Electronic Theses and Dissertations (Masters)
Permanent URI for this collectionhttps://hdl.handle.net/10539/37990
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Item Understanding the experiential intersections of violence, gender identities and mental health, in the accounts of male parolees, in Gauteng, South Africa(University of the Witwatersrand, Johannesburg, 2023-03-15) Kallenbach, Jessica Jade; Bowman, BrettImprisonment in South Africa has been categorized by untold hardships and suffering. Some of the major factors which influence life in correctional centres in South Africa, are embedded within violence, gender identities and mental health. These three constructs – violence, gender identities and mental health – appear embedded within the logic of the correctional centre regime. Thus, to understand the entirety of an offender’s experience during incarceration, it is necessary to investigate the intersections of violence, gender identities and mental health. This was achieved using a qualitative hermeneutic phenomenological approach to centre on the participants’ experiences. This research consisted of six semi-structured face-to-face interviews with male parolees at Zonderwater Correctional Community Centre. The interviews were based on a self-developed questions derived from research by Akhona (2014), Bantjes et al. (2017), Celinska and Sung (2014) and Gear and Ngubeni (2002). The interview questions were open-ended and focused on the participants’ subjective meanings, understandings and experiences regarding the dynamic intersection of violence, gender identities and mental health in South African correctional centres. The findings of this research revealed that the exposure to and involvement in violent acts are inextricably related to the fundamental deprivations that offenders are subjected to and the associated “pains of imprisonment”. This revelation demonstrated the negotiation of gender that takes place within these confines, making acts of sexual assault and violence deemed more acceptable. In navigating this system of violence and gender identity negotiations, the findings of this study illustrated the emotional and mental impact that this environment has on offenders. This highlighted the pertinent need for the Department of Correctional Centres (DCS) to address current gaps in the rehabilitation models they use. These gaps could account for the recidivism rate in South Africa. It is clear that the intersection of violence, gender identities and mental health play an influential role in determining the reported experiences of offenders. The study thus has the potential to contribute to policies, by illustrating that a multi-layered approach to rehabilitation is required.Item Caregiver experiences of Attachment and Bonding Practices in Neonatal Intensive Care Units in Gauteng, South Africa(University of the Witwatersrand, Johannesburg, 2024) Prinsloo, Engela Maria; Neill, Joanne; Sawasawa, CynthiaBackground: Infant attachment and bonding are crucial within the early post-natal period to ensure a secure and healthy relationship from which the infant can explore the world thereby allowing for the development of a variety of skills. Context and culture are known to influence attachment and bonding practices. Then considering the challenging Neonatal Intensive Care Unit environment it is crucial to explore how this environment might influence attachment and bonding with a specific focus on context and culture. Objectives: This study aimed to describe the experiences of caregivers regarding attachment and bonding practices in the Neonatal Intensive Care Unit in central Gauteng, South Africa. Methods: A qualitative design was used to explore caregiver experiences around attachment and bonding practices concerning context and culture in the Neonatal Intensive Care Unit. An advertisement was posted on online forums for caregivers in South Africa who have had infants admitted to the Neonatal Intensive Care Unit. Non-probability, purposive sampling and snowball sampling was used to collect data. Both in-person and remote semi-structured interviews took place and were used to collect data. Thematic analysis was used as data analysis. Results: The following themes and subthemes were identified; the act of mothering in the NICU (with subthemes loneliness and disempowerment of caregivers, the emotional roller coaster ride, and the need for psychological/emotional support), Culture in the NICU (with subthemes care in the NICU, the influence of culture and caring for a baby in the NICU, and limited information-giving practices in the NICU), and a Sense of missing out (with subthemes unexpected pre-term birth, feeling estranged, and the tension between society’s image and the reality of having a baby in the NICU). While context and culture influence attachment practices amongst caregivers, in the case of an infant being admitted to the NICU, these practices do not take precedence, but rather the health of the infant. Implications: Methodological recommendations include alternative sampling and data collection methods than online advertised snowball sampling that allow for a larger and more diverse sample size. Policy and practice recommendations for NICUs include improving accessibility to psychological support services and orientating information on the NICU for caregivers.Item An exploration of the Lived Mental Health Experiences of psychologists working in the public sector during the COVID-19 pandemic in South Africa(University of the Witwatersrand, Johannesburg, 2023) Harvey, Zena; Laher, SumayaThe COVID-19 pandemic severely impacted mental health in South Africa, exacerbating the existing mental healthcare treatment gap. Psychologists working at public institutions have been at the forefront of providing mental health care to the public during the crisis. However, psychologists themselves may be considered a vulnerable group at risk of developing adverse mental health outcomes, such as depression, anxiety, burnout and vicarious