Volunteer caregivers provide essential services to people in the terminal stages of AIDS and their families. Volunteers are exposed to stress and burnout. This study investigated the relationships between stress, coping strategies, levels of burnout and resilience in this population. Volunteers from Societas ‘O Sosiale (SOS) Children Villages and community based organisation (CBO) partnerships, were selected using non-probability purposive convenience sampling. A total of 110 participants were given the Experience of Work and Life Circumstances Questionnaire (WLQ), Brief-Cope, Maslach’s Burnout Inventory (MBI), a Resilience scale and the Living Standard Measure to complete. Statistical analyses were performed on the data. This includes descriptive statistics, reliability analysis, factor analysis, correlations and multivariate analysis of variance. The study found that volunteer caregivers experience high stress levels and burnout related to stressors outside work, remuneration, personnel policies and high resilience. High burnout is associated with all forms of coping. Further it is shown that training in problem-solving skills, counselling, government and public lobbying for support, registration with relevant professional bodies, furnished offices, reasonable recruitment requirements and compensation are needed to help the care givers avert the effect of stressors and control stress by stopping it from turning to burnout. / Psychology / M.A. (Psychology with specialisation in Research Consultation)

Indiana University-Purdue University Indianapolis (IUPUI) / Greater levels of loneliness have shown consistent associations with poorer mental and physical health; however, the reason for these relationships is unknown. Engagement in poorer health behaviors among individuals with higher levels of loneliness is one potential explanation for this relationship. Self-regulation theory suggests that coping with feelings of loneliness may impair attempts to control health behaviors. Caregivers of cancer patients have been found to have poor health behaviors (e.g., inadequate exercise) and high levels of loneliness. Thus, the aim of the study is to examine whether health behaviors mediate the relationships between loneliness and mental and physical health outcomes among caregivers of cancer patients. Methods: A secondary data analysis was conducted using data from a longitudinal study of cancer patients and their family caregivers who were staying at the American Cancer Society’s Hope Lodge. Participants completed self-report questionnaires measuring levels of loneliness, engagement in health behaviors (i.e., exercise and fruit and vegetable consumption), mental and physical health, and demographic and medical characteristics at three time points over a 4-month period. A bootstrapping macro was used to examine the indirect effect of loneliness on mental and physical health via health behaviors. Results: Contrary to hypotheses, exercise and fruit and vegetable consumption did not mediate the relationships between loneliness and physical and mental health among cancer patients’ caregivers. Additional research is needed to determine whether health behaviors partially account for the relationships between loneliness and health outcomes or whether alternate explanations for these relationships should be considered.

The escalating number of people infected by HIV and AIDS poses a challenge to current resources both at the hospital and household level. Community/Home based care is a viable option in response to the scourge of HIV/AIDS to compliment secondary and tertiary care as well as providing support to affected families in coping with the stress of caring for their terminally ill family members. This study explored the effectiveness of the implementation of Community/Home based care services by focusing on three sites at Bushbuckridge i.e. Cunningmore, Maviljan and Hluvukani. Findings revealed that family members were satisfied to have community caregivers entering their homes to provide care and support to their AIDS ill family members. Significant barriers were highlighted by families and community caregivers that hinder effective implementation of the programme, for instance, cultural sensitivity. The study proffered recommendations on how to deal with these issues. / SOCIAL WORK / MA(SS) (SOCIAL WORK)

The escalating number of people infected by HIV and AIDS poses a challenge to current resources both at the hospital and household level. Community/Home based care is a viable option in response to the scourge of HIV/AIDS to compliment secondary and tertiary care as well as providing support to affected families in coping with the stress of caring for their terminally ill family members. This study explored the effectiveness of the implementation of Community/Home based care services by focusing on three sites at Bushbuckridge i.e. Cunningmore, Maviljan and Hluvukani. Findings revealed that family members were satisfied to have community caregivers entering their homes to provide care and support to their AIDS ill family members. Significant barriers were highlighted by families and community caregivers that hinder effective implementation of the programme, for instance, cultural sensitivity. The study proffered recommendations on how to deal with these issues. / SOCIAL WORK / MA(SS) (SOCIAL WORK)

