Faculty of Humanities (ETDs)
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Item South African Audiologists’ Perceived Knowledge, Views and Reported Practice in the Realm of Fall Risk Screening with Older Adults(University of the Witwatersrand, Johannesburg, 2023-06) Van Rie, Kayla Jade; Kanji, Amisha; Naudé, AlidaBackground: Falling in older adults has contributed significantly to injury and loss of life worldwide, thus, warranting the development of fall screening and prevention measures. Audiologists routinely evaluate older adults and are also key role players in balance disorders. The effectiveness of FRS and prevention is believed to depend on the healthcare professional's level of knowledge and practice in fall prevention. Little is however known about South African (SA) audiologists’ views, perceived knowledge, and practice in the realm of fall risk with older adults. Objective: The objective of this study was to determine the perceived knowledge, views and reported practices of SA audiologists in the realm of FRS with older adults. Method: A mixed methods approach with a sequential triangulation design was utilised. The participants recruited for this study were SA audiologists who were registered with the Health Professions Council of SA (HPCSA) and had experience with older adults. The systematic review was used to inform the data collection tools. The data was then collected via online surveys and online interviews. Purposive sampling was used as the survey Uniform Resource Locator (URL) link and interview invitations were distributed via email to the SA Association of Audiologists (SAAA) and, the National Speech Therapy and Audiology databases and was also distributed via audiology-specific social media platforms. One hundred and six (n=106) participants completed the online survey and eighteen (n=18) participated in the online interviews. Data from the survey was analysed using descriptive and correlation statistics, and a deductive thematic analysis was used for interview data. Results: The research study findings indicated a strong motivation among audiologists to learn more about supporting older adults at risk of falling, as almost 100% (n=102) expressed a desire for further training. Notably, the results showed that 83% (n=88) of participants XVIII believed that audiologists lacked sufficient training in FRS during their undergraduate curriculum, aligning with their perception of limited knowledge in conducting FRSs. In light of these results, it is, however, encouraging that 68% (n=73) of participants believed that audiologists had an important role to play in FRS and 58% (n=62) believed that it should be within the audiologist’s scope of practice. Ninety percent (n=95) of participants believed that incorporating FRS would change clinical practice and may provide the profession with an opportunity for expansion. Several challenges which could influence the perceived feasibility of the implementation of FRS clinically were reported, including the need for additional training (80%; n=85), lack of time (48%; n=51), difficulty collaborating with multidisciplinary team (MDT) members (38%; n=40) and discomfort with the vestibular portion of their scope of practice (38%; n=40 ). Currently, it appears that very few audiologists are conducting FRSs with older adults. The results clearly suggests an opportunity for audiologists to expand their current perceived scope of practice, enhancing their role in preventative audiology. Conclusion: Overall, this study found that SA audiologists viewed embracing the implementation of FRS positively. A lack of perceived knowledge and anticipated challenges were reported to limit the implementation of FRS clinically.Item The impact of childhood trauma on intimacy: A literature review exploring Drama Therapy techniques for intimacy recovery in adult relationships.(University of the Witwatersrand, Johannesburg, 2023) Magee, Kathryn; Thibedi, Linda (Mdena)This research paper explores how Drama Therapy techniques may be used for intimacy recovery in adult relationships in the context of childhood trauma. The immediate and long term consequences of childhood trauma are multifaceted and vary significantly. However, studies indicate that exposure to trauma during childhood adversely impacts brain development, which may disrupt other developmental processes as well as an individual’s capacity to form and maintain intimate relationships in adulthood. Intimacy is a vital element of relationships in that it provides a framework for communication and connection on various levels. Despite correlations between the two notions, research pertaining to the treatment of trauma with the intention of fostering intimacy is limited. Similarly, in the Drama Therapy field, there is little evidence indicating how the discipline could be adapted with the specific intention of fostering intimacy in relationships. Through an integrative literature review method, research pertaining to the impacts of childhood trauma, how childhood trauma influences intimacy, and predominant trauma treatment approaches and their effects, were explored. This informed an analysis of various Drama Therapy approaches, which may be useful in dealing with childhood trauma and fostering healthy relationships. From the literature examined, Drama Therapy may serve as a versatile tool for emotional regulation, narrative exploration, vulnerability and sharing, and transformation and empowerment, which all have the potential to foster intimacy in relationshipsItem 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 Understanding the experiential intersections of violence, gender identities and mental health, in the accounts of male parolees, in Gauteng, South Africa(University of the Witwatersrand, Johannesburg, 2023-03-15) Kallenbach, Jessica Jade; Bowman, BrettImprisonment in South Africa has been categorized by untold hardships and suffering. Some of the major factors which influence life in