Student Number : 9512861R - MA research report - School of Psychology - Faculty of Humanities / The present study served to investigate the way in which continuous exposure to potentially traumatic incidents impacts on the South African Emergency Care Practitioner (ECP). The study sought to investigate the presence of symptoms of posttraumatic stress (PTS) in the sample and the events which appear to pose the greatest threat to these ECPs’ mental health. The notion that individuals exposed to the same traumatic stressors can present with very different posttraumatic responses has led to the acknowledgement that the relationship between exposure and PTS is a complex one. Studies have examined a multitude of variables believed to impact in some way on this relationship, with particular emphasis on individual appraisals and coping styles. Less attention has been afforded the role of social phenomena in the development of posttraumatic stress disorder (PTSD). The attention that has been afforded these phenomena has tended to examine social support as a unidimensional construct, and studies have often measured different social support conceptualisations. Utilising a recognised psychosocial framework, the present study sought to investigate the impact of social support in the relationship between exposure and PTS. It sought to examine three distinct facets of social support, namely: the appraisal of being supported, the perception of available supportive behaviours from family and friends, and an individual’s orientation towards utilising support. The study used a cross-sectional, correlational design to investigate the relationships between exposure, PTSD symptoms and social support. The procedure involved the anonymous completion of several standardised self-report measures by 107 ECPs from Netcare 911, a private South African emergency care organisation. These measures included a revised version of the Paramedic Work Exposure Checklist (PWEC), the Revised Impact of Event Scale (RIES), the Social Support Appraisals Scale (SS-A), the Social Support Behaviours Scale (SS-B) and the Network Orientation Scale (NOS). The events that tended to be rated as having the most negative emotional impact among respondents involved assisting abused or injured children, witnessing the death or injury of a coworker, assisting victims of sexual assault, dealing with equipment failure or the incompetence of others and receiving inadequate or incorrect information when dispatched on a call. The correlational analyses revealed that exposure to events rated as having a negative emotional impact was significantly and positively associated with symptoms of PTSD in the sample. Correlational analyses also revealed that each of the facets of social support measured was significantly negatively associated with symptoms of PTSD. The results indicate that the mode and source of support most significantly associated with symptoms of PTSD in the sample was the perception of available emotional support from friends. In spite of the direct relationships observed between symptoms of PTSD and the facets of social support examined, none of the social support facets investigated emerged as a significant buffer in the relationship between exposure and PTSD. The study highlights the need for additional research, including longitudinal investigation, into the role of multiple facets of social support in the relationship between exposure and PTSD. Some suggestions for future research and the practical application of the findings of the research are offered.

MSc (Med) Epidemiology and Biostatistics, Faculty of Health Sciences, University of the Witwatersrand, 2009 / Abstract not included on cd

Thesis advisor: Thomas O'Hare / Depression in adolescence is associated with a number of negative consequences, including low school achievement, substance abuse, increased risk of later major depression, and suicide. Adolescent children of immigrants are arguably at greater risk of depression than their native counterparts, due to greater likelihood of migration-related stress, a minority racial/ethnic background, lower socioeconomic status, and lower proficiency in the host society language. Informed by theories of assimilation and social network theory, this study examines the contribution of assimilation, sociodemographic factors, and social supports to depressive symptoms in immigrant and native United States adolescents. Nationally representative data on United States adolescents from Waves I and II of the National Longitudinal Study of Adolescent Health (N = 4,263) are analyzed. Results demonstrate immigrant adolescents report significantly higher levels of depressive symptoms and more risk factors for depression than their native peers. However, hierarchical regression analysis shows generational status ceases to be a significant correlate of depressive symptoms when age, sex, race/ethnicity, socioeconomic status, and home language are controlled. Mediation analysis shows unique relationships between control variables, social supports, and depressive symptoms. Findings are in accordance with social network theory, but challenge assimilation theories premised on the assumption that immigrants face unique migration related challenges that are overcome through generations. Findings support adolescent children of immigrants and native children share common non-migratory related risk factors of depressive symptoms, and adolescent children of immigrants are at greater likelihood of experiencing these risk factors. Practice and policy implications are discussed. / Thesis (PhD) — Boston College, 2013. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social Work.

