Text in Afrikaans / Summaries in English and Afrikaans / This research sets guidelines for parents of chronically ill children. The guidelines are aimed at equipping the parents to cope more efficiently with the chronic illness and to support other family members in doing so. The nature of chronic illness and its effect on the sick child, his education, the parents and siblings have been researched in the literature study. Chronic illness affects family members in different ways. The· illness affects the sick child's physical, emotional, cognitive, moral and psychosocial development. The parent's total existence and the education of their child are also affected. The illness influences the emotional, cognitive, moral and psychosocial development of siblings. The effect of chronic illness on family members gives rise to certain needs concerned with coping with the illness. Parents as the caretakers of the family and educators of the child are mainly responsible, to assist family members to deal with the illness and its consequences. An empirical study was carried out, involving 102 parents of chronically ill children. This study confirmed that the chronic illness impedes the education process and complicates the adequate development and maturation of specifically the sick child. The effect that chronic illness has on other family members was also confirmed. The empirical study proved that parents need assistance to cope with the illness. They need assistance for themselves as well as assistance in helping other family members to cope. Based on this literature study and the results of the empirical research, guidelines were developed for the parents of the chronically ill child. These guidelines empower the parents in their support roles. It enables them to deal with the needs of the family thereby enabling family members to cope more efficiently with the illness. Several guidelines have been given regarding how to cope with the matters concerned with educational, physical, emotional, cognitive, moral and psychosocial consequences of the illness. Parents should streamline these guidelines to suit the needs of every unique child and the rest of his family. / Hierdie navorsing stel riglyne vir ouers van 'n cluoniese siek kind. Die riglyne is daarop gemik om die ouers te bemagtig om cluoniese siekte beter te kan hanteer en ander gesinslede te steun in hulle hantering van die siekte. Die aard van cluoniese siekte en die effek daarvan op die siek kind, sy opvoeding, die ouers en sibbe is in die literatuurstudie nagevors. Cluoniese siekte raak elke gesinslid op verskeie wyses. Die siek kind se liggaamlike, emosionele, kognitiewe, morele en psigososiale ontwikkeling word deur die siekte beYnvloed. Ouers se totale bestaan en hulle opvoeding van die kind word deur die siekte geraak. Die siekte beYnvloed sibbe se emosionele, kognitiewe, morele en psigososiale ontwikkeling. Die effek van chroniese siekte op elke gesinslid laat behoeftes, wat met die hantering van die siekte verband hou, by elkeen ontstaan. Ouers as versorgers van die gesin en opvoeders van die kind is grootliks verantwoordelik om die siek kind en ander gesinslede te help om die siekte en die gevolge daarvan te hanteer. 'n Empiriese ondersoek is uitgevoer waarby I 02 ouers van cluoniese siek kinders betrek is. Die empiriese ondersoek het bevestig dat cluoniese siekte opvoeding kan bemoeilik en toereikende ontwikkeling en volwassewording by veral die siek kind kompliseer. Chroniese siekte se effek op die ander gesinslede is ook bevestig. Die empiriese ondersoek het aangedui dat ouers behoeftes aan hulp het om die siekte te kan hanteer. Ouers se behoeftes het verband gehou met hulp aan hulself en hulp om die ander gesinslede te help om die siekte beter te hanteer. Op grond van die literatuurstudie en die resultate van die empiriese ondersoek, is riglyne vir ouers van die cluoniese siek kind geskryf. Die riglyne bemagtig ouers as steungewers deurdat hulle toenemend in staat gestel word om in die gesin se behoeftes te voorsien, sodat gesinslede die siekte beter kan hanteer. Verskeie riglyne om sake rakende die siekte te hanteer, is gegee. Daar is aan opvoedkundige, liggaamlike, emosionele, kognitiewe, morele en psigososiale aspekte aandag gegee. Die ouers behoort die riglyne te verbesonder vir elke unieke kind en sy gesin. / Psychology of Education / D.Ed.(Sielkunde Opvoedkunde)

Utilizing the longitudinal component of the National Population Health Survey (NPHS) (1994/1995-2000/2001), designed to collect comprehensive information on the health status of the Canadian population and related socio-demographic information, differences in health status between immigrants and non-immigrants (i.e., native-born individuals) were explored. Specifically, the analysis investigated how chronic conditions influence the health of immigrants, the role of stress and mental health upon immigrant health status, and the influence and role of previously underrepresented variables such as age and arrival cohorts on foreign-born health status. The conceptual approach of this project draws upon a 'population health' perspective, which suggests that the most influential determinants of human health status are non-medical in nature, but rather can be identified as the social and economic characteristics of individuals. Analysis was completed through the use of ordinary least squares stepwise regression and logistic stepwise regression in association with descriptive stochastic methodologies. Analysis of the mental health and stress variables suggests that, contrary to what has been expressed in literature in the past, both immigrants and the native-born do not perceive stress, distress, or depression to be major problems or health concerns in their lives. Furthermore, the analysis indicated, as was expected, that older immigrants are at greater risk of developing more chronic conditions relative to younger groups, and that arrival cohorts, the period in which an immigrant entered the nation, do exert a considerable influence on the health status of the foreign-born. Surprisingly, this analysis indicates that the Healthy Immigrant Effect (HIE), which proposes that recent immigrants, regardless of country of birth, tend to be in better health than the Canadian-born population upon entering the nation, may be more apparent than real, especially when investigating mental health and stress conditions amongst the foreign-born. / Thesis / Master of Arts (MA)

