This study explored the effect of the Lifeplan® programme, an Africa Unit for Transdisciplinary Health Research (AUTHeR) initiative, on the psychological well–being of the rural community of Taung, in the North West Province of South Africa. A mixed method sequential explanatory research design was followed where quantitative data were obtained in a pre– and post–evaluation phase. Participants were adult individuals (N=99) between the ages of 20 and 83 years, with a mean age of 43 years, living within six rural towns in the Taung community. Participants were randomly divided into an experimental group (n=47) and a control group (n=52). Four standardised scales, the General Psychological Well–being Scale (GPWS) (Khumalo, Temane, & Wissing, 2010), the Patient Health Questionnaire (PHQ–9) (Kroenke, & Spitzer, 2002), the Coping Self–Efficacy Scale (CSE) (Chesney, Neilands, Chambers, Taylor, & Folkman, 2006), and the Mental Health Continuum - Short Form (MHC–SF) (Keyes, 2006; Keyes, Wissing, Potgieter, Temane, Kruger, & van Rooy, 2008), validated for use in a Setswana–speaking group, were administered to measure psychological well–being. Qualitative data were obtained through conducting semi–structured interviews with a simple random sample of 30 participants three months after presentation of the programme. The quantitative findings reflected a small increase in the general psychological and emotional well–being of the experimental group. Between–group comparisons showed small practical significant differences (d=0.19 - 0.40) in the experimental group on most of the measuring instruments. Qualitative results suggest that the participants in this study experienced the Lifeplan® programme as educational, and contributing positively towards their general well–being. Participants felt that they have become more attentive to their health needs especially through exercise, a healthier diet and better attendance to overall hygiene. Suggestions for further research and possible programme interventions include a follow–up study to evaluate the sustainability of skills obtained and changes made as a result of the Lifeplan® programme. / Thesis (M.A. (Psychology))--North-West University, Potchefstroom Campus, 2011.

Because of the HIV– and Aids pandemic, a paradigm shift is currently noticed in the traditional role expectation of educators. Except for didactical education, they are also confronted with professional and personal demands on a daily basis. These changes in professional and personal roles are often traumatic and sufficient coping skills as well as support, seems to be limited. The REds–program (resilient educators) was developed for this reason - to empower educators to cope more resiliently with these demands. This study was conducted in order to determine if this program is effective in the empowerment of educators. Two articles follow, from which the first one examines and explores the content, nature and extent of the program. The evaluation of the REds–program follows in the second article. Findings suggest that there were participants that were empowered in the long run and direct feedback from participants confirm that they found the program to be valuable on professional and personal areas. / Thesis (M.A. (MW.))--North-West University, Potchefstroom Campus, 2011.

Until recently, the health professions have largely followed a medical model, which seeks to treat patients by focusing on medicine and surgery, and gives less importance to beliefs and to the faith in healing, in the physician, and in the doctor-patient relationship. This reductionist view of patients being only material body is no longer satisfactory. Patients and healthcare professionals have begun to value the role of elements such as faith, spirituality, hope and compassion in the healing process. The effect of such spiritual elements in health and quality of life has led to research in this field in an attempt to move towards a more holistic view, which included the non-material dimension. The goal of this study was to explore the understanding of spirituality among healthcare professionals and patients at the CHBAH. The primary research question, which this study attempted to answer, was: What is the understanding of spirituality among the healthcare professionals and patients at CHBAH? In view of this primary research question, the following secondary research questions were formulated: * What does a literature review produce regarding spirituality in healthcare and what are the current practices related to spirituality in healthcare. * What are the views of healthcare professionals and patients concerning the relevance of spirituality in their day-to-day lives and healthcare interventions? * What are the spiritual needs of patients and to what extent does spirituality contribute towards their coping with health-related issues? * Which practical and scientific recommendations can be offered to healthcare professionals regarding including/incorporating spirituality in healthcare services in CHBAH? In view of the aim, the researcher identified the following specific objectives for this study: * To explore spirituality in healthcare by means of a literature review; * To explore and describe the views of medical social workers and other healthcare professionals about the relevance of spirituality in a healthcare setting; * To explore and describe the understanding of spirituality among healthcare professionals and patients in CHBAH; * To propose a protocol as an organizational framework on the incorporation of spirituality in healthcare at CHBAH. This protocol should be implemented during social workers‟ and other healthcare professionals‟ interactions with patients. Chapter 1 provides an introduction, problem formulation, goal, research question and the objectives of this study and a brief overview of the methodology. Chapter 2 focuses on the description of research methodology that was utilised in this study. Chapter 3 is composed of a literature study on spirituality and the religions identified and explored in CHBAH, as well as existing practices related to spirituality in health care. In Chapter 4, the data generated through narratives from focus-group discussions and healthcare professionals‟ spiritual journey is processed and reported. In Chapter 5 a proposed protocol for inclusion of spirituality in healthcare services in CHBAH is presented and discussed in detail Chapter 6 consists of the conclusions and summary of this study. / PhD (Social Work), North-West University, Potchefstroom Campus, 2014

