the larger study was to examine the cognitive construction of the individual and how they utilised their individual resources to construct who they are and how they perceived the difficulties and challenges that they face and the decisions they make regarding their health. HIV and AIDS is a debilitating disease and it affects millions worldwide. South Africa, presently, has the largest burden of this disease with those between the ages of 15 – 49 years of age being most affected. As previously mentioned the decisions that individuals make can impact on their health. Decisions to take necessary precautions such as protected sex during sexual intercourse can decrease the progression of the disease. Decisions made regarding abstinence of risky behaviour as well as being committed to taking medication could also positively impact health. People living with HIV and AIDS find it difficult to adjust to the challenges that this disease presents. Depression is often experienced due to the changes in self image and perception. Studies show that females are twice more likely to experience depression than men. There has however been no conclusive evidence showing the reason for this, however, the perception of stress based on gender could shed some light on this matter and how these perceptions can increase the likelihood of women being more vulnerable to depression. Due to the limitation of this study, it will only look at depression as it relates to HIV and AIDS. Psychological problems such as depression can hamper the adjustment process and the effect of depression is evident in that it can lower the CD 4 + cells. Not only are those living with HIV and AIDS affected by depression, but they also have a lifetime prevalence to depression. It is important to have an effective screening tool for depression so that the detection of this disease can be made and effective treatment can be implemented to enhance health. The sample consisted of 113 adult participants that have already been diagnosed with HIV and AIDS. The primary aim of this study was to compare the Beck’s Depression Inventory II (BDI II) and the Hospital Anxiety and Depression Scale –(the Depression component) (HADS-D) as a screening tool for depression. Exploratory Factor Analysis revealed a 5 factor structure which accounted for 60.14 % of the total variance. The HADS yielded one factor accounting for 14.33% of total variance. The BDI II has proven to be more a reliable measure of depression with 0.89 according to the Cronbach’s Alpha co efficient opposed to 0.375 as per the HADS-D. The secondary aim was to establish the sociodemographic and disease profiles of the participants under study. / South Africa

<p>This study utilised secondary data from a larger study that looked at individuals that are already infected by HIV which is entitled Implicative personal dilemmas and cognitive conflicts in health decision making in HIV positive adults and adults with AIDS. The primary aim of the larger study was to examine the cognitive construction of the individual and how they utilised their individual resources to construct who they are and how they perceived the difficulties and challenges that they face and the decisions they make regarding their health. HIV and AIDS is a debilitating disease and it affects millions worldwide. South Africa, presently, has the largest burden of this disease with those between the ages of 15 &ndash / 49 years of age being most affected. As previously&nbsp / mentioned the decisions that individuals make can impact on their health. Decisions to take necessary precautions such as protected sex during sexual intercourse can decrease the&nbsp / progression of the disease. Decisions made regarding abstinence of risky behaviour as well as being committed to taking medication could also positively impact health. People living with HIV and AIDS find it&nbsp / difficult to adjust to the challenges that this disease presents. Depression is often experienced due to the changes in self image and perception. Studies show that&nbsp / females are twice more likely to experience depression than men. There has however been no conclusive evidence showing the reason for this, however, the perception of stress based on&nbsp / gender could shed some light on this matter and how these perceptions can increase the likelihood of women being more vulnerable to depression. Due to the limitation of this study, it will&nbsp / only look at depression as it relates to HIV and AIDS. Psychological problems such as depression can hamper the adjustment process and the effect of depression is evident in that it can lower the CD 4 + cells. Not only are those&nbsp / living with HIV and AIDS affected by depression, but they also have a lifetime prevalence to depression. It is important to have an effective screening tool for depression so that the detection of this&nbsp / disease can be made and effective treatment can be implemented to enhance health. The sample consisted of 113 adult participants that have already been diagnosed with HIV and AIDS. The&nbsp / primary aim of this study was to compare the Beck&rsquo / s Depression Inventory II (BDI II) and the Hospital Anxiety and Depression Scale &ndash / (the Depression component) (HADS-D) as a screening tool&nbsp / &nbsp / for depression. Exploratory Factor Analysis revealed a 5 factor structure which accounted for 60.14 % of the total variance. The HADS yielded one factor accounting for 14.33% of total variance. The BDI II has proven to be more a reliable measure of depression with 0.89 according to the Cronbach&rsquo / s Alpha co efficient opposed to 0.375 as per the HADS-D. The secondary aim was to establish&nbsp / the sociodemographic and disease profiles of the participants under study. </p>