Thesis (MA)--Stellenbosch University, 2002. / ENGLISH ABSTRACT: The focus of the present review is the quality of life (QOL) of parents caring for a child with epilepsy. The review is informed by published books and articles available on the Psychlit and Medline databases. The paper provides an overview of epilepsy and the problems patients, particularly children, are confronted with. The important roles that parents fulfil in their child's life is followed by a discussion of the stress and burden experienced by parents caring for a child with epilepsy. Descriptions and definitions of the construct QOL are followed by reported research findings on the QOL of patients with epilepsy. The importance of the QOL of parents caring for a child with epilepsy is emphasized and this leads to an examination of existing research on the QOL of these parents. Research on the QOL of parents of children with epilepsy is limited despite the important roles parents fulfil in the life of their child with epilepsy and the potentially negative consequences of these additional roles for the child, the parents and the remainder of the family. Identification and an understanding of the dimensions of QOL of parents that are impacted upon by a child's epilepsy may produce improved treatment outcomes and QOL for children diagnosed and living with epilepsy. Recommendations for future research are included in the present review. / AFRIKAANSE OPSOMMING: Die fokus van hierdie oorsig is die lewenskwaliteit van ouers wat 'n epileptiese kind versorg. Die oorsig is gebaseer op gepubliseerde boeke en artikels wat beskikbaar is op Psychlit en Medline databasisse. Die oorsig voorsien 'n omskrywing van epilepsie asook van die probleme wat pasiente, veral kinders, ondervind. Die belangrike rolle wat ouers in hul kinders se lewe speel word bespreek en dit word gevolg deur 'n bespreking van die stres en druk wat ouers wat epileptiese kinders versorg, ondervind. Beskrywings en definisies van die konstruk lewenskwaliteit word aangebied, gevolg deur 'n opgawe van navorsingsbevindinge oor die lewenskwaliteit van epiletiese pasiënte. Die belangrikheid van die lewenskwaliteit van ouers van 'n epileptiese kind word beklemtoon en dit lei tot 'n oorsig van huidige navorsing oor die lewenskwaliteit van hierdie ouers. Ten spyte van die belangrike rolle wat ouers in die lewe van hul epileptiese kind speel en die moontlike negatiewe gevolge van hierdie bykomende rolle vir die kind, die ouers en die ander familielede, is navorsing oor die lewenskwaliteit van ouers met epileptiese kinders beperk. Identifisering van en insig in die faktore wat 'n impak het op die lewenskwaliteit van ouers met 'n epileptiese kind, kan lei tot verbeterde behandelingresultate en hoër lewenskwaliteit vir kinders wat gediagnoseer word en wat met epilepsie saamleef. Aanbevelings vir toekomstige navorsing word ook in hierdie oorsig gemaak.

Caring for the chronically ill is a growing phenomenon that deserves careful attention and research, since the quality of life of the palliative caregiver is threatened by the continuous exposure to psychological, physiological, as well as relational burdens. A hermeneutic phenomenological study was used to explore palliative caregivers‟ experiences of compassion fatigue when caring for chronically ill patients in a hospice setting. Semi-structured interviews were conducted with Bophelong Community Care Centre‟s palliative caregivers between the ages of 20 and 60 years who were employed in a hospice for a minimum of at least two years, thus well-placed to describe their experiences of compassion fatigue when caring for chronically ill patients in a hospice setting. Data was collected through individual interviews, recorded and transcribed. Using thematic analysis, meaningful patterns and themes of data were discovered to better understand compassion fatigue as a phenomenon of interest. The findings pointed to four categories, i.e. the effects of compassion fatigue on palliative caregivers‟ emotional wellbeing, personal and work relationships, physical discomfort, and spiritual awareness, that describe the experiences of palliative caregivers of compassion fatigue in a hospice setting, thus providing a holistic understanding of the complexity of compassion fatigue in a palliative care hospice setting. / Psychology / M. A. (Psychology)