Obesity and physical inactivity (PI) are major health problems world-wide, and leading contributors to the high incidence of overweight, cardiovascular and metabolic diseases in children both globally and in South Africa in particular. Despite the importance of physical activity (PA), health-related physical fitness (HRPF) and body composition to health, very few studies have investigated the longitudinal relationship between these variables in children. Three articles based on this research were written in which a total of 283 adolescent learners (111 boys and 172 girls) with a mean age of 14.90±0.72 years from the Physical Activity and Health Longitudinal Study (PAHLS) participated. The students’ physical characteristics were measured using the protocol of the International Society for the Advancement of Kinanthropometry (ISAK); the EUROFIT test protocol and International Physical Activity Questionnaire (IPAQ) were used to assess the children’s HRPF and PA levels, respectively. In the first article, the results showed that girls had a slightly higher significant BMI (21.43±4.37 kg/m²) than the boys (20.01±3.71kg/m²) (p=0.002), and were substantially more overweight (32.4%) and fatter (%body fat=26.01±8.51) than the boys (17.1%)). A total of 85 (30%), 78 (27.5%) and 88 (31.1%) of the students had low, moderate and high PA involvement. It was concluded that girls were more overweight and less active than boys. The second article examined the relationships between body composition, health-related fitness and PA. Inverse relationships were found between BMI and the health-related fitness items of SBJ and BAH. Furthermore, BMI negatively associated with SAR and endurance performance, especially in girls. Percentage body fat was negatively related to SBJ, BAH, SAR and endurance performance. The aim of the third article was to evaluate the longitudinal development of HRPF, anthropometry and body composition status among the children. Regression coefficients showed that changes in BMI were inversely associated with those in health-related physical fitness. The changes in %BF were negatively associated with SBJ, BAH and aerobic capacity (VO2max) in the boys and girls. The results also yielded a low significantly positive association between changes in WHtR and SBJ in both genders, while low inverse associations were found between WHtR and BAH in girls, and VO2max in both genders. It is concluded that the incidence of overweight and PI was especially high in girls and excessive fatness negatively affected the girls’ fitness performances. Changes in BMI, % body fat and WHtR were negatively related with the children’s strength and running performances, especially among the girls in which the relative increase in overweight negatively affected their endurance running and static strength performances. In view of the health implications of the findings, it is necessary to create an enabling environment and opportunities to promote physically active lifestyles and develop life-long positive attitudes towards PA among students. Community-based strategies targeted at facilitating sustainable PA intervention programmes in schools are recommended. / PhD (Human Movement Science), North-West University, Potchefstroom Campus, 2014

Until recently, the health professions have largely followed a medical model, which seeks to treat patients by focusing on medicine and surgery, and gives less importance to beliefs and to the faith in healing, in the physician, and in the doctor-patient relationship. This reductionist view of patients being only material body is no longer satisfactory. Patients and healthcare professionals have begun to value the role of elements such as faith, spirituality, hope and compassion in the healing process. The effect of such spiritual elements in health and quality of life has led to research in this field in an attempt to move towards a more holistic view, which included the non-material dimension. The goal of this study was to explore the understanding of spirituality among healthcare professionals and patients at the CHBAH. The primary research question, which this study attempted to answer, was: What is the understanding of spirituality among the healthcare professionals and patients at CHBAH? In view of this primary research question, the following secondary research questions were formulated: * What does a literature review produce regarding spirituality in healthcare and what are the current practices related to spirituality in healthcare. * What are the views of healthcare professionals and patients concerning the relevance of spirituality in their day-to-day lives and healthcare interventions? * What are the spiritual needs of patients and to what extent does spirituality contribute towards their coping with health-related issues? * Which practical and scientific recommendations can be offered to healthcare professionals regarding including/incorporating spirituality in healthcare services in CHBAH? In view of the aim, the researcher identified the following specific objectives for this study: * To explore spirituality in healthcare by means of a literature review; * To explore and describe the views of medical social workers and other healthcare professionals about the relevance of spirituality in a healthcare setting; * To explore and describe the understanding of spirituality among healthcare professionals and patients in CHBAH; * To propose a protocol as an organizational framework on the incorporation of spirituality in healthcare at CHBAH. This protocol should be implemented during social workers‟ and other healthcare professionals‟ interactions with patients. Chapter 1 provides an introduction, problem formulation, goal, research question and the objectives of this study and a brief overview of the methodology. Chapter 2 focuses on the description of research methodology that was utilised in this study. Chapter 3 is composed of a literature study on spirituality and the religions identified and explored in CHBAH, as well as existing practices related to spirituality in health care. In Chapter 4, the data generated through narratives from focus-group discussions and healthcare professionals‟ spiritual journey is processed and reported. In Chapter 5 a proposed protocol for inclusion of spirituality in healthcare services in CHBAH is presented and discussed in detail Chapter 6 consists of the conclusions and summary of this study. / PhD (Social Work), North-West University, Potchefstroom Campus, 2014

