3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item Perceptions of caregivers on their role in stimulating child development in a low socio-economic community(2019) Kometsi, MalikomoThe research was conducted in a low-socio economic community. The population of the study was the primary caregivers of the children aged three to five that were enrolled at the Early Childhood Development (ECD) Centre which was poorly resourced. Play is the primary occupation in childhood, and the means through which children learn and develop. The situational circumstances in the community and the lack of resources at the ECD centre had prohibited these children from engagement in occupations of meaning. These children were occupationally deprived, thus could not reach their full developmental potential. The study aimed to explore the perceptions of primary caregivers on their roles in the stimulation of normal milestone development for their children as preschoolers in local ECD centre in a low socio-economic status community. The research purpose was to break the negative cycle of occupational deprivation through active involvement of the caregivers. It was therefore vital to understand the caregivers’ involvement and their own perceptions regarding stimulation of developmental milestones so as to meet them where they are in the development of context specific interventions for prevention of developmental delays. The methodology used was qualitative research and the design a descriptive study. Methods of data collection were semi-structured interviews with 10 primary caregivers and the ECD practitioner. The interviews were done in the caregivers’ home language of Setswana and transcribed in Setswana. The interviews were analysed through thematic data analysis, originally in Setswana. The themes and selected codes were translated into English. Three themes emerged which included the caregivers’ perception of their role in stimulation, facilitators and barriers for stimulation and lastly how the caregivers perceived their involvement in the ECD centre where their children were enrolled. The caregivers expressed their willingness to stimulate their children, but the unavailability of educational resources came as a barrier. With regards to their involvement in the ECD centre, they expressed their dissatisfaction over the non nutritious menu served daily as a well as lack of comfortable bedding. The lack of communication between the caregivers and ECD practitioner regarding progress of the children, was the biggest concern for both parties. The ECD practitioner and the caregivers mutually found the meeting as a starting point to discuss matters of concern. Caregiver involvement would be improved through collaboration with the occupational therapist for context specific interventions.Item The experiences of primary caregivers of cancer patients admitted to a hospice(2018) Ketlogetswe, Tinalipi SophinahDesign and Methods A qualitative descriptive design was used for this study and conducted 22 in-depth interviews purposively selected. Sample size was determined by data saturation and qualitative content analysis was used to analyse the data. The inclusion criteria were 18 years and older, ability to speak basic English, identified by the patient as the primary caregiver and willingness to participate. Findings: Participants had different relationships with the sick person; however, caring for a sick mother was the most common. Three themes arose from the data: emotional responses towards the care giver role, personal cost of care giving and spiritual issues relating to care giving. Caring for a person with cancer in the last phase of life was not easy. Participants were overwhelmed by the care responsibilities. Some could not cope with the new role as they were emotionally distressed. Participants were financial burdened by the care needs of the patients; care giving was costly while others sacrificed their source of income to provide care. Most participants used religious practices to cope with their situation. Conclusion: Caring for cancer patients at the last phase of life was not an easy task. Participants were overwhelmed by the responsibilities and demands of caregiving. Most participants were emotionally exhausted and drained and feeling inadequate to perform these responsibilities. The financial burden was related to the care needs of the sick person. The caring role lead to some participants losing their jobs to provide care to their sick loved one.Item Impact of caregiver burden in paediatric epilepsy at Charlotte Maxeke Johannesburg Academic Hospital, South Africa(2018) Sabo, Umar AbbaBackground: Chronic health conditions such as epilepsy may impose a high level of stress on the caregivers. The burden of epilepsy can cause significant dysfunction in the affected families resulting in a negative impact on the child’s adaptation to the disease. This study seeks to evaluate the effects of caregiver burden on the health-related quality of life (HRQOL) of the caregivers and their family functioning as well as factors associated with high impact of the caregiver burden. Methods: The participants consisted of primary caregivers who were involved in childcare for at least six months before study onset. Informed consent was obtained. One hundred and nine eligible caregivers recruited over a three months’ period completed questionnaires providing information on their socio-demographic and epilepsy-related variables