A society's moral heart can be judged by how well it provides for its weakest and most vulnerable citizens. In recent years significant strides have been made to improve the quality of institutionalized persons' lives. However, because we have not yet fully developed a moral vision of long-term care living, residents do not always receive the basic care that they should. Particularly ignored and inadequately addressed is the complex moral and social issue of residents' sexual lives. Currently there is little support for sexual activity or sexual care in long-term care settings. Society's moral rules are designed for independent people living in their own homes. Professional governance bodies have created moral rules regulating short-term professional interactions and responsibilities but rarely have ones that pertain to longterm care settings. The aim of the present research is to contribute to the development of a moral vision of how long-term care institutions should manage sexual activity and sexual care. A qualitative study was designed to identify the factors that negatively influence sexual activity and sexual care, and the supports that residents and staff respectively need in order to have sexual lives and provide sexual care. Using an exploratory design the investigator conducted in-depth interviews with twenty-four residents and staff and carried out twenty hours of participant observation with two community residents. Six negative influences on residents' sexual lives and nine negative influences on staffs provision of sexual care were identified. The work also explores ethical and legal issues pertaining to the provision o f sexual care. It is argued that residents have moral rights to sexual care which impose duties on institutions to provide that care. Legal barriers to providing such care are then considered, and found not to be insurmountable. The above research and explorations led to three conclusions. First, unless sexual care is available residents cannot have sexual lives. Second, for sexual care to be available institutions must accept that it is their moral responsibility to provide it and ensure that staff are adequately supported. Third, institutions should develop a framework for the delivery of sexual care. / Arts, Faculty of / Graduate and Postdoctoral Studies / English, Department of / Graduate

The purpose of this study was to examine the interrelationships among the themes of Taylor's (1983) Cognitive Adaptation Theory for schoolagers with asthma. In addition, the influence of Taylor's (1983) themes on the children's social behavior was also tested. The three themes of Taylor's (1983) theory included A Search for Meaning, Restoration of Self-Esteem, and Gaining a Sense of Self-Mastery. Two components of A Search for Meaning included the Impact of Disease and the Cause of Disease. Relating Behaviors-Cooperating Behaviors was the index of social behavior. Forty-five Caucasian children between the ages of seven and ten years who had a diagnosis of asthma and did not have any mental disability were the convenient sample. Data were collected in the children's homes. Three questionnaires and two interviews were used to measure Taylor's (1983) themes and Relating Behaviors-Cooperating Behaviors. Descriptive statistics were used to answer the research questions and provide additional findings related to the conceptual framework. Two relationships among Taylor's (1983) themes were significant (p ≤ .05). Children who reported greater impact of asthma upon their lives (Impact of Disease) reported lower self-esteem (Restoration of Self-Esteem). Children who reported greater impact of asthma upon their lives (Impact of Disease) also reported a lesser internal locus of control orientation (Gaining a Sense of Self-Mastery). The Cause of Disease was the only concept which correlated significantly with Relating Behaviors-Cooperating Behaviors and thus, influenced this concept. Children who named a cause for their asthma reported more relating and cooperating skills. The Cause of Disease explained 6.5% of the variance for Relating Behaviors-Cooperating Behaviors. Characteristics of the children's asthma condition and their families were significantly related to the themes of Taylor's (1983) theory and Relating Behaviors-Cooperating Behaviors. Developmental differences were found from age group analyses. The classification of the children's responses for the cause of asthma and reliability and validity estimation for the HIIS were also reported. Five potential sources of error which may have affected the findings included design, instrument, subject, investigator, and specification errors. Suggestions for future research with the conceptual framework were discussed.

No description available.

The relationship of spirituality, self-transcendence, and social support to morale in chronically ill elderly was the focus of this research study. The research was based upon a developmental framework of aging. Individuals answered questionnaires regarding their perspectives on the above variables to determine how significantly the variables related to feelings of morale. Findings revealed that self-transcendence and social support were significantly correlated with morale in this population. No significant relationship between spirituality and morale was found. Self-transcendence and social support together accounted for 45% of the variance in predicting morale in the chronically ill elderly. Findings also revealed existing relationships between spirituality and gender, education level and social support, and length of illness and social support.

This study briefly reviews both historical and recent conceptualizations of dependency. In particular, it focuses on this concept's applicability to patients with chronic illnesses, especially those with allergies. Type and degree of dependency were seen as an important factor in the approach to the medical and psychological treatment of clinical ecology patients. The purpose of the study was to develop an objective measure of dependency which could quickly identify patients whose dependency conflicts interfere with the treatment process. The study was divided into three phases. In the first phase test responses by 84 inpatients to the CAQ, MMPI, and the HAT as well as historical and demographic data were analyzed by a series of stepwise discriminant analysis. The 53 resulting items were examined for those which most concisely discriminated between the two identified groups (pathologically dependent and nonpathologically dependent). These 15 items were used to test 120 additional patients in phase II. Fourteen items were retained and the coefficients obtained classified the patients in phase I and II with a 98.81 percent and 94.17 percent degree of accuracy respectively. These classification coefficients were used to classify another 30 patients in phase III with a 96.67 percent rate of accuracy. These results provide exceptionally strong support for the hypothesis that group classification can be obtained through the use of an objective screening instrument. The pathologically dependent patients tend to focus on disease, frequently are unemployed, have histories of childhood illnesses, have limited emotional controls, are depressed, ambivalent, and distrustful. Additionally, they experience difficulty establishing goals or accepting personal responsibility. Those patients identified as nonpathologically dependent exemplify the more positive aspects of these traits. The pathologically dependent patients appear to be caught in a dilemma between wellness and satisfaction of dependency needs. While all patients need an organized approach to treatment, the pathologically dependent require an extremely structured repititious approach and may require long term psychological intervention in order to make positive steps toward wellness.

No description available.