Thesis advisor: James Lubben / Thesis advisor: Ce Shen / Historically, recovery from addiction has been synonymous with sobriety and when a person relapsed, all the gains they had made were erased. More recently efforts are underway to redefine recovery as a multidimensional process of change characterized by abstinence, improved health, citizenship, and actions taken by individuals to reach their full potential. This study contributes to the evolution of a more holistic understanding of recovery across the life course by utilizing four waves of data from the Pathways to Long-Term Abstinence Study (N=355) to examine how social recovery capital, stress, and individual contextual factors shape the physical health, mental health, and well-being of individuals recovering from addiction. Results from growth curve analysis indicate that the mental health and well-being of those recovering from addiction improve over time, while their physical health declines. Evidence also confirms that the positive influences of social recovery capital extend beyond sobriety to both directly and indirectly alter global health trajectories. While findings presented here offer hope that life can get better in some areas, they also raise significant concern over a long term pattern of declining physical health and the negative effects of stress that persist during recovery. A person's ability to sustain abstinence contributes to improvements in mental health and well-being, but not to physical health, suggesting that the physical damage done while actively abusing substances is significant and enduring. Finally, women recovering from addiction were confirmed to suffer disproportionate physical and mental health disparities, adding to the already substantial body of literature that suggests gender-specific prevention and treatment interventions across disciplines are needed to keep girls from becoming addicts and to better serve the unique needs of women who do. Given that social recovery capital is able to simultaneously influence multiple domains of recovery, interventions targeting enhancement of social recovery capital may prove particularly valuable in the effort to help people recover from addiction. / Thesis (PhD) — Boston College, 2013. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social Work.

