PhD (Advanced Nursing Science) / Department of Advanced Nursing Science / See the attached abstract below

Teenage pregnancy is an ever increasing dilemma in South Africa. Dealing effectively with pregnant teenagers is a continuous challenge for the health care providers particularly the nursing staff. The present study focuses on the reproductive health care services in a Gauteng province clinic and pregnant teenagers' experiences of their interaction with the nursing staff. Six pregnant teenagers were included in the study. Data consistied of the participants' narratives regarding the health care services provided by the nursing staff. Themes from the narratives were identified and explored according to a Social Constructionism stance within the Postmodernist paradigm. Factors found to affect the experiences of the pregnant teenagers included acceptance, respect, effective communication, privacy, trust and the dedication and professionalism of the nursing staff. / Psychology / M.A. (Clinical Psychology)

Text in Afrikaans / Summaries in English and Afrikaans / In an exploratory study variables influencing the intention to use contraceptives and contraceptive use of teenagers and the association between these variables were determined.A random quota sample consisting of 231 and 224 school boys and girls (14 - 18 years) were selected and the final investigating group were 315 sexually active teenagers. According to loglinear analyses the following variables showed a significant relationship with the intention to use contraceptives: attitudes towards the use of contraceptives, perceptions of accessibility and locus of control. Variables that showed a significant relationship with actual contraceptive use were gender, knowledge about reproduction and contraceptives, beliefs and attitudes towards the use of contraceptives, traditional values such as proving fertility before marriage and family size, perceptions of social approval of contraceptive use as well as perceptions of accessibility to contraceptives. An important conclusion was that an urgent need exists for effective sex education programmes and better access to contraceptives. / In 'n verkennende veldstudie is faktore wat verband hou met swart tienderjariges se intensie om kontraseptiewes te gebruik en werklike kontraseptiewe gebruik ge'identifiseer en die verhoudings tussen die faktore is bepaal. 'n Ewekansige kwotasteekproef van 231 en 224 plattelandse skoolseuns en meisies ( 14 - 18 jaar) is betrek en die finale ondersoekgroep was 315 seksueel aktiewe tienderjariges. Volgens logitmodelontledings het die volgende veranderlikes 'n beduidende verband getoon met die intensie om van kontraseptiewes gebruik te maak: houding teenoor die gebruik van kontraseptiewes, persepsies van toeganklikheid tot kontraseptiewes en lokus van beheer. Veranderlikes wat 'n beduidende verband getoon het met werklike kontraseptiewe gebruik was geslag, kennis oor menslike reproduksie en kontraseptiewes, menings en houdings oor die gebruik daarvan, tradisionele waardeor'ientasies soos die bewys van fertiliteit voor die huwelik en gesinsgrootte, persepsies van sosiale ondersteuning vir kontraseptiewe gebruik asook persepsies van toeganklikheid tot kontraseptiewes. 'n Belangrike gevolgtrekking was dat daar 'n dringende behoefte bestaan na effektiewe seksuele voorligtingsprogramme en grater toeganklikheid tot kontraseptiewes. / Psychology / M.A.(Psychology)

The purpose of this study was to explore and describe the contributory factors to the high teenage pregnancy rate within a district hospital in the Ehlanzeni district of the Mpumalanga Province, South Africa. Quantitative, non-experimental, descriptive and exploratory research was conducted to explore the contributory factors to the high teenage pregnancy rate. Data collection was done using a self-designed structured interview schedule. The findings of the study supported the assumptions that there are factors related to biography, individual perceptions, knowledge and awareness of; and practices, perceptions regarding the use of contraception. Perceived seriousness and barriers to the use of safeguards that could have prevented pregnancy contribute to the high teenage pregnancy rate thus emphasise the need to develop strategies to prevent teenage pregnancies / Health Studies / M.A. (Health Studies)

Submitted in fulfillment of the requirements for the Degree in Masters of Technology in Nursing, Durban University of Technology, Durban, South Africa, 2015. / Introduction Teenage pregnancy is a socioeconomic challenge and an important public health problem for communities in South Africa. Considerable research has been done on teenage pregnancy in South Africa but it focused mostly on teenage girls. Aim of the study The aim of the study was to explore and describe young males’ perceptions, to identify the roles they play in this phenomenon and to determine the factors that influence their perceptions as well as their practices regarding teenage pregnancy. Methodology A qualitative, explorative, descriptive design was used to conduct the study. The study was guided by the Johnson Behavioural Model System. The study population consisted of young males who were studying at the Free State School of Nursing. Data saturation was achieved after interviewing 10 participants. The four major themes emerged from data obtained were as follows: Theme 1: Perceptions regarding teenage pregnancies, Theme 2: Risk factors leading to teenage pregnancies, Theme 3: Cultural and traditional practices influencing perceptions about teenage pregnancies, Theme 4: Measures to prevent teenage pregnancies. Thematic analysis of data was done. Results The findings of this study revealed that young males were not involved in reproductive health programmes aiming to prevent teenage pregnancies. They lacked knowledge regarding the use of, and the available types of contraceptives. Cultural and traditional practices such as misinterpreting circumcision and cultural beliefs, including misconceptions about sexual practices, played a crucial role such as not using contraceptives during sexual intercourse that could lead to teenage pregnancy. This study recommends that young males need to be actively involved in reproductive health.