Obesity and physical inactivity (PI) are major health problems world-wide, and leading contributors to the high incidence of overweight, cardiovascular and metabolic diseases in children both globally and in South Africa in particular. Despite the importance of physical activity (PA), health-related physical fitness (HRPF) and body composition to health, very few studies have investigated the longitudinal relationship between these variables in children. Three articles based on this research were written in which a total of 283 adolescent learners (111 boys and 172 girls) with a mean age of 14.90±0.72 years from the Physical Activity and Health Longitudinal Study (PAHLS) participated. The students’ physical characteristics were measured using the protocol of the International Society for the Advancement of Kinanthropometry (ISAK); the EUROFIT test protocol and International Physical Activity Questionnaire (IPAQ) were used to assess the children’s HRPF and PA levels, respectively. In the first article, the results showed that girls had a slightly higher significant BMI (21.43±4.37 kg/m²) than the boys (20.01±3.71kg/m²) (p=0.002), and were substantially more overweight (32.4%) and fatter (%body fat=26.01±8.51) than the boys (17.1%)). A total of 85 (30%), 78 (27.5%) and 88 (31.1%) of the students had low, moderate and high PA involvement. It was concluded that girls were more overweight and less active than boys. The second article examined the relationships between body composition, health-related fitness and PA. Inverse relationships were found between BMI and the health-related fitness items of SBJ and BAH. Furthermore, BMI negatively associated with SAR and endurance performance, especially in girls. Percentage body fat was negatively related to SBJ, BAH, SAR and endurance performance. The aim of the third article was to evaluate the longitudinal development of HRPF, anthropometry and body composition status among the children. Regression coefficients showed that changes in BMI were inversely associated with those in health-related physical fitness. The changes in %BF were negatively associated with SBJ, BAH and aerobic capacity (VO2max) in the boys and girls. The results also yielded a low significantly positive association between changes in WHtR and SBJ in both genders, while low inverse associations were found between WHtR and BAH in girls, and VO2max in both genders. It is concluded that the incidence of overweight and PI was especially high in girls and excessive fatness negatively affected the girls’ fitness performances. Changes in BMI, % body fat and WHtR were negatively related with the children’s strength and running performances, especially among the girls in which the relative increase in overweight negatively affected their endurance running and static strength performances. In view of the health implications of the findings, it is necessary to create an enabling environment and opportunities to promote physically active lifestyles and develop life-long positive attitudes towards PA among students. Community-based strategies targeted at facilitating sustainable PA intervention programmes in schools are recommended. / PhD (Human Movement Science), North-West University, Potchefstroom Campus, 2014