Os baixos índices de amamentação exclusiva sugerem a falta de estrutura que forneça apoio efetivo para que a mulher tenha condições de escolher e decidir em relação ao início e a duração da amamentação. Em nossa percepção, há uma dissonância entre o apoio instituído e o apoio esperado pela mulher. Sendo assim, questiona-se o que é o apoio para amamentar, como a mulher/nutriz interpreta as ações de apoio de sua rede social e quais são os elementos mais relevantes para ela. Consideramos que a definição do apoio à amamentação carece de clareza e consenso. Questionamos se o apoio à mulher no processo de amamentação pode ser considerado um fenômeno socioculturalmente construído e sua natureza prática influenciada pelos mecanismos de comunicação existentes na sociedade. Desta forma, elegemos os pressupostos das Representações Sociais para nos levar a conhecer as representações de um grupo de nutrizes sobre apoio para amamentar e identificar as ações de apoio do entorno social que são recebidas e percebidas por elas no processo de amamentação. O local do estudo foi o Centro de Saúde Escola Samuel Barnsley Pessoa (CSE Butantã-SP). Participaram 14 mulheres, em processo de amamentação com filhos até a idade de seis meses, abordadas no setor de pediatria e puericultura do referido serviço. Os dados foram obtidos por meio de entrevista e organizados segundo a proposta do Discurso do Sujeito Coletivo, o que propiciou a construção de seis discursos que representam as percepções das mulheres e versam sobre as suas experiências de amamentação, com enfoque para o apoio recebido e percebido nos contextos hospitalar, familiar e profissional. Dos resultados do estudo, apreende-se que o apoio é um fenômeno de grande amplitude constituído por aspectos da promoção, da proteção e do incentivo ao aleitamento materno. Em relação às ações de apoio para amamentar, segundo as perspectivas das mulheres, é possível compreender o apoio diante de três dimensões: instrumental, afetiva e estrutural. A dimensão instrumental, no contexto hospitalar, engloba elementos de ordem prática e informacional do manejo da amamentação. No contexto familiar, a dimensão instrumental relaciona-se principalmente ao auxílio financeiro e ajuda nas tarefas domésticas, permitindo à mulher, dedicar mais tempo ao bebê e a amamentação. A dimensão afetiva engloba elementos das relações interpessoais, no contexto público e privado, enfatizando a maneira como o apoio é oferecido. A dimensão estrutural diz respeito às ações do contexto social no tocante ao trabalho assalariado. Não há reconhecimento de apoio para amamentar oferecido pela sociedade, mas sim obstáculos a serem transpostos para o reconhecimento no ambiente profissional, como mulheres trabalhadoras e mães. As necessidades expressas pelas mulheres representam um desafio de revisão das práticas a todos os envolvidos na promoção, proteção e apoio à amamentação; portanto, os serviços de saúde deveriam prover ações baseadas na percepção das mulheres na busca de uma parceria com sua rede familiar e também integração com os aparelhos sociais disponíveis / The low exclusive breastfeeding rates suggest the lack of structure to provide effective support for the woman to have conditions to choose and decide regarding to the beginning and the duration of breastfeeding. In our perception, there is a dissonance between the instituted support and the women\'s expected support. In that way, it was questioned what is the support for breastfeeding, how the woman/nourisher interprets the action support of her social network and what the most relevant elements are for her. It was considered that the definition of breastfeeding support lacks clearness and consensus. It was questioned if the support to the woman in the breastfeeding process may be considered a socioculturally built phenomenon and its practical nature influenced by mechanisms of communication existent in society. This way, we elected the presupposed in Social Representations to make us know the representatives of a group of nourishers on the support to breastfeed and to identify the support actions of the social surrounding, which can be received and perceived by them in the breastfeeding process. The place of study was Centro de Saúde Escola Samuel Barnsley Pessoa (CSE Butantã-SP). The fourteen women who attended it were in the breastfeeding process, whose children were up to six months old, approached at the pediatric and child welfare sectors of the service aforementioned. Data was obtained through interview and organized according to the purpose of Collective Subject, which offered the construction of six discourses that represented the women\'s perceptions and turns to their experiences in breastfeeding, focusing on the received and perceived support in the hospital, family and professional contexts. From the study outcomes, it was seen that support is a phenomenon of great extension, made of aspects of promotion, protection and encouragement to breastfeeding. Regarding to the actions to support breastfeeding, according to women\'s perspectives, it\'s possible to understand support in three dimensions: instrumental, affective and structural. The instrumental dimension, in the hospital context, concerns to practical and informative elements on managing breastfeeding. In the family context, the instrumental dimension is mainly related to the financial support and help on household chores, allowing women to dedicate more time to the baby and breastfeeding. The affective dimension involves elements of interpersonal relationship, in the public and private contexts, focusing on the way support is offered. The structural dimension concerns to the actions of social context regarding to the salaried job. There is no gratitude of support to breastfeeding offered by society; instead, there are obstacles to be overcome for its value in the professional setting, as working women or mothers. The needs expressed by women represent a challenge to review the practices for all of those involved in promotion, protection and support to breastfeeding; therefore, healthcare services should provide actions based on women\'s perception in seeking a partnership with the family network and also the integration with the social facilities available