Submitted in fulfillment of the requirements for the degree of Master of Technology: Environmental Health, Durban University of Technology, Durban, South Africa, 2016. / South Africa, like many other developed countries, is challenged by the under attendance and delay in initiation of antenatal care (ANC) services among pregnant adolescents. Adolescents are more vulnerable to pregnancy related complications, which may contribute to maternal and child mortality and morbidity. This study aimed at evaluating the under attendance and/or delay in initiation of ANC services among young pregnant adolescents (13-16 years old) as a risk for adverse maternal and birth outcomes. The research was based at a district hospital on the North Coast of Kwazulu-Natal. A retrospective review of all young adolescent (13-16 years old) maternity case records for the period from 2011-2013 was conducted. Data collected included ANC trends in attendance, obstetric and perinatal outcomes. A total of 314 pregnancies were recorded among young adolescents at this single hospital over a period of 3 years. Adolescent pregnancy was associated with a risk of late ANC booking and reduced ANC visits. The prevalence of anaemia (32%) was relatively high among the girls. Fifty percent of all adolescents received episiotomies while, 45(14%) experienced perineal tears. Logistic regression models found that the condition of perineum was significantly associated with HIV status (OR= 0.36; 95% CI=0.16; 0.84; p<0.05). HIV positive mothers were more likely to have an intact perineum post-delivery. However, HIV positive adolescents were twice as likely to be diagnosed with anaemia compared HIV negative mothers (results not significant). Underutilisation of ANC (i.e less than 4 visits) was significantly associated with lower gestational age (< 37 weeks) (OR=2.64; 95% CI=1.04; 6.74; p<0.05). Fifteen percent of young mothers delivered early (< 37 weeks), 10% delivered babies with a low birth weight (< 2500g) and 15% of the neonates suffered fetal distress. Low birth weight, low Apgar scores as well as the incidence of maternal anaemia and Pregnancy Induced Hypertension (PIH) were found to be related to late ANC booking. Qualitative findings highlighted the perceived barriers of ANC by pregnant adolescents. Interviews identified the following as factors that hindered access of care; financial barriers, attitudes of Health Care Workers (HCW), system barriers and fear of HIV testing. Urgent population based strategies are required to encourage timeous initiation of ANC among adolescents. Strengthening of health education programs on the benefits of ANC attendance among adolescents can be utilized as part of an approach to address the current public health concern. / M