This study focuses on self care among patients with hypertension visiting primary health care clinics in the Naledi sub-district in the North-West Province. Hypertension is one of the chronic diseases that shorten the life expectancy of many people globally and remains the most common and rapid growing cardiovascular disease, affecting 20 million people in sub-Saharan Africa. Hypertension is one of the quadruple burdens of disease associated with risky lifestyle behaviours like unhealthy diets with excessive energy intakes, physical inactivity and tobacco use. Although taking the mentioned common modif iable factors and the fact that hypertension is a manageable condition into consideration, the reality remains that the hypertension. A non-experimental, quantitative research was used to reach the aim of the study namely to identify and describe the self care abilities of patients diagnosed with hypertension, as well as explore and describe their knowledge and perceptions on hypertension. This was done by means of objectives to explore and describe self care abilities, knowledge and perceptions among patients diagnosed with hypertension; if there is an association between self care, knowledge and perception in relation to the level of education, age, income and time period and if there was association between self care and knowledge and perception of patients with hypertension visiting PHC clinics in Naledi sub-district in the North-W est Province. A literature review was first conducted for a clear understanding of self care and hypertension. Thereafter a structured questionnaire, consisting of demographical information, and questions on self care, knowledge and perception among patients with hypertension, was employed. Trained field workers assisted in data collec tion. A number of 142 questionnaires were completed by patients visiting PHC clinics. The demographic data was first analysed with results shown in the frequency table. The exploratory factor analyses were done for data reduction on self care, knowledge and perception among patients with hypertension. Descriptive statistics and Cohen effect sizes for factors on self care, knowledge and perception in relation to the level of education, age, income and other chronic illnesses of patients diagnosed with hypertension, correlational descriptive statistics between self care and knowledge and perception were done. The results revealed that patients with hypertension with low levels of education lack information with regard to hypertension. The higher the income of patients with hypertension, the better their self care abilities compared to those with low income. Patients who are English and Afrikaans speaking have more internal positive power and have better management abilities of hypertension than those who are Setswana speaking. Younger patients have more internal positive power, which declines with age. Those patients who are newly diagnosed with hypertension have more information on management abilities than those who have been diagnosed more than two years. The conclusion regarding the relationship of self care and knowledge and perception of hypertension is that the patients diagnosed with hypertension need knowledge on hypertension in order to adhere to self care abilities. The more knowledge patients have the better they will be able to adhere to self care activities. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.

Leisure-time physical inactivity is a global public health concern affecting all people in different walks of life, including employees. This inactivity is associated with chronic diseases of lifestyle as well as low work capacity. The purpose of this study was two-fold: to determine leisure-time physical activity (LTPAI), coronary risk- (CRI), health status (HSI) and lifestyle (LSI) indexes of some executive employees in selected African countries; and to determine the effect of leisure-time physical activity (LTPA) on the coronary risk-, health status- and lifestyle- indexes of some executive employees in selected African countries.A cross-sectional study design was followed on a group of 156 (mean age 41.22±10.17) executive employees. Participants were grouped according to age (<35 years; 36–46 years and > 46 years). Standardized questionnaires were used to collect data. Out of 156 participants in the study, 43% occupied top level management and 57% middle level management positions. When data were analyzed according to age groups, 31% and 69% in the less than 35 years age group were in the top and the middle level management, respectively. In the age group 36 to 46 years of age, 47% were in the top level of management and 52.8% middle level management. With regard to LTPA, top level managers (71.6%) scored low LTPA as compared to middle level managers (62.9%). Top level managers scored higher percentages (14.9%) for developing the risk of coronary heart disease. The results show a negative effect of physical activity on selected health parameters, with significant negative relationships between low LTPA and daily lifestyle index (r= -0.52; p=0.01), and moderate LTPA and daily lifestyle index (r= -0.71; p<0.001) for middle managers. It can be concluded that both top and middle level managers exhibited low LTPA and high risk for developing coronary heart disease. It was apparent that the managers in low LTPA are prone to bad stages of life style, health status and coronary risk- indexes compared to the ones with moderate and high LTPA. Additionally, low and moderate LTPA inversely affected selected health parameters of executive employees. No significant association was found for high LTPA with selected health parameters. The study therefore recommends a strategic intervention programme geared towards improving the present state of affairs among the managers in the corporate environment. / Thesis (MA (Biokinetics))--North-West University, Potchefstroom Campus, 2013.

