School of Human and Community Development (ETDs)

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Subject: search.filters.subject.SDG-3: Good health and well-being

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    Developing a management framework for predicting adherence to HIV care and treatment in Eswatini
    (University of the Witwatersrand, Johannesburg, 2024) Mango, Thabiso; Kasese-Hara, Mambwe; Mulaudzi, Mamakiri
    The primary objective of this research was to develop a management framework for predicting adherence to HIV care and treatment in Eswatini. To achieve this goal, the study delved into the comprehension of adherence to HIV care and treatment among people living with HIV/AIDS (PLHIV); identified psychological factors influencing adherence to HIV care and treatment; evaluated Theory of Planned Behavior (TPB)- based indicators to assess their effectiveness in predicting adherence behaviour to HIV care and treatment before commencing antiretroviral therapy (ART); and validated the applicability of the TPB in predicting adherence to HIV care and treatment. The study employed a sequential exploratory mixed methods approach in its research methodology. An initial qualitative study was conducted to explore the adherence beliefs of newly diagnosed PLHIV towards HIV care and treatment. The process involved gathering qualitative data on the beliefs of 19 recently diagnosed HIV-positive patients from a local HIV Clinic in Manzini, Eswatini. A thematic analysis revealed 226 beliefs, which were then condensed into 45 themes to establish the final set of significant beliefs categorised under TPB precursors: behavioural outcomes, subjective standards, and perceived behavioural control. The results of this qualitative study played a crucial role when constructing the TPB questionnaire, as the data gathered from the study were used as variables in creating the questionnaire. The TPB questionnaire, derived from the qualitative research, was distributed to 152 participants as part of the main quantitative study. This investigation unveiled the complex interplay between individuals' perceptions of social norms, attitudes, and perceived behavioural control in shaping their adherence to HIV care and treatment. While the opinions of influential figures in participants' lives were significant, the study found that participants' personal beliefs and attitudes towards adherence had a more substantial influence. During a span of 12 months, the 152 participants were closely observed, and their adherence to HIV care and treatment was assessed at baseline and endline points to evaluate the predictive validity of the TPB measure. The analysis of the collected data revealed that, despite participants appearing to adhere to their medication regimen iv based on clinic visits and self-reported pill usage, their viral loads remained detectable. This study underscored the drawbacks of solely relying on self-reported data and emphasized the necessity of employing alternative approaches to accurately assess levels of adherence. The study revealed limitations in the application of the TPB in addressing adherence to HIV care and treatment in developing nations with socioeconomic challenges. The original TPB model mainly concentrates on predicting and explaining behavioural intentions but overlooks the objective evaluation of the observed behaviour. When assessing adherence to HIV treatment, it is crucial to analyse the effectiveness of the behaviour being observed to identify the elements that lead to good adherence. This research suggests expanding the existing TPB model to overcome its limitations by including factors other than observable behaviour. A conceptual management framework for HIV care and treatment based on the TPB was developed to overcome the shortcomings of the TPB in predicting adherence to HIV care and treatment in underdeveloped countries. Four crucial additions were incorporated: (1) an enhanced behavioural intention (2) developmental challenges driven by socio-economic factors (3) subjective confirmation regarding the behavioural action, and (4) behavioural validation of the behavioural action. In addition to various aspects, it recommended that the conceptual framework developed by this study to manage HIV/AIDS care and treatment based on the TPB should undergo a validation process before its implementation with the aim of validating its effectiveness.
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    The Experiences of Black Female Postgraduate Students With Mental Health During The Covid-19 Pandemic, 2019-2021, The Case of Witwatersrand University
    (University of the Witwatersrand, Johannesburg, 2024) Mashiane, Sphiwe; Bala, Samkelo
    The COVID-19 global pandemic has compelled institutions of higher education to transition to emergency remote learning, leading many postgraduate students, both nationally and internationally, to begin their studies online. Research has shown the need for universities to support the transition from undergraduate to postgraduate as this is a major transition into academia. Research has also revealed that the struggle with mental health has increased with this transition and additionally with the COVID-19 pandemic, however, there is a lack of research investigating the experiences of Black females in the academic space and their experiences with mental health. Thus, this study aims to understand the experiences of Black female postgraduate students with mental health during the spread of COVID-19, 2019-2021. The research approach used for this study was the qualitative approach as it was the most appropriate in seeking to understand the experiences of a unique group such as a Black female postgraduate. A case study design was employed, and the experiences shared were explored through the lens of the intersectionality theory and the research was grounded by the interpretivist paradigm. The sample was drawn from the population of students from Witwatersrand University and the sample consisted of eight (8) participants. The method of data collection was computer-mediated interviews which were interpreted using a five-phase thematic analysis. The participants' responses revealed that although all eight participants experienced challenges with their mental health sharing symptoms associated with anxiety, stress, depression, and loneliness, only two participants used the psychosocial services offered by the university. The reasons for not seeking help from the university psychosocial services included fear of the unknown, services feeling unreachable, stigma and fear of not being assisted immediately. The most shared reason for not seeking help however was participants not perceiving the need to seek help. Participants, therefore, opted for coping mechanisms such as sleeping, partying, and using substances and most participants turned to their spirituality. The study, therefore, made recommendations for campus psychosocial services to employ more mental health practitioners such that there is education about mental health and the services offered.
