3. Electronic Theses and Dissertations (ETDs) - All submissions
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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.Item Trauma in the South African Police force : personality and coping as risk factors for developing post-traumatic stress disorder.(2014-07-03) Waterston, DanielleThe South African service (SAPS) has a reputation for being resilient despite the amounts of trauma they are exposed to. Research has shown that this occupation is one of the most stressful. However, research surrounding the SAPS suggests that police work is one of society’s most stressful occupations. The way in which individuals respond to such traumatisations is dependent on numerous factors, two being personality and coping. In so far, this study investigated three main areas around police reservists – a unit within the SAPS - in order to understand their responses to trauma: whether personality factors were related to post-traumatic stress symptomatology (PTSS) in the police reservist population; whether coping moderated the relationship between personality factors and PTSS; whether a personality factors predict coping style. A quantitative analysis was conducted among a sample of 36 reservists in the Gauteng area of South Africa. This study found that the relationship between Neuroticism and PTSS is mediated by coping, specifically Emotion-Focused and Dysfunctional Coping styles. A relationship between Conscientiousness and PTSS showed to be prevalent, however this is not due to the mediation affect of coping. Furthermore, Neuroticism and Extraversion showed to predict coping style. Specifically, Neuroticism showed to affect EFC and DC and Extraversion showed to affect EFC. The descriptive statistics showed that this sample of police reservists is suffering from PTSD. Implications of these findings are discussed and directions for future research are explored.Item Managing incidents of domestic violence: lay trauma counselors' perspectives on implementing trauma intervention strategies(2014-04-02) Smith, Eulinda V.Domestic violence is rife in South Africa and the negative impact thereof is brought by survivors into their homes, communities and workplace settings. Trauma counsellors often take on the work responsibility of intervening in cases of domestic violence to meet the needs of the survivor. Adopting a qualitative research design, the researcher explored the perceptions of trauma counsellors in their workplace setting regarding intervention strategies used when providing services to survivors of domestic violence. Purposive sampling was used to identify 13 adult lay trauma counsellors, both male and female employed by a non-government institution operating as a 24-7 hour Crisis Hotline in the Johannesburg Metropolitan area. The researcher gathered data by conducting personal, semi-structured interviews with research participants. Data analysis took the form of Thematic Content Analysis. The researcher identified that the participants seemed not to be aware of workplace systems and procedural guidelines, and tended to adopt a personalized approach in dealing with survivors of domestic violence. Most participants managed cases utilising ‘early crisis intervention models’ as a once-off trauma intervention strategy although they did not perceive it as being effective. It is thus recommended that such stand-alone intervention strategies should not be implemented unless further follow-up or after-care support is offered to the survivors of domestic violence.Item Cognitive vulnerability as a predictor of alcohol misuse and posttraumatic stress in trauma-exposed university students.(2013-04-04) Webster, VictoriaCognitive vulnerabilities have been implicated in the development of post-traumatic stress disorder and alcohol use disorders, two disorders that commonly co-occur. The comorbidity of these two disorders continues to pose a significant threat to the well being of university students. This study investigated the associations between the cognitive vulnerability of negative attributional style and both post-traumatic stress symptoms and alcohol use patterns. The number of reported traumatic events were also included in analyses. A battery of self-report questionnaires was completed by 123 university undergraduate students (mean age of 20.41 years). Negative attributional style was found to be significantly associated with post-traumatic stress symptoms, but not with alcohol use. It was also suggested that multiple traumas have an impact on post-traumatic stress, despite levels of alcohol use. These results suggested that the cognitive vulnerability of negative attributional style is predictive of posttraumatic stress in students and research in this area is valuable for increasing resilience, prevention and recovery among trauma survivors. Recommendations for future research, especially concerning multiple traumatisation is discussed.Item Investigating constructions of masculinity in men's talk of male rape.