Thesis (MA)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: An exploratory study of the extent and nature of adolescent pregnancy resolution and pre-abortion counselling was undertaken. Little research has been done on pre-abortion counselling in South Africa since the Choice of Termination of Pregnancy Act (92 of 1996) was passed in February 1997. This study emphasised pre-abortion counselling since this is a new field for most counsellors. A literature study was conducted on adolescent pregnancy, focussing on the factors and possible consequences of the choice to carry the pregnancy to term or to terminate it. Adolescents, more than adults, need assistance to make this decision. Crisis intervention was explored as a possible counselling model for pregnancy resolution and pre-abortion counselling. The preliminary investigation included interviews with social workers and nursing professionals in Mossel Bay. Nursing professionals were included in the study since they administer the pregnancy tests and are therefore the first professionals with whom the pregnant adolescent comes into contact. This investigation revealed that nurses, not social workers, do most of the preabortion counselling in Mossel Bay. The Choice on Termination of Pregnancy Act emphasises the importance of supplying pre and post-abortion counselling at the facility providing the termination of pregnancy. The Act also envisages this as primarily a medical concern, with the implication that nursing professionals should do the counselling. The role of professional counsellors such as social workers is not mentioned in the Act. The Act lays down that training will be provided to equip nursing professionals with necessary skills to render this service. The empirical study examined the training and skills of nursing professionals and social workers to determine whether they were adequately qualified to render these services. The respondents' attitude towards pregnant adolescents who choose abortion was also investigated, since this would influence their counselling skills. The investigation revealed that many of the nurses did not seem confident in their counselling although they felt that they were adequately qualified to counsel pregnant adolescents. The nurses explained that they did not feel that they had enough knowledge of the different options, especially foster care and adoption and therefore referred patients to a social worker or Options Pregnancy Centre (a volunteer based counselling centre). The social workers felt confident in counselling adolescents who decided to carry pregnancy to term. The counselling model used was crisis intervention, which is most appropriate for pre-abortion counselling as well. However they felt that they did not have enough information of abortion procedures and emotional consequences of abortion to counsel a pregnant adolescent requesting an abortion effectively. The study showed that respondents felt empathy and understanding for the adolescents' situation and the seriousness of the decision needing to be made. The study also found that social workers and nurses were willing to attend further training in order to improve their knowledge and their counselling skills. The training should therefore not focus on attitudes but simply on improving counselling skills. Training should focus on the nature of a crisis and the steps of crisis intervention. / AFRIKAANSE OPSOMMING: 'n Studie is gedoen om die aard en omvang insake die besluitneming ten opsigte van tienerswangerskappe en berading voor 'n aborsie te ondersoek. Sedert die Wet op Beëindiging van Swangerskap (92 van 1996) in Februarie, is weinig navorsing in Suid-Afrika gedoen oor berading voor 'n aborsie. Hierdie studie beklemtoon voorafgaande berading aangaande aborsie, aangesien dit 'n onbekende terrein vir baie beraders is. 'n Literatuurstudie oor tienerswangerskap is geloods met die fokus op faktore en moontlike gevolge van die keuse om die volle termyn van die swangerskap te voltooi of die beëindiging daarvan. Adolessente het meer ondersteuning nodig as volwassenes om so 'n keuse uit te oefen. Krisis-ingryping is ondersoek as 'n moontlike model vir die beslissing van 'n swangerskap en berading wat 'n aborsie voorafgaan. Met die voor-ondersoek is onderhoude met maatskaplike werkers en verpleegkundiges in Mosselbaai gevoer. Verpleegkundiges was deel van die studie aangesien hulle die eerste kundiges is met wie die swanger tiener in aanraking kom, omdat hulle die swangerskaptoetse uitvoer. Dié navorsing toon dat verpleegsters in Mosselbaai (nie maatskaplike werkers nie) grotendeels die berading voor 'n aborsie hanteer. Die Wet benadruk hoe belangrik dit is om beradingsdienste vir voor- en na-aborsie te voorsien by die plek waar die aborsie toegepas word. Dié Wet beskou dit ook primêr as 'n mediese aangeleentheid, gevolglik behoort verpleegkundiges die berading te doen. Daar word egter nie melding gemaak van die rol van professionele beraders soos maatskaplike werkers, in dié verband nie. Die Wet bepaal ook dat verpleegkundiges opleiding sal ontvang om hulle met vaardighede toe te rus om so 'n diens te lewer. Die opleiding en vaardighede van verpleegkundiges en maatskaplike werkers is dus getoets aan die hand van studies, gegrond op praktiese ervaring, om te bepaal of hulle bevoegd is om die dienste te lewer. Daar is ook ondersoek ingestel na die respondente se houding teenoor die swanger adolessent wat 'n aborsie verkies, aangesien hul vermoë om die berading te hanteer, beïnvloed kan word. Die ondersoek toon dat baie verpleegsters onseker voorgekom het tydens berading, hoewel hulle gevoel het dat hulle bekwaam is om swanger adolessente te adviseer. Hulle verklaar dat hulle nie genoeg kennis oor die verskillende opsies, veral pleegsorg en aanneming, gehad het nie, en dus pasiënte na 'n maatskaplike werker of Options Pregnancy Centre verwys het. Maatskaplike werkers het berading aan swanger adolessente wat die termyn van die swangerskap wou voltooi, met sekerheid hanteer. In die proses is krisis-ingryping uitgeoefen wat dan ook gepas is vir berading voor 'n aborsie. Die maatskaplike werkers het egter gevoel dat hulle nie genoeg inligting oor die aborsieproses en die emosionele gevolge daarvan gehad het om die swanger adolessent wat 'n aborsie verlang, effektief voor te lig nie. Die studie het getoon dat respondente die adolessent se situasie en die erns van die besluit wat gemaak moes word, met empatie en begrip hanteer het. Met die studie is ook bevind dat maatskaplike werkers en verpleegsters bereid was om verdere opleiding te ontvang en sodoende hul kennis en vaardighede te verbeter. Die opleiding moet dus nie op houdings fokus nie, maar eerder die ontwikkeling van vaardighede. Dit behoort te fokus op die aard van die krisis en die stappe van krisis-intervensie.

