4. Electronic Theses and Dissertations (ETDs) - Faculties submissions
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Item 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, SamkeloThe 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.Item Experience of bowel, bladder and sexual problems and the effectiveness of a health program on quality of life and mental health in people with spinal cord injury in Manguzi(University of the Witwatersrand, Johannesburg, 2023) Tomes, Lauren Meagan; Sonti PilusaBackground: The quality of life of people with spinal cord injury is significantly affected by secondary health conditions such as bowel, bladder, and sexual problems. Literature on the experiences of bowel, bladder, and sexual problems is limited and studies on health interventions in people with SCI are also scarce in South Africa. Aim: To explore the experience of bowel, bladder and sexual problems and the effectiveness of a health program on the quality of life and mental health, as well as to determine the effectiveness of a health program on the quality of life (QoL) and mental health of people with SCI in Manguzi, KwaZulu Natal. Method: This study was a mixed study. An explorative qualitative study design using semi structured interviews was employed. The interviews were transcribed verbatim, and content analysis was conducted to identify the themes and categories. A Quasi-Experimental quantitative design was used. A face-to-face health program on the prevention and management of bowel, bladder, and sexual problems in SCI was conducted for the participants with SCI. WHOQoL Bref and SF-12 questionnaires were administered before and six weeks post-intervention respectively. Paired t-test was used to identify changes in QOL and mental health pre and post intervention. Significance was set at p-value ≤ 0.05. Results: The themes that emerged from the experience of bladder and bowel problems were “no control” and “frustration”. The categories related to the experiences were: types of bladder and bowel problems, managing bladder and bowel problems and the effects on well-being: The main theme for the experience of sexual health problems was “Dissatisfaction”. The categories were: types of sexual health problems, factors influencing sexual activity, the impact of sexual problems, and the management of sexual health problems. The long-term care needs for bowel and bladder problems included access to proper toilets, nappies, medication (Dulcolax), ease of bowel movement, and health information on diet and how to manage their bowel and bladder problems better. The long-term care needs for sexual health problems included the need for medication (sexual enhancement pills) and information on how to manage sexual health problems. There were no statistically significant changes in the pre-test and post-test scores of both the quality of life and mental health.Item Child and Adolescent Mental Health in South Africa: Experiences of Black Psychologists(University of the Witwatersrand, Johannesburg, 2023-10) Seboka, Kanelo; Amod, ZaytoonThis study explored the experiences of Black psychologists working with children and adolescents within the South African context. The purpose of this investigation was to shed light on these experiences, whose insights could contribute to teaching and training as well as to policy developments in relation to child and adolescent mental health in this country. A descriptive qualitative approach was employed for this study. Individual, semi-structured interviews with ten Black psychologists who are registered with the Health Professions Council of South Africa (HPCSA) was the primary data collection method, analysed using thematic data analysis. Eight themes were identified: Perceptions of Psychology and Mental Health; Systemic Influence and Understanding; Parent/Caregiver Psychoeducation; Inter-Professional Collaboration; Professional Competence; The ‘Black Culture’ and Context; Indigenous Knowledge and Practices and Mental Health Resources and Policies in South Africa. Findings indicated the need for promotion of the following aspects: mental health psychoeducation to eliminate negative health-seeking behaviours, professional inter collaboration and overall child and adolescent mental health. Findings further indicated the need for more cultural diversity in psychology training programmes as well as the prioritisation of child and adolescent mental health in government policies. Based on this, it is recommended that schools/clinics be reliable sources of mental health information; inter-professional training that has cultural relevance be offered at tertiary level; and for promotive and intervention programmes to be implemented in schools as a form of psychosocial support for the learners, teachers and the broader community.Item The relationship between mental distress and somatization in hospital based health care workers in Gauteng during covid-19 pandemic in 2020(University of the Witwatersrand, Johannesburg, 2023) Ramuedi, Ntsako Khosa; Kerry Wilson, NiohBackground Mental distress among Health Care Workers (HCWs) is an urgent health concern, and somatization is a known outcome of mental distress. The Covid-19 pandemic increased stress for HCWs globally due to working with Covid-19 patients and resource limitations. Although there was already a lot of mental distress in HCWs in prior years, the coronavirus pandemic made