The purpose of this study was to explore the lived experiences of older caregivers of adult AIDS ill children in Umlazi Township in the province of Kwa- Zulu Natal. A qualitative research design which was exploratory was executed with a sample of purposively selected participants who are the members of the organization that provides support to the older caregivers. Data saturation occurred after focus group and in depth individual interview with ten participants. The findings revealed that older caregivers experience lot of challenges which ranges from emotional, physical, financial, psychological, social and time constraints when caring for their adult AIDS ill children .The study further revealed that older caregivers developed a wide range of coping strategies to face their challenging caregiving task and most of the older caregivers utilized positive coping strategies. Recommendations that are described focus on the inclusion and consultation of older caregivers in all decisions and programmes about them. / Appendix C (Interview guide) in English as well as in Zulu / Social Work / M.A. (Social Behaviour Studies in HIV/AIDS)

Dementia of Alzheimer‟s Type is a degenerative neurocognitive disease accounting for majority of Dementia‟s. It affects millions of people worldwide and thousands of people in South Africa. Apart from the economic burden this illness places on the country, it has detrimental effects for those who provide care for individuals with this illness, who are mostly spouses. The spousal caregivers bears great financial, social and emotional burden which worsens as the disease progresses. The aim of this study is to phenomenologically explore and describe the lived experiences of spousal caregivers in caring for the spouses with Dementia of Alzheimer‟s Type. This South African study was therefore qualitative in nature and was conducted in the province of KwaZulu- Natal, in the city of Pietermaritzburg. Eight participants were interviewed using a semi-structured questionnaire. Data was analysed using interpretative phenomenological analysis (IPA). The main findings of this study are the negative emotional affects that the caregiving role creates. Caregiver stress and strain is experienced as well as the experiences of various losses including lack of intimacy and ruined expectations for the future as the disease progresses. The caregiving role also created negative implications for the social lives of caregivers and coping mechanisms were seen to be very important. / Psychology / M.A. (Psychology)

The purpose of this study was to explore the lived experiences of older caregivers of adult AIDS ill children in Umlazi Township in the province of Kwa- Zulu Natal. A qualitative research design which was exploratory was executed with a sample of purposively selected participants who are the members of the organization that provides support to the older caregivers. Data saturation occurred after focus group and in depth individual interview with ten participants. The findings revealed that older caregivers experience lot of challenges which ranges from emotional, physical, financial, psychological, social and time constraints when caring for their adult AIDS ill children .The study further revealed that older caregivers developed a wide range of coping strategies to face their challenging caregiving task and most of the older caregivers utilized positive coping strategies. Recommendations that are described focus on the inclusion and consultation of older caregivers in all decisions and programmes about them. / Appendix C (Interview guide) in English as well as in Zulu / Social Work / M.A. (Social Behaviour Studies in HIV/AIDS)

The focused of this study is the role of capacity building in Community Home Based Care (CHBC) for HIV/AIDS patients. The study forms part of my Master's in Development Administration programme, undertaken through UNISA. The dissertation was accomplished by studying the TASO community initiative in Sseeta-Nazigo, Mukono District, Uganda. It explores the concept of capacity building and its applicability to CHBC. The primacy data was gathered by conducting Key Infonnant Interviews (KIIs) and Focus Group Discussions (FGD). The secondary data was gathered by reviewing literature to augment the primary data. In addition, data was gathered through observations within the community. The fmdings have identified seven critical components of capacity building: community mobilisation, skills development, Information, Education and Communication (IEC) Voluntary Counselling and Testing (VCT), networking and collaboration, support and supervision, Monitoring and Evaluation (M&E). The study observed that capacity built in the above areas resulted in three outcomes: skills development, improvement in procedures, and institutional development. Informed recommendations were subsequently made related to the seven componentsof capacity building in CHBC / Development Studies / M. A. (Development Studies)

