Children diagnosed and treated for cancer experience a profound life-transformation as they are confronted with unprecedented physical, psychosocial and emotional challenges. Children’s experience of diagnosis and treatment is often accompanied by a lack of participation and reduced control. Extensive research has been conducted on a variety of supportive interventions. Only a limited amount of research, however, has investigated the potential of animal-assisted activities (AAAs) to afford specialised support for the child hospitalised with cancer. Moreover, of this limited research, few studies explore AAAs in relation to participation and control. The purpose of this study was to explore and describe how participation and control are experienced during animal-assisted activities by children hospitalised with cancer. Paediatric oncology patients between the ages of 8 and 14 with any type of cancer were offered the opportunity to participate in the study, which comprised of animal-assisted activities at the facility where patients received their medical care. Five children were included in the final sample. Data were gathered by means of non-participant observations, participant interviews, graphic questionnaires and field notes. Data were then analysed in accordance with steps proposed by Tesch (1990: 142-145), which involved coding according to categories and related themes. Five major themes emerged, including (1) approach to animals, (2) body awareness, (3) level of engagement, (4) level of dependence and (5) communication. Nine sub-themes were derived from data analysis. Under “approach to animals”, the sub-themes were (i) taking the lead, (ii) grooming and affection and (iii) laughter and spontaneity. The sub-themes of “body awareness” were (iv) protection of body and (v) comfort. The sub-themes of “level of engagement” were (vi) initiative and (vii) choice. Finally, the sub-themes of “communication” were (viii) verbal communication and (ix) non-verbal communication. The study provides insight into the participation and control experienced during animal-assisted activities by children hospitalised with cancer. When the initial and final AAA sessions were compared, changes were noted in terms of the children’s approaches to the dog, their body awareness, their level of engagement, their level of dependence and their communication. These changes are associated with an enhanced sense of participation and control, aspects that are often reported to be diminished in children who are diagnosed, treated and hospitalised with cancer. AAAs should therefore be considered an effective means of supporting children hospitalised with cancer. / MA (Psychology), North-West University, Potchefstroom Campus, 2015

Children diagnosed and treated for cancer experience a profound life-transformation as they are confronted with unprecedented physical, psychosocial and emotional challenges. Children’s experience of diagnosis and treatment is often accompanied by a lack of participation and reduced control. Extensive research has been conducted on a variety of supportive interventions. Only a limited amount of research, however, has investigated the potential of animal-assisted activities (AAAs) to afford specialised support for the child hospitalised with cancer. Moreover, of this limited research, few studies explore AAAs in relation to participation and control. The purpose of this study was to explore and describe how participation and control are experienced during animal-assisted activities by children hospitalised with cancer. Paediatric oncology patients between the ages of 8 and 14 with any type of cancer were offered the opportunity to participate in the study, which comprised of animal-assisted activities at the facility where patients received their medical care. Five children were included in the final sample. Data were gathered by means of non-participant observations, participant interviews, graphic questionnaires and field notes. Data were then analysed in accordance with steps proposed by Tesch (1990: 142-145), which involved coding according to categories and related themes. Five major themes emerged, including (1) approach to animals, (2) body awareness, (3) level of engagement, (4) level of dependence and (5) communication. Nine sub-themes were derived from data analysis. Under “approach to animals”, the sub-themes were (i) taking the lead, (ii) grooming and affection and (iii) laughter and spontaneity. The sub-themes of “body awareness” were (iv) protection of body and (v) comfort. The sub-themes of “level of engagement” were (vi) initiative and (vii) choice. Finally, the sub-themes of “communication” were (viii) verbal communication and (ix) non-verbal communication. The study provides insight into the participation and control experienced during animal-assisted activities by children hospitalised with cancer. When the initial and final AAA sessions were compared, changes were noted in terms of the children’s approaches to the dog, their body awareness, their level of engagement, their level of dependence and their communication. These changes are associated with an enhanced sense of participation and control, aspects that are often reported to be diminished in children who are diagnosed, treated and hospitalised with cancer. AAAs should therefore be considered an effective means of supporting children hospitalised with cancer. / MA (Psychology), North-West University, Potchefstroom Campus, 2015