<p>This study utilised secondary data from a larger study that looked at individuals that are already infected by HIV which is entitled Implicative personal dilemmas and cognitive conflicts in health decision making in HIV positive adults and adults with AIDS. The primary aim of the larger study was to examine the cognitive construction of the individual and how they utilised their individual resources to construct who they are and how they perceived the difficulties and challenges that they face and the decisions they make regarding their health. HIV and AIDS is a debilitating disease and it affects millions worldwide. South Africa, presently, has the largest burden of this disease with those between the ages of 15 &ndash / 49 years of age being most affected. As previously&nbsp / mentioned the decisions that individuals make can impact on their health. Decisions to take necessary precautions such as protected sex during sexual intercourse can decrease the&nbsp / progression of the disease. Decisions made regarding abstinence of risky behaviour as well as being committed to taking medication could also positively impact health. People living with HIV and AIDS find it&nbsp / difficult to adjust to the challenges that this disease presents. Depression is often experienced due to the changes in self image and perception. Studies show that&nbsp / females are twice more likely to experience depression than men. There has however been no conclusive evidence showing the reason for this, however, the perception of stress based on&nbsp / gender could shed some light on this matter and how these perceptions can increase the likelihood of women being more vulnerable to depression. Due to the limitation of this study, it will&nbsp / only look at depression as it relates to HIV and AIDS. Psychological problems such as depression can hamper the adjustment process and the effect of depression is evident in that it can lower the CD 4 + cells. Not only are those&nbsp / living with HIV and AIDS affected by depression, but they also have a lifetime prevalence to depression. It is important to have an effective screening tool for depression so that the detection of this&nbsp / disease can be made and effective treatment can be implemented to enhance health. The sample consisted of 113 adult participants that have already been diagnosed with HIV and AIDS. The&nbsp / primary aim of this study was to compare the Beck&rsquo / s Depression Inventory II (BDI II) and the Hospital Anxiety and Depression Scale &ndash / (the Depression component) (HADS-D) as a screening tool&nbsp / &nbsp / for depression. Exploratory Factor Analysis revealed a 5 factor structure which accounted for 60.14 % of the total variance. The HADS yielded one factor accounting for 14.33% of total variance. The BDI II has proven to be more a reliable measure of depression with 0.89 according to the Cronbach&rsquo / s Alpha co efficient opposed to 0.375 as per the HADS-D. The secondary aim was to establish&nbsp / the sociodemographic and disease profiles of the participants under study. </p>