traumatisation due to the nature of their profession. This vulnerability may have been further amplified during the COVID-19 pandemic. The well-being of psychologists is integral to ensuring high quality patient care and to the overall management of pandemic and other disease outbreaks. There remains a significant dearth in the available literature examining the lived mental health experiences of psychologists, especially those working in the public sector. This study aims to address this pertinent gap by investigating the lived mental health experiences of ten psychologists employed in South African public institutions, amidst COVID-19 pandemic. Semi-structured interviews comprising sixteen questions were conducted with each psychologist. The following five overarching themes emerged from an Interpretive Phenomenological Analysis (IPA): ‘The personal effects of COVID-19 on psychologists’, ‘Changes to therapy During COVID-19’, ‘Experiences of COVID-19 exposure in public hospitals’, ‘Coping Mechanisms’ and ‘Survivor Guilt: Privilege during the pandemic’. A discussion of the abovementioned findings highlighted the importance of addressing, prioritising and monitoring the psychological wellbeing of these public sector-psychologists, during pandemic and other disease outbreaks to increase their support structures.Item The investigation of intrapsychological processes of primary school teachers with regards to the use of Corporal Punishment: A Case Study(University of the Witwatersrand, Johannesburg, 2023-03) Arosi, Sinovuyo Luyanda; Mayisela, SimangeleCorporal punishment has been legally abolished and identified as having detrimental effects on the psychological well-being of children. The reconstruction of external events and interpersonal states, such as corporal punishment, into intrapsychological and interpsychological activity, demonstrates the vulnerability of humans. Primary school teachers are instrumental in the development of higher mental functioning and the mental transformation of young children. The current study examined the intrapersonal processes of primary school teachers and their attitudes towards the use of corporal punishment when disciplining learners. A case study design was employed to explore teachers’ views on the abolishment of corporal punishment and the intermental, socio-cultural and cultural-historical mechanisms which inform their preference for corporal punishment. The teachers from a township school in the East of Johannesburg completed a demographic questionnaire and participated in focus group discussions and individual interviews. This qualitative data was collected using audio recordings which were transcribed and thematically analysed. Vygotsky’s sociocultural approach was used to understand the transformation of the human mind using cultural tools, namely, corporal punishment. Through the cultural-historical teachers’ meaning-making regarding the preference of corporal punishment in their context. The findings of this study suggest that the teachers in the case study school use and view corporal punishment through the lens of an internalised good and abusive tool. Though some of the teachers express support for the abolition of corporal punishment, they currently use this discipline measure. The findings present a paradox that represents the internal state of ambivalence that exists within the participants. These findings suggest that this may contribute to the continued use of corporal punishment in the case study school.Item Experiences of stroke survivors with aphasia and their significant others during the COVID-19 pandemic in Ekurhuleni, South Africa(University of the Witwatersrand, Johannesburg, 2023-09) Kathrada, Nabeelah Ebrahim; Kater, Kelly-Ann; Neille, JoanneBackground and Aim: Stroke, a neurological condition, can lead to communication impairments, including aphasia, and has been associated with increased burden of care for significant others. With changes in stroke care due to the COVID-19 pandemic, it was considered essential to explore the perspectives of stroke survivors and their significant others. This study aimed to investigate the lived experiences of individuals diagnosed with stroke and aphasia during the COVID-19 pandemic, along with their significant others, within the South African context. Methodology: Employing a qualitative phenomenological design, this study utilised homogenous purposive sampling. Semi-structured interviews were conducted with seven stroke survivors with aphasia and their significant others. Interviews were conducted individually or as a unit, depending on participant preference. Data analysis followed an inductive thematic approach, with interpretation guided by the biopsychosocialtech model. Findings: The study's findings reveal challenges faced by participants as a result of the COVID-19 pandemic. These challenges encompass difficulties related to facility admission, interactions with healthcare workers, loss of autonomy, limited communicative abilities, reduced social networks and engagement in pre-stroke activities, struggles with re-entering the work environment, changes within family dynamics and interpersonal relationships, as well as evidence of burden of care for significant others. While technology was acknowledged as a potential valuable resource and telerehabilitation a possible successful intervention approach, their effective use posed challenges and limitations. Although rehabilitation was deemed beneficial, the need for potential transformation within the field of aphasia rehabilitation is outlined, particularly with respect to the active involvement of persons with aphasia and their significant others as well as the use of technology in a South African context. Implications and Conclusion: This study contributes to the understanding of the lived experiences of persons with aphasia and their significant others within the South African context during the COVID-19 pandemic. The findings have the potential to inform policy and practice by emphasising