as well as paediatric quality of life (PedsQL) family impact module. High impact on HRQOL/ Family functioning was defined by Score below the inter-quartile range. Results: The median HRQOL score of the caregivers was 46.3 (IQR = 31.3, 67.5) while the median family functioning score was 46.9 (IQR = 31.3, 71.9). In participants categorized with high impact, raw scores ≤ 31.3 were obtained for both caregiver burden and family functioning. The family functioning score correlated strongly with the HRQOL score of the caretakers, ρ = 0.78 and p<0.001. Multivariate analysis identified lower caregiver education level and a high seizure frequency as independent predictor of high impact of caregiver burden after adjusting for age of the caregivers and the number of anti-epileptic drugs taken. Conclusion: The burden of caregiving for children with epilepsy in Johannesburg impacts negatively on family functioning. The burden of care was associated with high seizure frequency and lower level of caregiver education.Item Knowledge, attitude and practices of caregivers (KAP) on management of childhood diarrhoes amond children aged between 0-5 years attending child welfare clinic (CWC) in Mogoditshane Village, Botswana(2018) Mosweu, Gofaone JessicaBackground: Diarrheoa continues to plague on Botswana children, resulting in high mortality of children below five years. In 2015 childhood diarrheoa accounted for 6 percent of deaths of children in Botswana. Good knowledge, attitude and practices of caregivers is pivotal to protection, prevention and treatment of childhood diarrhoea, hence reduce mortality thereof. Study aim: The aim of the study was to determine the level of Knowledge, Attitudes and Practices (KAP) of caregivers on management of childhood diarrhoea among children between 0 to 5 years attending childwelfare clinics in Mogoditshane village, Botswana. Methodiology: A cross-sectional survey with a convenience sampling was used to select participants. A structured questionaire was used to collect data from 84 respondants regarding demography, knowledge, attitudes and practices on management of dirrhoea in children. Data was analyzed using Epi Info software. Descriptive statistis included measures and frequency tabulations and and inferential statistics included cross-tabulations to investigate statistical associations with KAP were used for analysis. Multiple logistic regression models were used to determine factors associated with KAP. Results: The study found inadequate KAP among caregivers that was significantly associated with gender and level of education. Gender was significantly associatedwith level of knowledge (p<0.001) and level of practice (p= 0.04) while level of caregivers education was significant with level of attitude. (p= 0.015). There was no statistical significant relationship found between KAP variables. Practice and knowledge (p-value close to 1), practice and attitude (p=0.70), attitude and knowledge (p=0.66). Mean age was 30 years (SD=8.38). 26 (32%) had good knowledge and 58 (68%) had moderate knowledge. The mean score of respondents’ attitudes was 14.33 (SD= 3,178) with 36 (43%) having good attitudes towards the prevention and treatment of diarrhoea while 48 (57%) had poor attitudes. 28(57%) of caregivers had good practices and (71%) had poor practices. Conclusion: Existing public health programs targeting prevention of diarrhoea and dehydration should consider gender, level of education, perceptions and beliefs of caregivers when planning for interventions.Item Prevalence of Disability in a Cohort of HIV-Infected children attending an urban paediatric HIV Clinic in Johannesburg, South Africa(2018) Brassell, Shane (Nee Hodges)Background: With the success of evolving antiretroviral therapy (ART), human immunodeficiency virus (HIV) has become a chronic condition, however, children infected with HIV have been shown to have developmental difficulties and disabilities. This study aimed to investigate the extent of disability among a cohort of HIV infected children in South Africa and whether they are being referred and accessing rehabilitative services. Methods: A cross-sectional study was conducted at an HIV clinic in Johannesburg. Caregivers/parents were interviewed about their child, using the Ten Question Screen for Disability Questionnaire (TQSD) along with a general additional questionnaire devised by the researchers on medical history, services referred to and accessed and socioeconomic status (SES). Clinical data, from the child’s clinic file were recorded. Results Of the 200 children whose caregivers/parents were interviewed, 50.5% experienced disabilities were 58.4% of those had more than one co-existing disability. Of the children who reported disability only 46% had been referred to one or more of the following support services; audiologist, physiotherapist (PT), psychologist, occupational therapist (OT) and/or speech and language therapist (SLT). Previous diagnosis of tuberculosis (TB), lower respiratory tract infections (LRTI) and low pre-combination ART (cART) CD4% were found to be associated factors in the presence of developmental disability and/or delay. Conclusion The prevalence of children with HIV and disability is high and these children are not being referred to and/or accessing the appropriate support services. Government policy and clinic practice need to shift their focus of management of children living with HIV, in order to integrate services that can