matters worse, with 45% of people reporting that the pandemic had a significant negative impact on their lives. Somatization can lead to increased use of health services, sick leave and poor health. Service delivery is also impacted negatively if the service providers are not well or are suffering from the mental distress and are also showing symptoms. Aim To identify if a relationship exists between mental distress and somatization symptoms in Gauteng hospital-based health care workers in 2020. Objectives. To describe the prevalence of mental distress and somatization among health care workers by socio demographic status. To identify the somatization symptoms associated with high GHQ-12 scores in health care workers during Covid-19. To describe the association between mental distress and somatization among health care workers during covid-19 adjusting for demographic variables. Methods Health care workers can be described as anyone working in the health sector or at a health facility. All staff in the three selected hospital facilities in Johannesburg, were given the opportunity participate in the study. The PHQ-15 and GHQ-12 tools were used to collect information on HCWs somatization and mental distress after the first wave of the Covid-19 pandemic in South Africa. The anonymous questionnaire consisted of the two tools and demographic questions was used. The responses to each question on the tools were summed in order to determine severity of mental distress and somatization in HCWs, a higher score indicating more stress and or more somatization. Logistic regression was used to determine the adjusted relationship between somatization and mental distress. Results The study had a sample size of 295. A large proportion of participants (52%) reported suffering somatic symptoms. Males mean somatization score was significantly lower than the females. The majority (62%) of HCWs were troubled indicating a high burden of mental distress in the health care sector. The most commonly reported symptoms were back pain, headaches and being tired or low energy, all three were significantly associated with mental distress among others. There was a positive moderate correlation between PHQ-15 and GHQ-12 scores (0.30592) (p < 0.0001). Logistic regression indicated somatization was significantly associated with mental distress with a significant OR 2.14 (p = 0.0029) adjusted for demographic factors in these workers. Conclusions There was a statistically significant positive relationship between somatization and poor mental health. Health care workers with mental distress may be at risk of somatization, particularly specific symptoms such as back pain, headache and having low energy. Females were more bothered by most of the somatoform symptoms as compared to their male counterparts. Support for health care worker’s mental health is required as well as increased awareness of somatization linked to mental distress. Policies and services need to be developed to protect and support HCWs mental health during times of stress in the sectorItem The demographic and clinical profile of HIV infected and non- infected children and adolescents attending two district psychiatric clinics in Sedibeng: a retrospective record review(University of the Witwatersrand, Johannesburg, 2024) Makofane, Lerato; Robertson, LesleyBackground: A limited district-based child and adolescent psychiatric service is provided in Gauteng province. Mental disorders are common in children and adolescents living with HIV and there is a bidirectional relationship between mental health and HIV. Aim: To ascertain the prevalence of HIV among children and adolescents attending two clinics and to compare clinical correlates of those living with and without HIV. Setting: Child and adolescent psychiatric clinics based at two community health centres (Zone 12 Clinic in Sebokeng township and Johan Heyns Clinic in a suburban area of Vanderbijl Park) in the Sedibeng district of Gauteng province. Methods: A retrospective record review was conducted of all active files. Results: 370 records (232 from Johan Heyns and 138 from Zone 12) were retrieved. Only five (1.4%) users were living with HIV, therefore no comparison could be made between users with and without HIV. All five users living with HIV were male and Black African, with an age range of 9-22 years. Of the five, three had one deceased parent and two had lost both parents. Psychiatric diagnoses were intellectual disability (n=3), epilepsy (n=3), ADHD (n=3), depression (n=1), and traumatic brain injury (n=1). Conclusion: Very few children and adolescents living with HIV attended either clinic. The sample reflects different help-seeking priorities and access among different communities regarding mental health. More services and research focusing on community child and adolescent mental health services is required.Item Investigating the psycho-social challenges of Implementing Inclusive Education among Learning Support Teachers at Metropole East Education District, Western Cape(University of the Witwatersrand, Johannesburg, 2023) Khoboko, Nkepeng Esther; Charamba, Erasmos; Aloka, PeterThe Implementation of inclusive education in schools is yet to reach expected levels in South African schools. Previous research has focused on teachers but very scanty research has been done among learning support teachers. This study examined psychological and social challenges of