Thesis (M. A. (Clinical Psychology)) --University of the North, 2002 / The aim of this study was to ascertain base-line information on knowledge, beliefs and feelings about tuberculosis among hospitalized tuberculosis patients. The study was conducted at Dr Machupe Mphahlele Memorial Hospital in the Limpopo Province of South Africa. A sample of 40 tubercuJos is patients, 21 males (52,55%) and 19 women (47,5%), was interviewed. h ·om the sample of 40, 22 patients (55%) too k part in the focus group discussions. Fourteen members of the community, who are relatives of those patients who tookpart in thestud, y were also included in the focus group discussions. The focus group discussions were aimed at better understanding of both the community and the patients' beliefs and perceptions of tuberculosis. The study revealed that the participants studied had a reasonably go od knowledge of tuberculosis. However, there was some confusio n regarding causative and risk factors of tuberculosis and some misconceptions thereof. The study has also found that traditional beliefs tend to impact on the patient's health seeking behaviour, treatment and the overall understanding of the disease.Tuberculosis treatment is still perceived by the majo rity of participants to being long, agonizing and cumbersome and there are still so me doubts as to whether tuberculosis is curable. Participants believed that tuberculosis carries social stigma and thus patients feel isolated in their communities. The results also suggested that education does play a role in the perception of the disease. Participants who had tertiary and secondary education were found to be more knowledgeable on symptoms and health beliefs of tuberculosis than those participants who had primary education, and those who did not have education at all. Factors such as age and gender did not appear to have any influence on the knowledge and feelings of patients on tuberculosis. Therefore, based on the findings, culturally sensitive health education and consideration of the patients' educational level are important variables when dealing with tuberculosis patients.

Hospitalization, surgery and anaesthesia are for some children associated with anxiety and could be a frightful experience which may result in later problematic behaviour. Pain is associated with the fears of hospitalization. The first aim was to investigate how pain in children is treated in Swedish hospitals as well as to assess the results of this treatment. Behaviour after hospitalization has been measured by the Post Hospital Behaviour Questionnaire (PHBQ). A second aim was to translate this instrument into Swedish and to validate it. The third aim was to analyze which factors (sociodemographic back¬ground; earlier experience; events at the hospital) that might be associated with changes in behaviour. Methods: A questionnaire regarding acute pain, its treatment methods and results of treatments as well as contributing factors to inadequate results, was sent to all departments in hospitals that might treat children. One form was answered by phy¬sicians and another form by nurses. In the second part of the study, a cohort of 340 children ages 2-13 were followed from two weeks before hospitalization until two weeks after. Data regarding socio¬demography and earlier health care experience were collected. The Child Behav¬iour Checklist was issued before and after hospitalization, the PHBQ was issued after. During hospitalization staff and parents assessed anxiety, pain and nausea mainly by VAS and Likert scales, (parents assessed own and child emotions). Children, older than 4-5 years of age, assessed their own pain using a faces scale. Results: Despite treatment, moderate to severe pain occurred postoperatively in 23% of patients and in 31% of patients with pain of other origin. Postoperative pain seemed to be a greater problem in units where children were treated together with adults and in departments where fewer children were treated. Pain could often or always be treated more efficiently according to 45% of physi¬cians and nurses. Of all departments, pain assessments were performed regularly in 43%, but pain measurement was less frequent. Opioids were never or infrequently used by 15 %. A five factor model fitted data better than the original 6 factor model when confir¬mative factor analyse was performed. Cronbach’s alpha was adequate for factors and excellent for the total score (0.92). Risk factors for increased problematic be¬haviour included the following: age less than 5 years of age, living in a one adult family, anxiety at anaesthesia induction, nausea at hospital and pain at home. Liv¬ing in a rural area and midazolam in premedication seem to be protective. Conclusions: Acute pain in children is still a problem. Inadequate pain treatment is mainly associated with organisational factors (missing prescriptions; a low rate of pain assessments). The PHBQ in Swedish translation is a reliable instrument and its relation to CBCL warrants its further use in research and quality control espe¬cially in younger children. Hospital-induced stress in older children needs further investigation. One third of the children who have been hospitalized and exposed to anaesthesia will have in¬creased problematic behaviour when returning home. Pro¬active interventions are suggested to prevent this by improving pain treatment at home.

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