assist children reach their developmental potential and improve their quality-of-life.Item Primary care givers experience of taking care of children with intellectual disability in Mpumalanga Province, Bushbuckridge region(2017) Dibakoane, Kgahliso AntoinethIn South African communities, especially rural societies, people have little or no knowledge about intellectual disabilities (ID), their causes and how they affect specific individuals. Societies which are governed by cultural and religious norms have different perspectives with regards to ID, which can result in different experiences because of fear and/or negative attitudes towards a particular phenomenon frequently caused by a lack of information. In most societies, the key focus is on the child who is intellectually impaired in terms of his/her psychological wellbeing and little consideration is given to the wellbeing of the caregiver. This study aimed to explore the lived experiences of caregivers of intellectually impaired children in Mpumalanga Province, Bushbuckridge region taking into consideration the multiple factors which are involved when caring for children with intellectual disabilities. The study therefore aimed at discovering primary caregivers’ experiences, how they react to such experiences, as well as whether culture has an impact in the understanding of intellectual disabilities and attitudes towards individuals with intellectual disabilities. This study was qualitative utilising a phenomenological research design and interpretive phenomenological analysis to analyse the data collected. A purposive sample of nine primary caregivers whose children attended a special school in Bushbuckridge was interviewed. The primary caregivers were all females between 31 and 77 years of age. Only one primary caregiver had higher education and the other eight participants either did not have any basic education or did not complete matric. Semi-structured interviews which consisted of 22 questions about the demographic information of both caregiver and child, background, knowledge/awareness of intellectual disability as well as the psychological well-being of primary caregivers were conducted. Most caregivers indicated that they had experienced or are still experiencing psychological strain due to caring for a child with an intellectual disability. Despite this, some found the experiences fulfilling rather than a burden. The majority of primary caregivers had no knowledge of the appropriate professionals to consult who could help their children and themselves. The caregivers had very little knowledge about intellectual disabilities and their meaning in their different cultures. Most participants emphasised religion as some took their children to church for healing and some regarded their children as gifts from God. Participants reflected about the silence around ID in their communities. All participants mentioned their uncertainties with regard to their children’s education and their lives indicating that they would be open to help and guidance with this. Primary caregivers also expressed their financial strains. Overall, the study indicated that ID awareness in the rural areas must be conducted in terms of education and to support primary caregivers of children with ID.Item Parents'/caregivers' and rehabilitation professionals' perspectives of occupational performance of children with cerebral palsy: a comparative study(2017) Chigonda, BeniginerThe study sought to compare the caregivers’ evaluation of the occupational performance and assistance needed by children with cerebral palsy (CP) to that of treating therapists to ascertain agreement about the children’s strengths/weaknesses so goals for intervention can be set. The Paediatric Evaluation of Disability Inventory (PEDI) parent/caregiver and therapist scores of 50 children with CP in Harare aged four to six and half years were analysed. The association between PEDI scores and the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) levels as well as the internal consistency of the PEDI for this sample were also determined. Correlations for the caregivers’ and therapists’ scores on the PEDI were strong to excellent. A marked decrease in functional skills on the PEDI was noted in relation to the GMFCS and MACS levels with a negative moderate correlation between the PEDI scores and the GMFCS levels for self care, a negative strong correlation for mobility but a negative weak correlation for social function. The similarity of scores indicates positive correlation that allows for collaborative goal setting and Family Centred Therapy with these children. Internal consistency was excellent for all functional skills domains and caregiver assistance.Item Exploring and describing experiences and needs of family members/significant others of male forensic patients in a specialist psychiatric hospital(2016) Pule, BashuFamily and caregivers play a vital role in providing support, care and assistance to forensic mental healthcare users. Family members of the forensic mental healthcare users often find their caregiving role stressful and suffer from significant stress and experience high levels of caregiver burden. Forensic patients need physical and emotional support from their family members to help them cope in the hospital, but the needs of those family members are often neglected when caring for the forensic patients in South Africa. The objective of the study was to explore and describe the