implementing inclusive education among South African learning support teachers. The following research questions were addressed in this study: (a) What are the psychological challenges of implementing inclusive education among learning support teachers? (b) What are the social challenges of implementing inclusive education among learning support teachers? (c) What kind of support do learning support teachers require to successfully implement inclusive education? The study adopted a qualitative approach and a multiple case study of five primary schools in the Metropole East Education District, Western Cape, was conducted. Through semi-structured interviews, data from ten participants was gathered. The five criteria of credibility, dependability, confirmability, transferability and authenticity were used to assure the trustworthiness of qualitative data. Thematic analysis was used to analyse the data. The study found that learning support teachers are psychologically and socially challenged when they have to implement inclusive education. The learning support teachers did get some support from the district officials but this was not sufficient to make them fully implement inclusive education in schools. Teachers expressed their deep concern about the lack of parental involvement, as it makes the SIAS policy referral process challenging. Moreover, teachers expressed that they were stressed out and burned out as a result of a variety of events that made their job to be stressful. The study concludes that the learning support teachers’ psychosocial challenges when implementing inclusive education remains a major concern for teachers in the Western Cape province of South Africa. Although the education department has implemented a number of strategies to help manage the psychosocial challenges of teachers, these methods mostly focus on the learners, leaving teachers with ongoing social and mental health issues. The study recommends that social workers, psychologists, and therapists should be stationed in schools, or alternatively, ordinary mainstream schools should be transformed into full-service schools.Item Exploring the influence of COVID-19 on the utilisation of the Employee assistance programme within a private medical laboratory in South Africa(University of the Witwatersrand, Johannesburg, 2023) Mavuso, Grisselda Sithembile; Umanah, TebogoEmployee assistance programmes (EAPs) are programmes designed to support employees to handle challenges that may affect their work performance. The programmes assist them to adopt behaviors that promote health, improve quality of life, support their personal growth and effectiveness, and ultimately contribute to the organization's bottom line. Despite the availability of EAP services, the prevalence of mental health disorders remains high both in South Africa, and the rest of the world. The COVID-19 pandemic presented a novel form of stressor in many lives globally and it negatively impacted employees worldwide. Health care workers, including medical laboratory workers, were hit the most by the effects of COVID-19 as they faced infected patients or infected patient samples on a daily basis. The aim of the study was to assess the impact of COVID-19 on the EAP usage in one of the largest private medical laboratories in South Africa. The study assessed if there were any notable changes in the use of the programme in year 2020 compared to the pre- COVID-19 period years 2018 to 2022. The study also aimed to understand the perceptions of the employees towards the programme and to find out if there are any benefits that the EAP offers to them. Many of the study’s interviewed respondents reported that COVID-19 presented immense psychological pressure in their lives. However, despite the severe negative impact of COVID-19, fewer respondents utilised the EAP in that COVID-19 period. Discrepant findings were however noted between the interviews and the secondary EAP data. Secondary data showed that there was an increase in the EAP usage rates between year 2020 - 2021, up to 20.4% from 15.37 % in year 2019. The respondents who have used the EAP reported that they derived great benefits from itItem An exploration of the Lived Mental Health Experiences of psychologists working in the public sector during the COVID-19 pandemic in South Africa(University of the Witwatersrand, Johannesburg, 2023) Harvey, Zena; Laher, SumayaThe COVID-19 pandemic severely impacted mental health in South Africa, exacerbating the existing mental healthcare treatment gap. Psychologists working at public institutions have been at the forefront of providing mental health care to the public during the crisis. However, psychologists themselves may be considered a vulnerable group at risk of developing adverse mental health outcomes, such as depression, anxiety, burnout and vicarious traumatisation due to the nature of their profession. This vulnerability may have been further amplified during the COVID-19 pandemic. The well-being of psychologists is integral to ensuring high quality patient care and to the overall management of pandemic and other disease outbreaks. There remains a significant dearth in the available literature examining the lived mental health experiences of psychologists, especially those working in the public sector. This study aims to address this pertinent gap by investigating the lived mental health experiences of ten psychologists