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    Neurocognitive Rehabilitation for an Adolescent HIV Population: The Case of Sustained Attention
    (University of the Witwatersrand, Johannesburg, 2024) Zondo, Sizwe
    The Human Immunodeficiency Virus (HIV) continues to be a significant disease burden. In terms of neurocognitive health, HIV crosses the blood-brain barrier, resulting in neuronal dysregulation and compromised neurocognition. Of further import, antiretroviral drugs are indicated to have limited permeability in the central nervous system and do not reverse compromised neurocognition, sequent HIV neuroinvasion. The objectives of the study were to investigate the efficacy of HIV cognitive rehabilitation therapy (HIV-CRT) in adolescent HIV. The first aim was to investigate the evidence for the cognitive rehabilitation of HIV in adolescent and geriatric samples, sequent neuroHIV. This investigation resulted in the publication of a meta-analysis detailing the efficacy of attention remediation in neuroHIV. The second aim was to examine the efficacy of fNIRS neuroimaging in measuring hemodynamic responses in the prefrontal cortex in adolescents neuroHIV. This investigation resulted in the publication of an article detailing the efficacy of fNIRS in detailing changes in oxygenated haemoglobin in adolescents living with neuroHIV. The third aim was to pair fNIRS optical neuroimaging with behavioural data to investigate changes associated with brain training at a cortical and behavioural level. The execution of the above aim resulted in the publication of an article detailing the procedures and methods to achieve the enquiry. The fourth article, under review, details findings related to neural efficiency and attention training. The final manuscript, under preparation, details functional connectivity outcomes related to attention training. To enable the analysis of the published articles, an initial cohort of 42 adolescents (mean age = 17.28) living with HIV participated in the study. Following attrition, the sample was reduced to 26 participants. Thirteen participants were assigned to the treatment group (n = 13; mean age = 16; SD = 1.2), which received cognitive rehabilitation to remediate attention. Thirteen children acted as controls (mean age = 17; SD = 1.3). Pre- and post-intervention data were analysed using behavioural and optical imaging data. 5 Findings indicated that HIV-CRT (attention) is associated with decreased oxygenated haemoglobin (HbO) and increased functional connectivity in the Central Executive Network (CEN). Contrary to expectation, HIV-CRT was associated with minimal behavioural gains, as indicated by neuropsychological assessments. Taken together, findings seem to suggest that in adolescent neuroHIV, customised HIV-CRT promotes cortical efficiency. However, brain training does not translate to immediate behavioural improvements at post-assessment. Summarily, findings suggest that cortical plasticity may precede near-and-far cognitive transfer gain in adolescents neuroHIV.
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    Career adaptability, occupational identity, and psychologica well-being after a career change during the covid-19 pandemic
    (University of the Witwatersrand, Johannesburg, 2024) Kutu, Siyamthanda; Donald, Fiona
    OBJECTIVE: This study aims to explore the relationship between career adaptability, occupational identity, and Psychological Well-being at Work in South African employees who experienced career change during the COVID-19 pandemic. The study is framed within the Career Construction Theory where the pandemic is contextualised as a career shock. METHODS: Employing a quantitative approach, this study adopts a correlational, non-experimental, cross-sectional research design. Purposive sampling, including criterion-based and snowball sampling techniques, was utilized to recruit participants. The sample comprised 62 South African employees who experienced career changes between 2020 and 2022 due to the pandemic's impact on the labour market. Data w as collected through structured online questionnaires, incorporating validated scales. Ethical considerations were addressed, ensuring informed consent, confidentiality, and minimal harm to participants. RESULTS: Regression analysis revealed significant positive relationships between career adaptability, occupational identity, and Psychological Well-being at Work. Specifically, both career adaptability and occupational identity emerged as strong predictors of Psychological Well-being at Work among the participants. Descriptive statistics provided insights into the sample characteristics, indicating a diverse range of career change experiences during the pandemic. The study under scores the importance of fostering adaptability and building a robust occupational identity to enhance employees' psychological well-being amidst career transitions, particularly in times of crisis like COVID-19.