The aim of this research was to explore the challenges faced by women providing home-based care to those infected and affected by HIV and AIDS. The specific objectives of the study were to explore the gender-related, sociocultural and socioeconomic challenges faced by these women; and to investigate best practices in home- based care. An exploration of the challenges women experience in their communities as they provide care for the HIV and AIDS infected and affected is located within a gender and power framework. Feminist theories are also used to try and explain the reasons behind the differences and inequalities that exist in the community, particularly as regards the women who provide home-based care. A qualitative study, which used both qualitative and participatory methods of data gathering, was undertaken in 2014 in Mzimba, Malawi. Data was collected from 26 women participants by means of Critical Incident Narrative interviews (5), Individual In-Depth Interviews (5), and two Focus Group Discussions (6 and 10 participants respectively). Three Key Informant Interviews were conducted with a Ministry of Local Government official, another with a Nursing sister at the Mzimba District Hospital Tuberculosis Ward, and the Mzimba District Hospital Home-based care Coordinator. Purposive and snowballing sampling techniques were used to recruit the research participants. A topic guide was used in critical incident narrative interviews. An interview schedule consisting open-ended questions and face interviews were used for the Individual In-depth Interviews. A topic guide was used for the Focus Group Discussions. All the data collection instruments were guided by the themes of social, economic, cultural, psychological challenges; food security, and coping mechanisms. An interview schedule consisting of open-ended questions were used for the Key Informant Interviews. A Check List of WHO minimum package for home-based care programmes was used to assess the actual program best practices. The methodology of this study was guided by the WHO framework on home-based care. In this framework, the home-based care programme includes the following elements which make up the minimum package of care: provision of care, continuum of care, education, supplies and equipment, staffing, finance and sustainability, and monitoring and evaluation. Very few studies have been concluded to understand the sociological issues that affect women who provide care to the HIV and AIDS infected and affected in households and communities. It is hoped that this study will in some way address this gap, and that the information and recommendations contained in this thesis will guide policy recommendations in Malawi that will incorporate the lived experiences of those who provide this care. The study revealed that women providing home-based care to the HIV and AIDS infected and affected experience harsh challenges. Women carry the burden of care as traditionally men do not provide care. Women experience extreme deprivation which manifests itself through a number of socio-economic difficulties and these include been shown in their inability to provide for their basic necessities such as food, and other household needs. For most of the women carers, the deprivation is a direct consequence of their low levels of education which rendered them unable to find employment of engage in successful business ownership. The women carers also lack social security in the sense that they do not have access to land for example which could ensure that they have some level of food security. When the main income earner died the women carers and their dependants were left to fend for themselves. Women carers also experienced various psychological problems and these included nightmares, insomnia, depression and these affected their physical health such a few reported lack of appetite for food as a major issue. Women carers and in particular the young women reported that they had to elements which make up the minimum package of care: provision of care, continuum of care, education, supplies and equipment, staffing, finance and sustainability, and monitoring and evaluation. Very few studies have been concluded to understand the sociological issues that affect women who provide care to the HIV and AIDS infected and affected in households and communities. It is hoped that this study will in some way address this gap, and that the information and recommendations contained in this thesis will guide policy recommendations in Malawi that will incorporate the lived experiences of those who provide this care. The study revealed that women providing home-based care to the HIV and AIDS infected and affected experience harsh challenges. Women carry the burden of care as traditionally men do not provide care. Women experience extreme deprivation which manifests itself through a number of socio-economic difficulties and these include been shown in their inability to provide for their basic necessities such as food, and other household needs. For most of the women carers, the deprivation is a direct consequence of their low levels of education which rendered them unable to find employment of engage in successful business ownership. The women carers also lack social security in the sense that they do not have access to land for example which could ensure that they have some level of food security. When the main income earner died the women carers and their dependants were left to fend for themselves. Women carers also experienced various psychological problems and these included nightmares, insomnia, depression and these affected their physical health such a few reported lack of appetite for food as a major issue. Women carers and in particular the young women reported that they had to drop of school to marry when their parents or guardians died. The other dimension to this issue was that the older women carers reported that during their young years, it was common place to find girls who did not attend school or were pressurised to get married because their parents did not believe in educating girls. The background is currently affecting the women carers as they find that they cannot get involved in profitable business or even look for employment. They lack the basic literacy levels that would allow them to be become more productive and ensure financial security. Women carers experienced a number of gender related challenges as they provided care and these included the burden of care being almost solely borne by the women. Women revealed that they have had to use various coping strategies in the face of the overwhelming challenges that they continue to experience. Elderly women have found ways to cope by selling the property such as land and household goods, conducting small scale informal business, and sending the children away to relatives to be fostered. The young women on the other hand have sometimes reverted to some dangerous strategies for coping such as getting a boyfriend to provide for their financial needs, engaged in transactional sex, and some got married very early. The other coping strategies that the young women employed were to conduct small businesses, depended on family and relatives to provide for their various needs. The women volunteers revealed that they used their group as a therapy group, they shared the work, and that they were involved in small scale businesses. The study has also revealed that there is a home-based care programme that is functioning fairly well. However, there are indications that as much as the various players are trying to assist those who are infected and affected by HIV and AIDS, there are severe gaps in the effectiveness of the programme. There is need for a review of the programme so that it answers to the needs of those who are caring for those who are on home-based care i.e. a more rigorous implementation of HBC programme is required. The overall findings of the study indicate that the poverty trap in which the women are caught impacts on every aspect of their existence, with little hope of them ever improving their conditions. There is need for the Malawi government to come up with strategic interventions that would alleviate of women in general but in particular those who are left to provide care at home. Such interventions could include poverty alleviation strategies for women who are providing care to ensure that their situation does not deteriorate once they begin to provide care. Since Malawi is a signatory to the UN Millennium Development Goals, it is important that the plight of women is revisited and find lasting solutions to the challenges that they experience. Women are still lagging behind in education for example. There is need to improve girls and women access to education. The health of women has been affected by HIV and AIDS. The Government of Malawi also needs to review the policies that are in place which address women’s health. Essentially the status of women is need of a major change in order for the country to achieve some level of development which is at par with other countries in the sub-Saharan African region. / Sociology / D. Phil. (Sociology)