employed in South African public institutions, amidst COVID-19 pandemic. Semi-structured interviews comprising sixteen questions were conducted with each psychologist. The following five overarching themes emerged from an Interpretive Phenomenological Analysis (IPA): ‘The personal effects of COVID-19 on psychologists’, ‘Changes to therapy During COVID-19’, ‘Experiences of COVID-19 exposure in public hospitals’, ‘Coping Mechanisms’ and ‘Survivor Guilt: Privilege during the pandemic’. A discussion of the abovementioned findings highlighted the importance of addressing, prioritising and monitoring the psychological wellbeing of these public sector-psychologists, during pandemic and other disease outbreaks to increase their support structures.Item Exploring attitudes, aetiology and help-seeking behaviours for Mental illness in the community of Diepsloot(University of the Witwatersrand, Johannesburg, 2023-02) Mkhize, Sandile Dionne; Laher, SumayaMental illness is a serious nation-wide health concern, with many individuals suffering from mental disorders. This study explored the attitudes of Diepsloot community members towards mental illness, their beliefs about the aetiology of mental illness and their help-seeking behaviours. Further the study explored whether attitudes and aetiology beliefs predict help-seeking behaviours in Diepsloot community members. Furthermore, issues of stigma and poverty were explored as factors contributing to understanding of and help-seeking behaviours for mental illnesses. A convenience sample of 154 community members in Diepsloot completed a questionnaire consisting of a demographics section, the Living Standards Measure, the Public Perceptions of Mental Illness questionnaire and two open ended questions asking about the factors that contribute to mental illness and the kind of advice the participants would give to a person who has mental illness. Quantitative data were analysed using descriptive statistics and multiple regression analyses. The open-ended questions were analysed qualitatively using thematic analysis. The results indicated that the participants had more neutral attitudes towards mental illness overall but an item-by-item analysis of the attitudes scale indicated negative attitudes. The participants perceived mental illness to be caused by biological and stress related causes but did identify other causes in their responses to the open ended question. In particular, psychological factors, substance use, social components/aspects in their community, financial challenges, biological influences and cultural influences were all identified. Among the participants, there was an endorsement of help-seeking behaviours that were aligned with western medicine, hospitalization, consulting with family and friends, and religion in both the quantitative and qualitative analyses. Seeking help from traditional healers was less dominant in the responses to the open ended question. The multiple regression results, with regard to predicting attitudes towards mental illness, suggested that the participants had positive attitudes towards mental illness if their level of knowledge was higher. A variety of predictors were revealed regarding the various help-seeking behaviours. An overlap was observed among the stress aetiology and the cultural beliefs aetiology as predictors. These results are discussed within the broader context of access to mental healthcare in South Africa as well as the need for more collaborative interventions.Item The experiences of grade 6 children at a mainstream urban primary school in Johannesburg on the effect of COVID-19 on their wellbeing(University of the Witwatersrand, Johannesburg, 2023-10) Nakaonga, Chitalu Ruth Sokoni; Watermeyer, Jennifer; Pretorius, EdmarieThe COVID-19 pandemic produced a plethora of mental and physical health issues. It was well understood that COVID-19 had affected the world in various ways, but little existed on how children in schools had been affected. With COVID-19 bringing about never seen before issues, this study explored how children were impacted by it. This research study allowed for an exploration of the experiences of grade 6 children in terms of how COVID-19 influenced their wellbeing whilst expected to focus on their schoolwork. As explored within this study, children in the school setting already have other school related stresses to deal with, COVID-19 was an unnecessary addition. A qualitative research approach and a phenomenological design was used in this research study. This research approach allowed for an in depth understanding of the children’s experiences. Purposive sampling, a type of non-probability sampling was used to sample seven grade 6 children to participate in the study. Data was collected through face-to-face semi-structured interviews using an interview guide. The collected data was analysed thematically. The research found that children were affected by COVID-19. Children shared how their learning looked different due to COVID-19 and how their relationships with others looked different due to the pandemic. This study also highlighted the level of understanding children had of what COVID-19 was. Through this study, there was a highlight on the importance of healthy relationships and dynamics within children’s immediate family. Their family played the greatest role in supporting them (the children) as they experienced life and school differently.