3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item Depression and anxiety in HIV infected individuals attending HIV treatment facilities at various sites in South Africa: occurrence and related factors. A descriptive-analytic study(2009-05-08T12:08:31Z) Thom, RitaInternational literature, most of which originates from First-world countries where HIV predominantly affects socially marginalised minority populations, has well-described the burden of mental disorder, particularly depressive and anxiety disorders in HIV-infected individuals. The few studies conducted in developing countries show contradictory results. This study aimed to describe the occurrence of mental disorders; particularly depressive and anxiety disorders, in a population of HIV-infected individuals attending HIV-treatment sites in Gauteng and Mpumalanga in South Africa from November 2004 to November 2005. A cross-sectional descriptive-analytic study, it included a clinical diagnostic interview and a semi-structured interview to explore postulated risk and protective factors, including demographic, clinical and psychosocial variables, for depressive and anxiety disorders in HIV-infected individuals. Three hundred and two (302) individuals were interviewed at the Perinatal HIV Research Unit’s associated Wellness clinics and at the Chris Hani Baragwanath Hospital’s Nthabiseng HIV clinic. Just over thirty percent of participants had a current mental disorder and the lifetime prevalence of mental disorder was 40%. Almost 17% of participants had a current depressive disorder and almost 16% had a lifetime depressive disorder. The occurrence of major depressive disorder, current and lifetime, was 3.64% and 10.26% respectively. Sixty percent of participants with lifetime major depressive disorder had their first onset after diagnosis of HIV status. The occurrence of current and lifetime anxiety disorder was almost 4%. Substance use disorders were common, affecting 7.6% of the participants at time of interview. Lifetime prevalence of substance use disorders was 18.9%, suggesting that knowledge of HIV status or other interventions may have resulted in this significant decrease. Identified significant risk factors for depressive disorder included a history of a lifetime depressive disorder, moderate or severe psychosocial stress and feelings of isolation. Being in a support group was found to be a protective factor against depressive disorder. While the results in this study are conservative compared to those of other similar South African studies in HIV-infected individuals, there was a statistically significantly increased occurrence of depressive and anxiety disorders (combined) compared to general population prevalence studies of these disorders in South Africa. Ways of improving access to mental healthcare for HIV-infected individuals and the general population, are discussedItem 'It's just your imagination': Fantasy proneness and social anxiety(2008-05-30T13:19:42Z) Garda, Zureida TanyaSelf-imagery plays a significant role in the development and maintenance of social anxiety (Hirsch, Clark and Mathews, 2006a). As a feared social event is anticipated, negative self- images become activated and this increases the experience of anxiety (Hirsch & Holmes, 2007). These continue to be present during the social event and become reinforced by negative interpretations of self-performance as well as by the responses of others (Hirsch, Clark, Mathews & Williams, 2003). Mental imagery is a key characteristic of fantasy proneness where the ability to generate vivid imagery forms part of imaginational ability (Sanchez-Bernados & Avia, 2004). This study investigated the relationship between fantasy proneness and social anxiety. As anticipation of a feared event plays a pivotal role in social anxiety; the establishment of a positive relationship between fantasy proneness (imaginational ability) and social anxiety may shed light on the role that imagination and fantasy play in how a socially anxious person imagines a feared event, which then contributes to the experience of social anxiety. The implications of a relationship between these constructs may indicate the role which imaginational ability (fantasy proneness) could play in underlying and maintaining social anxiety. Two self-report measures (the Creative Experiences Questionnaire and the self-report version of the Liebowitz Social Anxiety Scale) were administered to a sample of 50 non-clinical participants; 38 females and 12 males, within the age range of 19 to 52 years old. Both scales have been found to have adequate psychometric properties internationally (Fresco, Coles, Heimberg, Liebowitz, Hami, Stein and Goetz, 2001; Merckelbach, Horselenberg & Muris, 2001). Whilst no psychometric information on the use of these scales in the South African context could be found, the results of this study will contribute to the use of these scales in South Africa. The results of these scales were statistically correlated revealing that, within the research design and methodology parameters of this study, a weak, but significant, positive, relationship was found between the constructs of fantasy proneness and social anxiety. The implication of this finding is that imagination, as a cognitive process, plays a role in social anxiety. Clinically this suggests that whilst imaginative processes play a role in underlying social anxiety, they can also be utilised adaptively in cognitively countering social anxiety in a treatment context.Item Work design, anxiety and depression: A call centre case study(2008-05-23T08:40:26Z) Mphuthi, Faith LeratoThis research study explores the possible relationships that may exist between the work design, level of anxiety and depression in South African call centres. By investigating the work design of a call centre and exploring its relationship to anxiety and depression will help to achieve this. Variables that will be looked at in this research study are work design, anxiety and depression. Our sample comprised of call centre agents. The agents were came from one inbound and one outbound call centre. It was then realized during the analysis of the data that there is no significant difference between the two call centres therefore the two samples were merged into one sample thus increasing our sample size to a total of 56 respondents. Pearson correlation analysis revealed that significant positive correlations exist between all the variables, work design, level of anxiety and depression. It was also proven that the higher the JCI score the lower the anxiety and depression levels. Additional correlation tests were conducted to see whether there is a relationship that exists between JCI subscales, anxiety and depression. Results showed that not all of the sub-scales of the JCI show a significant correlation with Anxiety and Depression. Only Autonomy and Feedback to some degree correlate with Anxiety (r = 0.38; p = 0.004 and r = 0.26; p = 0.053). Variety and Authority correlated significantly and positively with Depression (r=0.38; p = 0.004; and r = 0.32; p = 0.017). These results indicate good support for this research study, illustrating that the manner in which work is designed will have an effect in the anxiety and depression levels experienced by the employees.Item Death anxiety and the attitudes of nurses towards dying patients in a private acute care hospital(2006-11-10T12:17:38Z) Govender, MogavaniIn order for caregivers to be better able to work with dying patients, they need to confront their fears about their own mortality and explore their feelings about their personal and professional losses. The importance of death anxiety research rests on the premise that death is an eventuality that everyone faces and how health professionals, specifically, deal with death anxiety is of considerable relevance as to the quality of care given to the terminally ill patient. The purpose of this study was to identify, explore and describe nurses’ personal fear of death (death anxiety) and explore whether an association exists between death anxiety and their attitudes towards dying patients in a private acute care hospital in Johannesburg. A quantitative, descriptive correlational survey was conducted to examine the relationship between death anxiety and nurses’ attitudes toward terminally ill patients in a private acute care hospital in the province of Gauteng in South Africa. Various extraneous variables have been identified and defined. No attempt was made to control or manipulate the situation as it was currently occurring. The study population comprised of all nurses working in this hospital who fulfilled the stipulated selection criteria. Data were obtained from nurses through the use of a self-administered questionnaire. The response rate was 42% of the expected population. A total of 93 responses were received. Descriptive statistics were used to analyze data and the significance of the relationships between variables was determined using the Fishers exact test (p-value of 0.05). The findings of this study were consistent to that of similar studies. Findings suggest high levels of death anxiety within the study population with correlating negative death attitudes. This may be associated with the fact that a significant proportion of the study sample was younger and less experienced as opposed to those who demonstrated lower levels of death anxiety and positive death attitudes and were more experienced and older. v A strong association was found between death anxiety and death attitudes. Statistically significant relationships between age and length of nursing experience/exposure were found. No significant relationships between sex, institutional support, death anxiety and death attitudes were found. Of import, the need for ongoing terminal care education was identified in this study.