Physical activity has several advantages for health. The first objective of this research was to determine the relationship between physical activity and selected physical and psychological health components. The physical components include: diabetes risk, obesity, cholesterol and cardiovascular disease. The psychological health components include stress and depression. Secondly, this research aimed to determine the relationship between physical activity and medical costs. Medical costs were divided into pharmaceutical, general practitioners and hospital claims. A total of 9 860 employees of the same financial institution in South Africa, between the ages 18 and 64 (x̄ = 35.3 ± 18.6 years), participated in the study and participation was voluntary. No differentiation was made between race groups. The assessment of selected health risk factors and physical activity was done by using the Health Risk Assessment (HRA) methodology developed by the company, Monitored Health Risk (MHM). Assessment included a physical activity, diabetes risk and cardiovascular risk questionnaire, BMI and random blood glucose measurements, as well as stress and depression scores. The amount of days absent from work in the past six months was also determined by the questionnaire. Participants was categorised in three groups – low, moderate and high physical activity participation. Medical expenditure data was obtained from Monitored Health Risk Management Pty (Ltd). Hospital, pharmaceutical and general practitioners (GP) claims included all costs occurring during a six month period. The majority of the study group showed low physical activity participation (78.27%). The results also showed that both men and women showed an increased risk for diabetes, and high physical activity levels have a practically and statistically significant effect on the reduction of diabetes risk. In this study all the physical activity groups of both males and females showed an increased average body mass index (BMI) and therefore are considered to be an increased risk according to the classification as stipulated by the study perimeters. The average means for cholesterol in all groups are categorised as low risk. No significant differences are seen between the female groups as well as between the different male groups. The men in the study group showed higher cardiovascular risk than women. There are no statistically significant differences between the women’s groups. However, regarding the male groups, the low physically active male group showed significant differences to the high physical active male group. Thus, in this study it appears that the men participating in high levels of physical activity show the lowest risk for cardiovascular disease and therefore appear to be influenced by physical activity. The majority of the study group is shown to be in the high stress category (55.48%). It seems that work issues (82%), financial problems (74%) and family problems (69%) contribute most to the population’s high stress levels and depression experience. The Physical activity index (PAI) in relation to stress only shows practical significance in moderate and high physical women. The PAI and stress-related index reports statistically (p≤0.05; 0.001) significant and practice significant difference within the population. There was also a statistically significant (p≤0.05) relation between stress and physical activity in relation to days absent. Although high levels of stress and low levels of physical activity are present in the population, the relation become statistically significant in relation with depression. The study group was divided into two groups when the medical cost was examined. One group consisted of those individuals who do not use chronic medication and the other group, those individuals that use chronic medication. The majority of the study group (chronic and nonchronic medication use), show low physical activity participation (average of 78.80%). The results show statistically and practically significant differences between the groups that do not use chronic medication and the groups that use chronic medication. The women that use chronic medication show an increase in pharmaceutical costs with an increase in physical activity. However, when investigating the GP cost of women who use chronic medication, there is only a small difference in GP cost in the different physical activity participation categories. The data shows that men have higher pharmaceutical costs than women in all the physical activity categories. The results also indicate that men who use chronic medication, participating in low levels of physical activity do show higher pharmacy and GP costs. Medical cost associated with hospitalisation of those men whose chronic medications show an average higher medical cost (R231.72 versus R672.71). The women who are on chronic medication show about two and a half times higher hospitalisation cost (R253.97 versus R650.82) and the men an almost four times higher cost (R189.34 versus R721.71). No practically significant difference was found between the groups. The women show an increased incidence of low physical activity participation (82.38%), whereas 68.80% of the men show low physical activity participation. Women who use chronic medication and participate in moderate physical activity show lower hospital costs. The women in this study group that use chronic medication and participate in high levels of physical activity show the highest hospital cost. The men’s profile indicates that medical cost due to hospital claims rise with the higher levels of physical activity. / Thesis (PhD (Human Movement Sciences))--North-West University, Potchefstroom Campus, 2013.

Adolescents who are subjected to adverse health risks which limit school attendance and academic performance, is a national as well as an international recognised problem considering healthy youth to be productive members of society. The South African Department of Health has introduced a re-engineering program for primary health care of which school-health is one of three main areas of the primary health care services focusing on, but not limited to immunization, teenage pregnancy, education about HIV/Aids, and screening for health problems such as poor eyesight and hearing impairment. During October 2012 the new school-health program was piloted in very poor schools in KwaZulu Natal, Gauteng and Limpopo and will over the next four years be implemented in poor Secondary Schools. The aim of this research was to explore and describe comprehensive school-health services in two selected secondary schools in the North West province in order to propose recommendations to enhance adolescents' quality of life. The researcher used an explorative, descriptive, holistic multiple case study to gather rich data from two separate institutions (secondary schools) to reach the following objectives: * To identify and describe the demographic profile from existing records/documents available at each selected secondary school. * To explore and describe how comprehensive school-health services are experienced by key stakeholders, in two selected secondary schools in the North West province. * To explore and describe the perceptions of key stakeholders on how comprehensive school-health services should be rendered in two selected secondary schools in the North West province to enhance the quality of life of the adolescent. A description of the demographic profile was possible by means of a demographic data sheet completed by the principal to understand the background of each school included in the research. Rich information of key stakeholders' experiences and views about comprehensive school-health services was gained by four focus group interviews. Results of the data analysis showed a lack of comprehensive school-health services to adolescents in two secondary schools. The findings included adolescents' health problems as well as physical and emotional challenges educators are not equipped for and/or have not sufficient time to manage. Conclusions made from the research findings, contributed to recommendations for the nursing practice, nursing education and nursing research to enhance the quality of life of adolescents through comprehensive school-health services in selected secondary schools in the North West province. / MCur, North-West University, Potchefstroom Campus, 2014