experiences and needs of family members/significant others of male forensic mental healthcare users in a specialist psychiatric hospital, and to recommend guidelines for the Psychiatric nurses to assist families of the forensic mental healthcare users to manage their stressful experiences. A qualitative, exploratory, descriptive and contextual design was followed to achieve the aim and objectives of the study. Purposive sampling was used for sample selection. Two open-ended questions were asked in a semi-structured interview. The audio taped interviews were transcribed verbatim and analysed using thematic content analysis Themes emerging were poor parental expectation, strained relationship with others, and the emotional and financial impact of caregiving. The families experienced emotional distress and lack of support by other family members as well as self-blame and strained relationships. These findings highlighted the need for inventions such as support groups and psycho-education for psychiatric nurses as well as families of forensic patients. The findings are to be used to guide professional development, counselling and family therapy sessions that would assist the family members and also caregivers of the forensic patients to cope. Key words: Experiences, Needs, Families, Forensic MHCU, Specialist Hospital.Item The influence of the Malamulele onward intervention model on caregivers of children with cerebral palsy(2016) Adan, Marilyn JeanAim This study utilised data collected during focus group discussions with caregivers of children with cerebral palsy in the Mnquma sub-district of the Eastern Cape that were conducted as part of a much larger, longitudinal study into the use of the Malamulele Onward Intervention Approach. This Approach provides intensive therapeutic intervention for children with cerebral palsy who live in poor rural areas in South Africa as well as education and home programme training for their caregivers. Method This study explored the influence of the Approach on the caregivers’ lives whose children attended the cerebral palsy clinics at the Butterworth and Tafalofefe Hospitals. The focus group discussions took place after the initial assessment of the children in 2007 and during follow-up visits in 2008, 2009 and 2010. The participants included IsiXhosa-speaking primary caregivers (N = 21, 16 mothers and 5 grandmothers). The discussions were audiotaped, transcribed and translated from IsiXhosa to English by professional translators and the content was analysed using thematic coding techniques. Findings Five main themes emerged related to the open ended questions posed to participants, namely ‘validation’, ‘empowerment’, ‘wellbeing’, ‘faith and hope’ and ‘stress and strain’. They revealed positive feedback on the Malamulele Onward programme and indicated that participation was worthwhile. Information on cerebral vi palsy proved useful and techniques learned and special equipment provided resulted in improvement in their children. Conclusions In general, the caregivers of children with cerebral palsy in this study reported a reduction in burden of care, improvement in psychological status and social support with enhanced quality of life overall.Item The experiences of primary caregivers caring for children with physical disabilities in Hardap region of Namibia(2016-07-28) Ndadzungira, AllanChild disability has not been addressed holistically in Namibia. The absence of policies and programmes has exacerbated the challenges faced by primary caregivers and children with physical disabilities. There is paucity of literature on the experiences faced by the caregivers of children with physical disabilities. The aim of this study was to explore the experiences of primary caregivers of children with physical disabilities in Hardap region, Namibia. The study population consisted of primary caregivers of children with physical disabilities from Hardap region and purposive sampling was used to select 20 participants. A qualitative research approach was used to collect data using a semi-structured interview schedule. The study was descriptive and exploratory in nature. The study was based on a case study of Hardap region, Namibia where it sought to bring an understanding of complex issues to add strength to what is already known through previous researches. Thematic content analysis was used to analyse the data. The study revealed that participants played important roles in providing care as they were involved in feeding, carrying, turning and lifting of the children as well as taking the children for medical check-ups. The study also revealed that participants experienced challenges in the care continuum which included carrying the children around due to lack of special equipment, financial challenges and lack of psychosocial support from the family. The study also noted that the participants used religion as a means of coping for their wellbeing. The Government of Namibia needs to set policies on disability issues to ensure the wellbeing of the primary caregivers. The caregivers need training that will help them to improve the quality of care offered to children with physical disabilities as well as improve the psychosocial functioning of the primary caregivers. It is thus anticipated that the results of the study will help in designing interventions that will help the primary caregivers and reduce their burdens. The study will also contribute to knowledge on disability and caregiving