The purpose of this study was to explore and describe the contributory factors to the high teenage pregnancy rate within a district hospital in the Ehlanzeni district of the Mpumalanga Province, South Africa. Quantitative, non-experimental, descriptive and exploratory research was conducted to explore the contributory factors to the high teenage pregnancy rate. Data collection was done using a self-designed structured interview schedule. The findings of the study supported the assumptions that there are factors related to biography, individual perceptions, knowledge and awareness of; and practices, perceptions regarding the use of contraception. Perceived seriousness and barriers to the use of safeguards that could have prevented pregnancy contribute to the high teenage pregnancy rate thus emphasise the need to develop strategies to prevent teenage pregnancies / Health Studies / M. A. (Health Studies)

A research report submitted to the Faculty of Humanities, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the award of Masters of Arts in Demography and Population Studies, 2017 / Background: Risky behaviours among adolescents are notably the most important factors contributing to negative health outcomes of this population group. Adolescents in South Africa are at risk of the HIV infection, unintended pregnancies, unintentional injuries (motor vehicle accidents) and substance and drug abuse. South Africa is regarded as one of the countries with nearly half adolescents living with HIV, as a result of unprotected sex. It is also regarded as one of the countries with motor accidents cases and as a result of reckless driving and substance use. To understand this, there is substantial research on the demographic and socio-demographic determinants of risky behaviour amongst adolescents but little research on the household and community factors. The main aim of this study is to determine the contextual determinants of adolescent risky behaviours in South Africa. Method: This study used data from the South African Youth Life Style Survey of 2008. The study sample size is 3336 adolescents aged 12 to 19 across all nine provinces in South Africa. Risky behaviours are organized using an ecological framework into individual, household, and community levels. Binary- multilevel logistic regression was employed to analyze the data. Results: The results indicated that age, sex, education, race, living arrangements, number of income earners, were significant, however, the relationship between risky behaviours and community level variables were negatively significant. . 3336 adolescents participated in the study, 934 (28.0%) had sexual intercourse and 158 (4.74%) had two or more sexual partners, and 234 (7.01) did not use a condom during their last sex. In terms of substance use, 34.24 % ever used alcohol and about 24.45% ever been a passenger with a driver under the influence. Adolescents who were living with their grandparents (OR=1.07), living in a household with seven or more members (OR=1.06), while residing in had a higher likelihood of engaging in risky behaviours. Findings demonstrated that community level factors were not associated with reports of risky behaviour among adolescents but were influential in shaping the risky behaviour of adolescents. Conclusion: Firstly, results from this research will provide a better understanding of the contextual factors that relate to risky behaviours. Secondly, results from this research will help inform polices such as the National Youth Policy in reducing risky behaviours. Lastly, interventions aimed at reducing risky behaviours among adolescents in South Africa should not only focus on individual level but also on the household and community engagement. / XL2018

Thesis (Ph. D. (Social Work)) -- University of Limpopo, 2018 / Teenage pregnancy is a social problem that affects and destroys the future of teenage girls, especially teenage learners. Its impact is not only felt by the teenage girls, but also by their families, schools, and the country in general. This study sought to develop an educational social group work model on teenage pregnancy for learners in schools in the North West province. To this effect, this study was anchored on five objectives, namely: to establish the extent of teenage pregnancy amongst learners in schools in the North West province; to assess factors that predispose learners to indulge in sexual activities despite the risk of pregnancy and sexually transmitted diseases; to describe the roles of parents in the prevention of teenage pregnancy amongst learners; to identify prevention measures used by the schools to prevent teenage pregnancy; and to develop, implement, and evaluate an educational social group work model on teenage pregnancy for learners. The study adopted a mixed methods approach by combining the qualitative and quantitative paradigms. The population of the study consisted of learners, while school principals, deputy principals, Life Orientation teachers, and parents/guardians were the key informants. The findings of this study confirm that teenage pregnancy is a serious problem that continues to affect schools. All grades from the secondary schools that participated in this study reported cases of learner pregnancies. The grades with high reported cases include Grades 10, 11, and 12, while Grades 8 and 9 appeared to be the least affected. Furthermore, the findings indicate that male learners are most likely to father children with female learners. The development of an educational social group work model on teenage pregnancy for learners was achieved via a literature review and the empirical findings from learners and the key informants. Group work as a method of the social work profession was chosen in this study because it is intensive in nature, and the follow-up sessions provided a platform for the evaluation of social worker interventions and the performance of individual members and the entire group. The developed model was implemented and evaluated. Different topics were discussed during a marathon of eight