Text in English / With the Acquired Immune Deficiency Syndrome (AIDS), first recognised in 1981 as a new disease that subsequently took on pandemic proportions, home-based caregivers became instrumental to ensure that, notwithstanding the encumbered health care systems, people living with HIV and AIDS (PLWHA) receive care, support and treatment within their households to live prolonged dignified lives. Despite their pivotal role in the field of HIV and AIDS care, there seems to be a dearth of literature, and research locally and internationally, from the ambit of Social Work on the topic of how HBCGs manage and cope with the work-related challenges they experience when caring for PLWHA and their need for Social Work support. Through this exploratory, descriptive, contextual and phenomenological qualitative study, I scrutinised the HBCGs’ experiences and associated challenges and the coping strategies they employ to address these challenges as well as their views on how social workers could support them in overcoming these challenges in the specific case on home-based care to PLWHA. Twenty-five HBCGs were identified and recruited through purposive and snowball sampling techniques from twelve home-based care organisations in South African provinces, namely, North West, Limpopo and Gauteng. Data was collected through individual face-to-face semi-structured interviews using an interview-guide. Data analysis was conducted through Tesch’s eight steps (in Creswell 2014:189) while Guba’s model (in Shenton, 2004) was adopted for data verification. Cast against Loretta Williams’ (2014) middle range theory of caregiving dynamics (Williams 2014), the coping theory of Lazarus and Folkman (1984) and the strength-based perspective (Saleebey, 2013) adopted as theoretical frameworks for this study, the following findings were revealed. The HBCGs were motivated by, among other factors, their mere desire to care for PLWHA; their personal experiences of caring for an ill relative; and future career aspirations to become involved in this care work. HBCGs were found to face various work-related challenges in connection with reactions from community members, the patients and their relatives; their unsafe working conditions; as well as from their colleagues, other role players and their own organisations. It was found that for most of the HBCGs their care work saddened, pained and discouraged them. In the midst of feeling sorry for their patients, they feared getting infected themselves, in addition to their work-related challenges that caused them to experience feelings of failure. The strategies adopted to cope with their work-related challenges included getting support from employers, receiving counselling and becoming involved in support groups. Finally, several suggestions were directed to the management structures of HBC organisations, the HBCGs themselves and social workers on how they could address the work-related challenges. Based on the research findings, some recommendations are forwarded concerning guidelines for Social Work support directed at work practice, policies and programmes; associated education and training endeavours; and continuous professional development initiatives, as well as avenues for further research. / Social Work / D. Phil. (Social Work)