(2010-05-28T10:18:39Z) Field, Shelley AnneThe research investigated how men perceive constructions of masculinity in the talk of male rape. Research on gender relations and masculinities is a growing area of interest. The topic of male rape however, remains underrepresented within this. Male rape draws on discourses of gender, trauma, sex, sexuality and violence. It further offers a controversial topic that participants could engage in to further make sense of the multitude of masculine identities that exist, and how these directly influence responses to gendered phenomena. It is therefore likely to elicit significant constructions of masculinities and hence was used as a vehicle to further add insight into the constructed nature of masculinities. This was achieved through the use of a group of thirteen men who were divided into three focus groups. Each focus group made use of a vignette and a semi-structured interview schedule. Through this method the masculine identities that arose in their talk on male rape were examined. Data were analysed using thematic content analysis in which a social constructionist perspective was applied. It was found that participants strongly adhered to a hegemonic masculine point of reference in discussions. The patriarchal nature of this masculine identity that is subordinating of both women and other masculine identities was consistently used in discussions, thus representing the relatively stable influence of hegemony in gendered relations. Subordinated masculinities emerged more subtly, illustrating a growing acceptance of multiple forms of masculine identities. The results were understood as largely representative of broader society that still elevates the constructed standards of hegemony in conceptualising masculinities. This study thus sheds light on the social constructionist nature evident in society that continually influences the connotations attached to gendered identities within it. The significance in considering the masculine influences in responding to male rape lies in the multiplicity of factors that each involves as these collectively shape society's continued gendered understanding in shaping reality. A topic such as male rape, that directly threatens constructed notions of masculinities, thus allows for a new understanding to emerge in its consideration of the masculine identities that arise in responding to this traumatic experience.Item Johnny Golightly comes home(2009-02-26T11:39:07Z) Hopkins, Patrick MarkAbstract Johnny Golightly Comes Home is a nonfiction novel about the writing of two books by Pat Hopkins. In particular it is an account of the author’s often troubled interaction with artist John Anthony Boerma, who once took on the persona of Johnny Golightly after reading Truman Capote’s Breakfast at Tiffany’s. It is a story about illusion and fantasy in the creation of a work of conceptual art. As the lies are stripped away, so a new character emerges – that of Johnny Gochristly, the messiah sent to take away the parameters of the world. And in this latter-day passion play the unwitting writer has the role of Judas. The accompanying reflexive essay reviews the themes as they appear in the book – especially those of epiphany brought on by trauma, which leads to a divine mission often associated with extreme eccentricity. It concludes with a section on the writing process.Item The role of the emergency nurse within the prehospital environment and the emergency room(2006-11-16T07:52:17Z) Gassiep, JasminCurrently the role of the Emergency Nurse in South Africa is not clearly defined. Nursing legislation does not effectively guide these nurses to enable them to cope with the high expectations and increasing demands for emergency care. Nor does it provide adequate legislative protection especially with regard to the responsibilities within the prehospital environment. This creates role confusion and conflict, which has a negative impact on the patient who requires emergency care, the advanced nurse practitioner and the emergency team. . The purpose of this research was to explore and describe the role of the South African emergency nurse in the prehospital environment and the emergency room and to formulate an instrument that can be used for policy formation, education, training and evaluation. The purpose was addressed though an action research process where data was collected in four phases that included both qualitative and quantitative methods. The process involved a group of experts who utilized their expert knowledge, skills and attitudes to explore and describe the phenomena being researched. They confirmed that the environment in which emergency nurses worked included the pre-hospital environment and emergency room. The data/roles identified and analysed were weighted to provide a weighting scale by means of a methodology referred to as “ Modelling of Human Judgement”. A competency rating was done to provide a three-point competency rating. The data/roles obtained was developed into a questionnaire and sent to the rest of the emergency nurse population for validation and verification. After validation and verification the information gathered was reduced, organized and with the assistance of a statistician (throughout all the phases) the data was analysed and an instrument developed for use as a policy framework for e.g. a scope of practice and unit standards. The instrument was quantified for educational and evaluation purposes. The instruments can be used to develop high levels of competency to encourage interdependent and autonomous decision-making, which is based on the knowledge of role expectations and sound professional decision making, which in turn is supported by appropriate legislation.