Females diagnosed with a substance use disorder (SUD) may experience more stigmatization and need more social support than males. Traditional therapeutic services provide interventions and treatment that is uniform for males and females. The available research on female substance users does not address meaningful connections and relationships with others, and its effect on overall wellness. The objective of this study was to address the importance of social support, stigmatization, and wellness. A sample of 232 females diagnosed with SUD, at least 18 years of age, responded to three instruments and a demographic form. The results of this study indicate that income and age are predictors of overall wellness and explained 12% of the variance in wellness, when using a multiple regression analysis, (adjusted R^2 = .119, p = .000). Relationship status and relationship length demonstrated significance as predictors of social support, explaining 5.6% of the variance in social support, using a multiple regression analysis, (adjusted R^2 = .056, p = .001). Number of children, age, and relationship length demonstrated significance as predictors of stigmatization, accounting for 9.4% of the variance in stigmatization, (adjusted R^2 = .094, p = .000). Social support accounted for 4.1% of the variance in stigmatization using a multiple regression analysis, (adjusted R^2 = .041, p = .001). Social support explained 39% of the variance in wellness, (adjusted R^2 = .394, p = .000). Using a hierarchical regression analysis to control for stigmatization, social support explained 44% of the variance in wellness, (adjusted R^2 = .438, p = .000). Finally, social support mediates the relationship between stigmatization and wellness, when using path analysis. This study provided support for specific treatment for females in substance abuse treatment; particularly concerning social support, stigmatization, and wellness. These females with SUD reported that social support increased wellness, correlating with decreased stigmatization. Conversely, females who experienced increased stigmatization and decreased social support also experienced decreased wellness. Social support mediated the impact of stigmatization and wellness. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2018. / FAU Electronic Theses and Dissertations Collection

Health care providers see patient information provision as one objective they must meet in an endeavour to provide good patient care. Received wisdom suggests that the more information a patient has available to them about their illness, its progression and treatment, the better their healthcare will be (Suzuki & Calzo, 2004; Information Strategy Team & Department for Health, 2010). However, this may not be the case. Some studies have shown that certain patients may not want information on their disease and patients may differ in the types of information they find most helpful depending in their information processing style (Miller, Fang, Diefenbach, & Bales, 2001; Suzuki & Calzo, 2004). In contrast, others may prefer certain types of information depending on the ways in which they cope with illness (Seale, Ziebland, & Charteris-Black, 2006) and the ways in which they process information once they have access to it (Caes, Vervoort, Eccleston, & Goubert, 2012; Eysenbach, Powell, Englesakis, Rizo, & Stern, 2004). One common source of information is through peer-to-peer interactions especially in hospital waiting rooms and ward areas, as these provide patients with the means to access others suffering from similar problems and ask to about their lives (Miller et al., 2001). However, in the digital age the internet is now emerging as the primary medium for both information gathering and peer-to-peer interactions of patient groups (Eysenbach et al., 2004). At present we know very little about how children use this mode of information gathering and support seeking in order to cope with illness, and more specifically with pain. At the very least the change of what we mean by space and place online alters the ways in which children may communicate with each other (Fox, Morris, & Rumsey, 2007). In this PhD thesis I begin, in chapter one by reviewing what limited research has been carried out on child pain information seeking. In chapter two, the first empirical study assesses what children who seek information and support online find when they search. This study is a content analysis of pain websites found by using search terms generated by teenagers. The second empirical study, in chapter three, assesses how adolescents access and use this information in the context of their wider pain coping. A questionnaire is utilised to assess these coping mechanisms. The third empirical study assesses what frequent users of the internet think of online health information. I accessed frequent users of the internet through an online message board Let’s Chat Pain. In the development of this message board a number of key ethical and methodological issues were brought to light and this study presented a solution to many of these issues. A paper describing some of the solutions presented by this case is presented in chapter four followed by the results of the study itself in chapter five. The final study assesses what impedes non-users of online health information and support in a focus group of non-users of online information and support in chapter six. The final chapter, chapter seven will draw some conclusions of the thesis.