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    The perceptions of social workers on the implementation of the Occupation Specific Dispensation policy (OSD) within the Department of Social Development in the Johannesburg Region
    (University of the Witwatersrand, Johannesburg, 2020) Mathebula, Sipho Sol; Masinga, Poppy
    The Occupation Specific Dispensation (0SD) policy was introduced in the public service for social workers in 2009 as a strategy to recruit and retain social workers with the introduction of new salary scales, career pathing, pay and grade progression and recognition of appropriate experience. The perceptions of social workers on the implementation of the OSD policy have not been established and this lack of knowledge leaves a gap in understanding the perceived impact this policy has had on social workers. The aim of the study was to explore the perceptions of social workers on the implementation of the Occupation Specific Dispensation policy within the Department of Social Development in the Johannesburg Region. Since implementation of the policy, there has been research studies conducted on the outcomes of the OSD policy within the public health sector yet no studies have been conduct that focus on the challenges encountered by social workers in the implementation of the policy. The study utilised the qualitative research approach which was exploratory and descriptive in nature. The collective case study design was adopted. A sample of ten social workers and three key informants were selected using purposive sampling. Data was collected using semi-structured interviews and analysed using thematic content analysis. The key finding was that the OSD policy was not effective in recruitment since it is rigid and inflexible. Another concern raised was the long period it took to move from one occupational level to the next resulting in a demotivated and demoralised workforce. The study also found that there was management bias in the implementation of the performance management and development system. The study contributes to our understanding of the perceptions about the unintended consequences of the OSD policy and how these are perceived to have impacted negatively on the recruitment and retention of social workers.
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    Psychological Well-Being and South African Socio- Economic Stressors: The moderating role of Leaders creating Hope
    (University of the Witwatersrand, Johannesburg, 2024) Aysen, Savannah; Milner, Karen
    The current research study explored whether leaders creating hope in their employees moderates the relationship between South African socio-economic stressors and employee psychological well-being. Existing literature indicates that stressors have dire implications for the well-being of employees and that psychological capital is a meaningful resource to elevate deteriorating well-being (Slone et al., 1999; Charles et al., 2013). Moreover, research reveals the potential of leaders to create hope within their organisations which may aid in elevating deteriorating well-being levels (Yukl, 1998; Helland and Winston, 2005). Accordingly, this research aimed to explore whether leaders creating hope would moderate the relationship between South African socio-economic stressors and psychological well-being. This study utilised a quantitative non-experimental cross-sectional research design to explore the statistical relationships between South African socio-economic stressors, psychological well-being and leaders creating hope. Data was collected through an online self-report questionnaire (N=130). The questionnaire contained a self-developed demographic questionnaire, an adapted South African socio-economic stressors scale, the Psychological General Well-Being Index, and the adapted Leaders Creating Hope scale. Results of the study indicated that both South African socio-economic stressors and leaders creating hope were correlated with psychological well-being, and a multiple regression analysis revealed that both South African socio-economic stressors and leaders creating hope are predictors of psychological well-being within the sample. However, even though leaders creating hope was found to have a positive effect on psychological well-being it did not have a moderating effect on the relationship between South African socio-economic stressors and psychological well-being.
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    Exploring older adult narratives of living with a depressed parent
    (University of the Witwatersrand, Johannesburg, 2024) Dzenga, Rachel; Canham, Hugo
    Research on children of parents living with a mental illness is prevalent in developed countries and has shown that parental depression is linked to a higher risk of adverse outcomes for children. However, less research exists that focuses on older adult narratives, specifically regarding the lived experiences of growing up with a depressed parent. Therefore, this study provided a deeper exploration of older adults reflecting on their childhoods and highlighted the role that narrative hindsight has on the relationships between depressed parents and children. Exploring the narratives of people who grew up with a parent with a depressive disorder was the core interest of this study. Convenience and snowball sampling was used, and seven participants over the age of 60 years in South Africa were interviewed. Narrative theory was used as both a conceptual framework and a methodology, and narrative analysis was used to analyse data from the semi-structured interviews. The findings of the study suggest that the lived experiences of growing up with a depressed parent alter family dynamics and roles in the home, creating parentification in childhood, feelings of unpredictability, chaos, and uncertainty in the home environment. The role of narrative hindsight illuminated ambivalent feelings towards their depressed parents and revealed a significant influence on their own parenting decisions as adults, such as choosing not to have children. Beyond the immediate home environment, social factors such as stigma, institutionalisation and additional support arose as significant factors in the accounts of participants. The study explored the depth of the human experience in the participants’ ambivalence, meaning making, and social context growing up with a depressed parent. Interviewing older adults highlighted the significance of narrative hindsight and its role in understanding how temporality and nostalgia can illuminate the narrative arc between parent and child. Overall, the study illustrated the need for further research in South Africa on older adult narratives that could possibly enrich the knowledge of health practitioners, educators and researchers about the lived experiences of growing up with a depressed parent, assisting with family-based interventions based on a deeper understanding of the effects of parental mental illness over decades.