This study utilised secondary data from a larger study that looked at individuals that are already infected by HIV which is entitled Implicative personal dilemmas and cognitive conflicts in health decision making in HIV positive adults and adults with AIDS. The primary aim of the larger study was to examine the cognitive construction of the individual and how they utilised their individual resources to construct who they are and how they perceived the difficulties and challenges that they face and the decisions they make regarding their health. HIV and AIDS is a debilitating disease and it affects millions worldwide. South Africa, presently, has the largest burden of this disease with those between the ages of 15 – 49 years of age being most affected. As previously mentioned the decisions that individuals make can impact on their health. Decisions to take necessary precautions such as protected sex during sexual intercourse can decrease the progression of the disease. Decisions made regarding abstinence of risky behaviour as well as being committed to taking medication could also positively impact health. People living with HIV and AIDS find it difficult to adjust to the challenges that this disease presents. Depression is often experienced due to the changes in self image and perception. Studies show that females are twice more likely to experience depression than men. There has however been no conclusive evidence showing the reason for this, however, the perception of stress based on gender could shed some light on this matter and how these perceptions can increase the likelihood of women being more vulnerable to depression. Due to the limitation of this study, it will only look at depression as it relates to HIV and AIDS. Psychological problems such as depression can hamper the adjustment process and the effect of depression is evident in that it can lower the CD 4 + cells. Not only are those living with HIV and AIDS affected by depression, but they also have a lifetime prevalence to depression. It is important to have an effective screening tool for depression so that the detection of this disease can be made and effective treatment can be implemented to enhance health. The sample consisted of 113 adult participants that have already been diagnosed with HIV and AIDS. The primary aim of this study was to compare the Beck’s Depression Inventory II (BDI II) and the Hospital Anxiety and Depression Scale –(the Depression component) (HADS-D) as a screening tool for depression.Exploratory Factor Analysis revealed a 5 factor structure which accounted for 60.14 % of the total variance. The HADS yielded one factor accounting for 14.33% of total variance. The BDI II has proven to be more a reliable measure of depression with 0.89 according to the Cronbach’s Alpha co efficient opposed to 0.375 as per the HADS-D. The secondary aim was to establish the sociodemographic and disease profiles of the participants under study. / Magister Psychologiae - MPsych

This thesis deals with the Czech and international ideas applied in the "Strategy of Reform of Psychiatric Care" issued in 2013 by the Ministry of Health of the Czech Republic. The main starting point of this work is the fact that the care of people with mental illness in Czech and international environment is oriented on the biological treatment of the patient with psycho- pharmaceuticals and that there is a deficit in the area of psychosocial treatment. International and Czech mental health policy seeks to promote a bio-psycho-social approach to patient's care. However, current psychiatry continues to be involved in conducting clinical research focused on the efficiency of psycho-pharmaceuticals. These studies are driven and sponsored mainly by the pharmaceutical industry. But international and Czech policies are still not able to adequately reflect this situation within the field of psychiatry. The Czech Republic has not so far paid attention to mental health issues and has lagged behind the other developed countries in this area. The empirical part of this work is divided into two parts. The first part of the research focuses on the Czech and international ideas applied in the "Strategy of Reform of Psychiatric Care" issued in 2013 by Ministry of Health. The methods used here are - content...

The number of students with learning disabilities entering the higher education system in South Africa is increasing dramatically. At the same time, the misconceptions about disabilities can have distressing consequences for disabled students. A thorough understanding of current staff attitudes and knowledge of learning disabilities will assist when setting up interventions aimed at improving perceptions. This qualitative, phenomenological case study uses the bio-psycho-social model of disability to explore staff perceptions at the University of the Witwatersrand. Interviews with staff members showed that a wide range of opinions and attitudes exist. Although perceptions varied between participants, the main findings indicated that they presented a poor understanding of what disability, and in particular, learning disability means. The conclusion was drawn that Wits University should be proactive in empowering their staff by providing them with opportunities to learn about disabilities. This investment in staff development should ultimately lead to a richer campus life where all students feel welcome. / Educational Studies / M. Ed. (Adult Education)

The number of students with learning disabilities entering the higher education system in South Africa is increasing dramatically. At the same time, the misconceptions about disabilities can have distressing consequences for disabled students. A thorough understanding of current staff attitudes and knowledge of learning disabilities will assist when setting up interventions aimed at improving perceptions. This qualitative, phenomenological case study uses the bio-psycho-social model of disability to explore staff perceptions at the University of the Witwatersrand. Interviews with staff members showed that a wide range of opinions and attitudes exist. Although perceptions varied between participants, the main findings indicated that they presented a poor understanding of what disability, and in particular, learning disability means. The conclusion was drawn that Wits University should be proactive in empowering their staff by providing them with opportunities to learn about disabilities. This investment in staff development should ultimately lead to a richer campus life where all students feel welcome. / Educational Studies / M. Ed. (Adult Education)