This study examines race differences and the relationship between religiosity/ spirituality and social support on quality of life (QOL) among people living with HIV/AIDS in Dallas/Ft. Worth, TX. The data were obtained from the Project VOICES research study conducted by the Center of Psychosocial Health Research at University of North Texas in 2003. This study explores the hypotheses that religiosity/spirituality and social support positively influences quality of life among people living with HIV/AIDS. The current study uses a diverse, gender-balanced sample consisting of African Americans (n = 156), aged 20-68, 47% male, 52% female and 1% transgendered) and Non-African Americans (n = 131), aged 19-65, 50% male, 46% female and 3% transgendered) (Caucasian, Latino, & others) to evaluate the relationship among variables of interest. Multiple regression analyses revealed that social support was a significant factor explaining quality of life (QOL) for African Americans when controlling for medical variables but did not for non-African Americans. Religiosity/spirituality was not found to be significant in this study. The implications of the findings are discussed.

Paediatric acquired brain injury (pABI) can lead to an array of long term physical, cognitive, emotional, and behavioural difficulties. Due to the long-term sequelae of more severe pABI, it presents a significant challenge to the child’s family. Studies have suggested that social support can positively impact psychological adjustment following a stressful life event, and can aid personal resilience. There remains limited qualitative investigation of subjective family and parental adjustment experiences following pABI. Researchers have argued for future research that include the experiences of parents who have children younger than 16 years old, and are able to shed light on the individual experiential journey of parents. The current study used interpretative phenomenological analysis (IPA) to explore to the experiences of adjustment and social support of parents of children with pABI. Purposive sampling was used to recruit 10 participants who were individually interviewed. Five superordinate themes emerging from the data were identified: 1) Lives changed forever, 2) Sense of self, 3) Interaction with services, 4) The psychological experience, 5) Coping and adjustment. Relevant literature and implications for future research and clinical practice are discussed.

Philosophiae Doctor - PhD / The Human immunodeficiency virus (HIV) and acquired Immunodeficiency syndrome (AIDS) are serious health issues that continue to affect many nations. Specifically, the sub-Saharan African region has the highest prevalence of HIV and AIDS worldwide. Africans living in informal settlements or townships have the highest prevalence of HIV in South Africa. Persons of low socioeconomic status (SES) in general become socialised into unhealthy behaviours and risk factors at early ages, and experience poor health outcomes. Physical activity (PA) is one cost-effective, non-pharmacological approach that has been reported as conjunctive therapy for HIV to effectively address these impairments. Aim: The aim of the study was to develop a contextualized intervention that promotes PA among persons living with HIV and AIDS (PLWHA) of low SES. Methods: A mixed methods approach was used. Studies included (1) a systematic review which assessed (a) specific and useful intervention techniques that were previously used in successful PA interventions (b) relevant behaviour change theories used to develop the intervention content, (2) a narrative review which examined the available literature on PA, social support and SES with a view to inform the design of effective PA interventions for PLWHA of low SES, (3) a cross sectional study which aimed at determining if age, body weight, height, gender, waist-to-hip ratio (WHR), educational attainment, employment status, CD4+ cell count, and body mass index (BMI) could predict overall PA among PLWHA of low SES in Cross roads Township in the Western Cape Province, South Africa (4) a cross-sectional study which (a) examined the PA profile of PLWHA of low SES based on PA domains and intensity and (b) determined whether employment status and level of education can predict PA among PLWHA of low SES in Cross roads Township in the Western Cape Province, South Africa (5) a mixed methods study which investigated the benefits and barriers of PA for HIV-positive women of low SES using the Exercise Benefits/Barriers Scale and focus group discussions, (6) a study which sought to develop a contextualised intervention for promoting PA among PLWHA of low SES and (7) a crossover study conducted at a community centre caring for HIV positive Black African Xhosa-speaking women of low SES in Nyanga Township in the Western Cape Province in South Africa. Results: The systematic literature review showed that the following techniques, namely, ‘provide feedback on performance’, ‘goal setting (behaviour)’, and ‘plan social support/social change’ were the most frequently used behavioural change techniques in interventions focusing on promoting PA for the management of chronic diseases amongst individuals of low SES. The review also showed that the Transtheoretical model of behaviour change and the Social Cognitive theory were the common theoretical frameworks of most study interventions.