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    An investigation of the financial and psychological impact of COVID-19 on students at the University of the Witwatersrand, South Africa
    (University of the Witwatersrand, Johannesburg, 2024) Maepa, Pontsho; Ntshongwana, Zintle
    The 2019 Coronavirus (COVID-19) intensified poverty, hunger, and health problems while having severe effects on sustainability measures. People faced psychological and financial difficulties because of the financial hardship caused by the pandemic.This study explored the financial and psychological impact of the COVID-19 pandemic among students on students from the University of the Witwatersrand, South Africa. A case study design was employed in this investigation. Ten (10) full-time University of Witwatersrand students, ages 18 to 30, were chosen using a purposive sampling technique. Individual interviews using a semi-structured interview guide were used to gather the data. The study found that while some participants reported minimal financial impact and effective coping strategies, others faced challenges with accommodation deposits, National Student Financial Aid Scheme (NSFAS) delays, and psychological distress. The study identified a range of emotional responses, including anxiety and academic concerns. Moreover, the transition to online learning presented both benefits and drawbacks, influencing students' academic performance and engagement. The study recommends considering the financial implications of accommodation deposits, ensuring timely disbursement of NSFAS allowances, and emphasizing interactive elements in online learning. Acknowledging the psychological toll, universities are urged to enhance mental health support services. Future pandemic responses should prioritise maintaining a supportive residential environment for students.
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    Adverse Childhood Experiences and Psychological Resilience among HIV Positive Youth in South Africa
    (University of the Witwatersrand, Johannesburg, 2024) Sigoda, Nozipho; Patel, Ruby
    Research has revealed and highlighted the plight of HIV and its effects on individuals, their families and larger communities. Through a qualitative research approach, this study sought to explore the experiences of black South African Youth who are living with HIV and their exposure to Adverse Childhood experiences. Experiences of stigma, inequality and disparity were also explored. The research was largely informed by the resilience theory (Garmezy, 1978) which enabled the researcher to make sense of the participants’ experiences. The researcher then employed a non-probability purposive convenience sampling approach to recruit participants who were either born with HIV or contracted it while they were young. Interpretive Phenomenological Analysis (IPA) was then used to analyse the data that was derived from the semi-structured interviews conducted. Further, the use of IPA allowed the researcher to pay attention to the lived experiences of the participants. The themes extracted from this study suggest that children growing up with HIV in South Africa are often subjected to various adverse experiences that often challenge health and developmental outcomes. This is demonstrated by the dominant themes of navigating changes in identity, experiences of stigma, discrimination and marginalisation, exposure to poor socio-economic conditions and lastly resilience strategies employed to mitigate harm from the experiences.
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    The Psychosocial Impacts of COVID-19 on Children: A Parents’ Perspective
    (University of the Witwatersrand, Johannesburg, 2024) Macingwane, Nontokozo; Mathebula, Mpho
    The societal and psychological repercussions of the COVID-19 pandemic on children have become a crucial focus, necessitating thorough examination. Given the pandemic's disruptions in various aspects of children's lives, ranging from education to social interactions, a comprehensive investigation is vital to unravel the intricate impacts on their well-being and development. This Qualitative research delves into the psychological and social consequences of COVID-19 on children aged 6-17 in Gauteng, South Africa. Through semi-structured interviews with seven participants, including parents and guardians, the study aimed to discern the psychological and social effects of the pandemic on their children. Employing thematic analysis, six major themes were identified: Psychological and Emotional Impact, Fear and Anxiety, Adjustment to Changes in Routine and Social Contact, Changes in Everyday Functioning, Impact on Learning and Education, and Changes in Behaviour and Emotions Post-Lockdown. The thematic analysis uncovered a range of emotional responses among children during the COVID-19 pandemic, including loneliness due to extended indoor confinement and diverse expressions of fear and anxiety. Furthermore, the findings emphasized the challenges in adapting to changes in social contact and routine, disruptions in everyday functioning, and notable consequences on children's learning and education. The COVID-19 pandemic significantly impacted the psychological well-being and social functioning of children, underscoring the need for focused support to enhance their resilience and overall well- being. The findings highlight the importance of prioritizing social connections, adaptive coping mechanisms, effective reintegration into educational settings, and collaborative efforts among stakeholders to support children's psychological resilience and overall well-being during and after the crisis