3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item Interventions which promote mental health among rescue workers: an integrative literature review(2024) Fitzsimons, JohnBackground: Rescue workers are at the forefront of humanitarian efforts during suddenonset disasters and remain a high-risk group for post-traumatic stress-related disorders. This is due to the nature of rescue work as well as the unique hazards inherent therein. This study endeavoured to identify and describe interventions which can bolster the mental health fortitude of rescue workers and lead to more rewarding work and better mental health outcomes. The mental health of workers is of concern for occupational health practitioners. Aim of study: To describe and synthesize interventions which positively impact the mental health and wellness of rescue workers. Design: The guiding framework by Whittemore and Knafl (2005), was used in conducting an integrative literature review. The study included the following 5 stages: problem identification, literature search, data evaluation, data analysis and presentation of findings. Method: Database searches were conducted in SCOPUS, PsycINFO, ProQuest, PubMed and EBSCOhost to identify studies in English including grey literature, from January 2010 to December 2019. A total of 241 papers were retrieved, with 74 of those being read in depth and 19 being selected based on the selection criteria. Results: Five themes were identified during this study. Commitment to humanity, The intrinsic nature of rescue work, Rescue workers are also the survivors of trauma, Health related quality of life, and Mental health support. Conclusion: A more proactive managerial involvement in the resourcing, training and support of rescue workers as well as a review of the policies surrounding their occupational conditions were factors which stood to potentially improve mental health outcomes. Occupational conditions included: length of shifts, the fostering of family and community support, and the integration and provision for leisure activities for their therapeutic benefit.Item Narratives on the frontline: a qualitative investigation of the lived experiences of healthcare workers during the COVID-19 pandemic in South Africa(2022) Kazadi, Angela Denyimi NyembueBackground: During the Coronavirus pandemic, a mental health pandemic emerged, with frontline healthcare workers’ arguably being the most affected. In South Africa, however, the sociohistorical background must be considered, as this virus poses a new threat to a country that has suffered a series of collective traumas. Aim: This study explored the qualitative, lived experiences of frontline healthcare workers in South Africa during the COVID-19 pandemic. Method: A lifeworld phenomenological framework was used in this study. Semi-structured interviews with 11 frontline healthcare workers were conducted as part of a broader study focused on the mental health of South African healthcare workers’ during COVID-19. The information gathered was analysed using the principles of reflexive thematic analysis. Results: This research showed that the lived experiences of frontline workers’ during the COVID-19 outbreak in South Africa are diverse and peppered with paradoxes. The findings revealed that working during COVID-19 is an emotional rollercoaster, that it is emotionally and mentally tiring, that there are concerns with the Department of Health and that COVID-19 has had a substantial influence on daily living. In addition, the data also demonstrate that the concept of a ‘front-line’ healthcare worker altered throughout the pandemic as a result of task shifting as healthcare personnel took on different responsibilities, moving them to the ‘frontline.’ Conclusion: This study adds to the body of knowledge about mental health and the working environment of health professionals during COVID-19. It also highlights the need to understand healthcare workers’ lived experience using qualitative methodologies, which has provided depth and new insights into the multiple realities of healthcare workers on the frontlineItem Counsellor's views of diversity and difference in an NGO counselling environment(2016) Reeves, Anne ElizabethThe topic of this research is lay counsellors’ attitudes towards difference in an NGO organization that offers a counselling service based on Carl Rogers’ Person-Centred approach. South Africa post-apartheid is a fragmented and traumatized society and attempts at redressing past inequities have largely overlooked the mental health care sector. As a result, NGO’s are increasingly having to fill the gap, with little co-ordination with or co-operation from professional mental health care practitioners. With critical race theory as a theoretical point of departure, Lacau and Mouffe’s discourse theory was used to analyze results from in-depth semi structured interviews with counsellors at an NGO in Johannesburg. The findings confirmed that counsellors’ attitudes towards difference are shaped by their and the client’s racialized identities, with the adherence to Rogerian principles and the need to be a ‘good’ counsellor, foreclosing any opportunity to critically examine subject positions and the role of history in how such positions are constructed. The introduction of a training component that includes historical analysis and courageous conversations about difference would better equip counsellors to carry the burden of complex presenting issues from a diverse clientele.Item Development-induced displacement and resettlement : a narrative inquiry into the experiences of community members physically displaced from a farm to a town in Mpumalanga, South Africa.(2014-09-17) Smithen, CaitlinAlthough expected to be beneficial to society, development projects, such as dam construction and mining, often result in the physical displacement of marginalized groups. This is known as Development-Induced Displacement and Resettlement (DIDR) and often has far-reaching negative consequences for the affected peoples (APS). These include further marginalization, increased poverty, identity deprivation and socio-psychological stress. While decades of knowledge inform theory and practice on the mitigation of these consequences, the psycho-socio-cultural (PSC) impoverishment that may result from DIDR is often left unaddressed. Furthermore, qualitative knowledge of the experiences of people affected by DIDR is lacking. This research study aimed to produce an in-depth understanding of how DIDR affects the PSC well-being and identity construction of APS. The research took the form of a qualitative case study, whereby a social constructionist, narrative method of inquiry was used to analyse and gather data. This involved undertaking in-depth, individual interviews with a small sample of APS who had been resettled from a farm to a town in Mpumalanga by a mining house. Briefly, it was found that, contrary to the prevalent finding that DIDR causes further impoverishment, the resettlement actually resulted in development for the APS and as such enhanced their PSC well-being and contributed positively to their identity construction. However, the complexity inherent in resettlement was highlighted, as the participants revealed that the resettlement had not come without some socio-economic costs. It is believed that the findings from this study will complement existing knowledge on DIDR, and inform the design and implementation of Relocation Action Plans (RAPs) that better mitigate the negative PSC effects of DIDR.Item Exploring the experience of community health workers operating in contexts where trauma and its exposure are continuous.(2014-08-22) Thomson, Kirsten JeanViolent and traumatic events are a regular occurrence in many South Africans’ lives. The term 'continuous traumatic stress’ was coined by South African anti-apartheid health professionals in the 1980’s to explain the continuous nature of violence and trauma happening within the country. Although the political agenda may have shifted, many South Africans are still living within a context in which violent and traumatic events regularly occur. However, little is known about how health workers respond to continuous trauma within the South African setting. The Community Health Workers - within this study - are part of the South African health model called ‘Primary Health Care Re-engineering’ that is currently being piloted. The research was exploratory in nature and used a mixed methods design. Twenty three Community Health Workers who participated in the study were from two sub-districts within the Ekurhuleni district, Gauteng, Johannesburg. The research included two face to face semi-structured individual interviews. The first included qualitative questions and completion of the quantitative Stressful Life Events Screening Questionnaire (1998) to explore past trauma experiences. Over a seven month period, the participants were asked to document traumatic event exposure and responses through the adapted Life Events Checklist (1995) and personal journaling. At the end of this period, participants were interviewed again to explore their current traumatic experiences. Qualitative data were analysed through thematic content analysis and quantitative data were used to substantiate information from the interviews and checklists. Results show that Community Health Workers – within this study - have a high prevalence of exposure to traumatic events (directly experiencing, witnessing and hearing about). Prominent events included physical and sexual assault, transport accidents, fires and explosions. Media played a powerful role in exposure to events. Traumatic and unexpected losses were key experiences that need to be considered when working with trauma in the South African context. Acknowledgement of experiences (peer and external) is an essential element in developing support structures. These findings – from the context of Ekurhuleni, South Africa - contribute to exploring and understanding the experience of ‘continuous traumatic stress’ for Community Health Workers.