the importance of addressing client needs based on their lived experiences. Additionally, the study underscores the significance of active family involvement in treatment and highlights the need to investigate barriers to implementation in this regard. The findings further emphasise the necessity of developing policies that outline the use of technology in rehabilitation and call for improved considerations in healthcare workers' interactions with individuals with aphasia.Item Understanding the experiential intersections of violence, gender identities and mental health, in the accounts of male parolees, in Gauteng, South Africa(University of the Witwatersrand, Johannesburg, 2023-03) Kallenbach, Jessica Jade; Bowman, BrettImprisonment in South Africa has been categorized by untold hardships and suffering. Some of the major factors which influence life in correctional centres in South Africa, are embedded within violence, gender identities and mental health. These three constructs – violence, gender identities and mental health – appear embedded within the logic of the correctional centre regime. Thus, to understand the entirety of an offender’s experience during incarceration, it is necessary to investigate the intersections of violence, gender identities and mental health. This was achieved using a qualitative hermeneutic phenomenological approach to centre on the participants’ experiences. This research consisted of six semi-structured face-to-face interviews with male parolees at Zonderwater Correctional Community Centre. The interviews were based on a self-developed questions derived from research by Akhona (2014), Bantjes et al. (2017), Celinska and Sung (2014) and Gear and Ngubeni (2002). The interview questions were open-ended and focused on the participants’ subjective meanings, understandings and experiences regarding the dynamic intersection of violence, gender identities and mental health in South African correctional centres. The findings of this research revealed that the exposure to and involvement in violent acts are inextricably related to the fundamental deprivations that offenders are subjected to and the associated “pains of imprisonment”. This revelation demonstrated the negotiation of gender that takes place within these confines, making acts of sexual assault and violence deemed more acceptable. In navigating this system of violence and gender identity negotiations, the findings of this study illustrated the emotional and mental impact that this environment has on offenders. This highlighted the pertinent need for the Department of Correctional Centres (DCS) to address current gaps in the rehabilitation models they use. These gaps could account for the recidivism rate in South Africa. It is clear that the intersection of violence, gender identities and mental health play an influential role in determining the reported experiences of offenders. The study thus has the potential to contribute to policies, by illustrating that a multi-layered approach to rehabilitation is required.Item Investigation of Middle Ear Function Through Wideband Absorbance Measure in Adults Living with Human Immunodeficiency Virus in Gauteng Province, South Africa(University of the Witwatersrand, Johannesburg, 2022-06) Sebothoma, Ben; Khoza-Shangase, KatjahBackground: The association between the human immunodeficiency virus (HIV) and auditory pathologies, including middle ear pathologies, has been extensively researched. However, most of this research has documented the middle ear pathologies of people living with HIV using conventional tympanometry with single probe tone, which has been shown to have poor sensitivity and specificity. Consequently, middle ear function and pathologies of people living with HIV may not have been accurately represented. While wideband acoustic immittance (WAI) such as wideband reflectance or/and absorbance measures emerged as a potential measure that can accurately identify early signs of middle ear pathologies and provide an accurate picture of the middle ear function, little is known about middle ear function and pathologies of adults living with HIV using wideband acoustic immittance. The value of preventive audiology in this population that comprises a big component of South Africa’s quadruple burden of disease cannot be overemphasized. Purpose: The primary purpose of this study was to investigate middle ear function through WAI in adults living with HIV. Specific objectives included to: review evidence on trends of middle ear pathologies in adults living with HIV; determine current practices employed by South African audiologists in identifying middle ear pathologies; determine the usefulness of using tele-practice to identify middle ear pathologies in adults living with HIV; determine the usefulness of wideband absorbance measures in identifying middle ear pathologies in adults living with HIV; determine the sensitivity, specificity, and characteristics of wideband absorbance measures in adults with and without HIV; determine the combined effects of HIV and comorbidities on hearing function; and explore risk factors that influence the development of middle ear pathologies in adults living with HIV. Participants: A non-probability purposive sampling was used to recruit and select participants. South African adults aged 18 years and above who were diagnosed and living with HIV in the Gauteng Province and attending an HIV clinic, as well as adults who are HIV negative as a control group were recruited and included in the study. Design: While the general methodology for this research comprised of a quantitative, cross-sectional design, each research article that forms part of this study has its own specific research design and methodology, and this is presented in each article. Data analysis: Data were analysed using the STATA version 1.5. For each paper (presented as chapters in this thesis), specific statistical analysis procedures were adopted, and are reflected in each of the chapters. Results: Findings in this