The development of palliative care in terms of recognizing the needs of the dying, palliative care becoming a nursing and medical speciality, the involvement of the World Health Organization in palliative care and the continuous development of treatment modalities available to cancer patients creates the expectation that the outcomes for the patient should also be positively influenced. The purpose of the study was to determine the most common symptoms of advanced cancer patients treated in a public and private hospital in Tshwane, and whether advances in palliative care improved the outcomes for these patients by decreasing the prevalence of symptoms experienced. The design of the study was a quantitative survey. The population consisted of patients with advanced cancer receiving palliative treatment as out patients in radiation and medical oncology clinics in a public and private hospital the Tshwane Metropolitan area. The sampling method was convenient and the sample size was 148 participants (n=148). Data was gathered by means of an interview and self report. Data analysis was done by means of descriptive statistics. The results of the study indicated that a high number of patients still experience problems that could have been prevented. Pain was found to be the biggest problem for patients (76.4%) followed by weakness and fatigue (65.5%), nausea and vomiting (65.5%) and a dry mouth (46.6%). Thirst was reported by 41.2% of the sample. The study provides evidence that the development of palliative care did not have a positive outcome for patients by reducing the prevalence of symptoms experienced.

<p> This study examines methods and barriers to minority leadership recruitment in healthcare organizations. Minorities are underrepresented in healthcare organizations at the executive level, even though staff and patient demographics are becoming increasingly diverse. This disparity in minority representation presents the potential for staff and patient needs, interests, and values to be overlooked by senior management and the strategies, policies, and programs they implement. This study conducted interviews with human resources personnel at healthcare organizations identified as top performers to determine whether their organizations engaged in minority recruitment methods, what methods were successful, and what barriers existed to recruitment of minorities. These results were compared to survey data compiled by the Institute for Diversity in Health Management. The results show significant room for improvement in the implementation of comprehensive methods to recruit minority senior management, with significant variation among organizations in the amount and type of methods to recruit minority executives. These findings lead to the conclusion that more pressure needs to be placed on healthcare organizations to identify best practices in minority recruitment and implement these in formal, comprehensive human resources activities related to recruitment, retention, and professional development.</p>

The research contained in this thesis was concerned with the parental care afforded to children and the effect of that parenting on the child's self-concept in relation to the aetiology of major depressive disorder (MDD). It was based upon psychoanalytic and cognitive theories of depression, which implicate negative relationships with significant others in childhood as of aetiological importance in MDD. Both schools also argue that this link is mediated by negative self-beliefs which a child develops as a consequence of such relationships. An attempt was made to identify, firstly, which aspects of parenting style are associated with such depression and, secondly, whether low self-esteem acts as a vulnerability factor for MDD. A measure of 'self-concept' was also created to test whether the way in which an individual thinks about themselves occupies a distinct role in the aetiology of MDD. A measure of neuroticism was taken in order to examine the role that this personality characteristic plays in relation to parenting and self-esteem. The main finding was that lack of maternal care was indirectly associated with MDD via 'selfconcept' and self-esteem, with the former preceding the latter in a hypothesised temporal order. A further indirect link was found between high levels of paternal overprotection and depression; this link being mediated, firstly, by self-esteem and, secondly, by neuroticism. It is suggested that there may be two separate routes to MDD and that these routes may be based upon 'sociotropic' and 'autonomy' schemas. The main suggestion, however, is that low levels of maternal care lead to the development of a sociotropic depressogenic schema and that this schema represents a vulnerability to depression. It is suggested that this schema will only lead to depression, however, if an individual experiences a schema relevant negative life-event which lowers self-esteem and sets up a cyclical process culminating in major depressive disorder.

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published_or_final_version / Public Administration / Master / Master of Social Sciences

published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences

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The TC program, designed to decrease preventable readmissions and support patients who have chronic illnesses including HF, at BUMCP has had a low referral rate. This low referral rate results in the program being unable to make an impact to decrease readmission rates in the HF population and increase quality of life among this patient population. The purpose of this project was to identify current barriers to referral and develop interventions directed at the identified barriers. An online survey was sent to a hospitalist group employed at BUMCP. Results revealed perceived barriers include decreased accessibility, limited number of accepted patient diagnoses, and lack of involvement in launch of TC. Recommended interventions include increased accessibility through 24 hours day, seven days week availability, abolishment of current accepted patient diagnoses, and implementation of Lewin's Change Theory to increase buy-in from physicians.