study revealed that middle ear pathologies are common and highly prevalent in adults living with HIV, reaching approximately 60% in the current sample. These pathologies vary according to type and severity, and this is influenced by the middle ear measure used for assessment. The common middle ear pathologies in this study were otitis media with effusion, chronic suppurative otitis media, with conductive hearing loss. Despite the existence and occurrence of middle ear pathologies, some audiologists do not regularly incorporate tympanometry into their clinical practice. Asynchronous tele practice, through video-otoscopy, was found to be useful and feasible in the identification of middle ear pathologies in adults living with HIV, with substantial agreement (K=0.5801 to 0.6047) between otorhinolaryngologists. The wideband absorbance measure was found to be more accurate in identifying middle ear pathologies than the tympanometry with 226Hz probe tone and pure tone audiometry using air/bone gap. The sensitivity of wideband absorbance reached 88%, while that for tympanometry with 226Hz probe and pure tone audiometry was below 20%. In addition, the wideband absorbance patterns, measured at ambient pressure and tympanometric peak pressure, were also established for participants with normal middle ear function and middle ear pathology. While there was a difference between the wideband absorbance pattern of participants with normal middle ear function and middle ear pathologies, with middle ear pathologies being lower in the low to mid frequencies (226Hz to approximately 3000) for both ambient pressure and tympanometry peak pressure, this difference was not statistically significant between and within groups. Finally, findings of this study indicated that adults living with HIV, with comorbidities such as hypertension and hypercholesterolemia, and risk factors such as advancing age and an extended use of ART, have an increased the risk of developing various types of hearing loss. Conclusion: Current findings highlight the importance of preventive tailored care for adults living with HIV. The study indicated that middle ear pathologies and hearing loss are high in adults living with HIV. The development of these pathologies is associated with comorbidities and other risk factors. Wideband absorbance measures appear to offer promise as a diagnostic measure for middle ear pathologies in this population. However, wideband absorbance must be used in conjunction with other middle ear measures such as video otoscopy to improve early identification and intervention of middle ear pathologies. While this study indicates that middle ear pathologies are common in adults living with HIV, the patterns of wideband absorbance suggest that middle ear function in this population may not be different to HIV negative control group. Findings of this study also highlighted the importance of training facilitators to capture quality video otoscopic images that can be used for tele practice in a South African context where demand versus capacity challenges exist in as far as ear and hearing care healthcare practitioners are concerned. Finally, this study raises implication for resource distribution, ensuring that accurate measures such as wideband absorbance measures are available in clinical setting, which will improve early identification and intervention in adults living with HIV.Item Men’s responses to the #menaretrash movement on Reddit: a social constructionist and psychoanalytic analysis(University of the Witwatersrand, Johannesburg, 2022) Stroucken, Paige AlexandraGender-based violence (GBV) has been declared a global pandemic by the United Nations and has been linked to traditional gender roles and societal pressure to achieve certain masculinities. The necessity of including men in conversations around gender and GBV interventions has been highlighted, however, there is limited research on men’s responses to GBV or to protests against GBV. This study aimed to contribute to the inclusion of men in GBV conversations by focusing on men’s responses to a particular online protest movement, #MenAreTrash (#MAT). This movement began in South Africa in 2016/17 in response to violence against women and was adopted by women across the world as a means to express anger toward broader gender discrimination, violence and gender power imbalances. This study examined men’s responses to the #MAT movement on Reddit (a free online social media platform). In particular, these men’s constructions of masculinity, women, and the #MAT movement were examined. Subreddits threads and posts (including comments) using the hashtag from January 2019 to January 2021 were analysed. An interpretive thematic analysis that utilized psychodynamic and social constructionist frameworks was conducted, which allowed for both intrapsychic and social aspects of responses to be explored. This study found that the predominant emotion displayed by men in the threads was anger, in response to feeling threatened. However, underlying this anger was anxiety. Anxiety was understood as an underlying response to feeling the need to defend their masculinity. Masculinity was constructed in two ways: as either unfairly under attack or needing to change. Some men felt that the good parts of masculinity were being ignored. Other men viewed masculinity as capable of being more responsive and adaptive to female causes. However, within these two constructions the complex nature of masculinity emerged, within which there were shifting positions of agency and victimhood. Men in the study constructed all women who support the #MAT movement as feminists, however, splits in this construction were also evident: women were either ‘reasonable feminists’ who demonstrate less combative support of the movement, or ‘radical feminists’, who aim to annihilate and alienate men. Overall, #MAT was constructed as damaging and stereotyping. However, a small number of men viewed the movement as helpful and necessary in generating awareness of GBV.