correctional centres in South Africa, are embedded within violence, gender identities and mental health. These three constructs – violence, gender identities and mental health – appear embedded within the logic of the correctional centre regime. Thus, to understand the entirety of an offender’s experience during incarceration, it is necessary to investigate the intersections of violence, gender identities and mental health. This was achieved using a qualitative hermeneutic phenomenological approach to centre on the participants’ experiences. This research consisted of six semi-structured face-to-face interviews with male parolees at Zonderwater Correctional Community Centre. The interviews were based on a self-developed questions derived from research by Akhona (2014), Bantjes et al. (2017), Celinska and Sung (2014) and Gear and Ngubeni (2002). The interview questions were open-ended and focused on the participants’ subjective meanings, understandings and experiences regarding the dynamic intersection of violence, gender identities and mental health in South African correctional centres. The findings of this research revealed that the exposure to and involvement in violent acts are inextricably related to the fundamental deprivations that offenders are subjected to and the associated “pains of imprisonment”. This revelation demonstrated the negotiation of gender that takes place within these confines, making acts of sexual assault and violence deemed more acceptable. In navigating this system of violence and gender identity negotiations, the findings of this study illustrated the emotional and mental impact that this environment has on offenders. This highlighted the pertinent need for the Department of Correctional Centres (DCS) to address current gaps in the rehabilitation models they use. These gaps could account for the recidivism rate in South Africa. It is clear that the intersection of violence, gender identities and mental health play an influential role in determining the reported experiences of offenders. The study thus has the potential to contribute to policies, by illustrating that a multi-layered approach to rehabilitation is required.Item The affordances of Narradrama as a tool for psychological adjustment among Traumatic Brain Injury survivors in South Africa(University of the Witwatersrand, Johannesburg, 2024-03) Bekker, Jané-Desire; Clarke, Lucy DraperTraumatic brain injury (TBI) is an acquired disability that can easily be overlooked, and there is a need for innovative, accessible and more effective therapeutic models for neuropsychological rehabilitation in the South African context. This practice-based research aimed to explore how Narradrama may assist TBI survivors in identifying and adjusting psychologically to their own identity, exploring ways to expand this identity and uncovering the affordances of familial witnessing. The practical application was conducted with a group of six to twelve adult TBI survivors in Johannesburg more than three years after their injury. Data was collected from interviews, six Narradrama sessions, and creative expressions made by participants. The findings in this study document two case studies and determined four sub-categories of witnessing that made an impact. Interpretative phenomenological analysis revealed the main themes of shame to empathy and disconnection to connection. For this sample group, a Narradrama approach proved effective for psychological adjustment to changes in identity and provided ways to expand confidence, meaning, agency and a sense of belonging.Item A transpersonal approach to drama therapy techniques for embodied grief work with women who experience loss and distress from an abortion.(University of the Witwatersrand, Johannesburg, 2024) Brollo, Gillian Susan; Pankhurst, MargieAbortion as a lived experience is not often explored in research or therapy, particularly when women are distressed as a result of an abortion. This research addresses the scarcity of such explorations through developing and testing a workshop model based on transpersonal drama therapy in order to examine how women who are distressed after an abortion express and manage their experience, and also how women can integrate an abortion into their life story in order to find healing. The two key questions are concerned with firstly, how embodied activities can bring unconscious feelings to the surface, and secondly how narrative can work to integrate a distressing experience into a life story so that its emotional impact is managed and the individual finds ways to move forward from the traumatic event. Chapter One is an introduction to the context, one in which women who experience a sense of loss or grief after an abortion find few places for support, healing and most importantly, for expressions of distress. The introduction touches briefly on the hyper-politicised nature of abortion as a phenomenon and how difficult it is to communicate nuance within such a polarised context. Chapter Two is a description of the theoretical framework of the transpersonal approach which also serves a literature review. The literature drawn on includes models of drama therapy, griefwork, embodied grief activities such as rituals, transpersonal philosophies which present a world where the material and the immaterial are connected and draws these theories together within an Afrocentric paradigm. Chapter Three describes the methodology and explains how the workshop was designed and its aims. Chapters Four and Five are concerned with how data was obtained and a data analysis and discussion flowing from that analysis. The final chapter looks at findings including a deep sense of relief and healing in being offered a space to explore their personal experiences of abortion, and in the affirmation provided by witnessing other women’s stories and telling of their own; and recommendations for future research such as trying the model with a rural cohort, and extending the process in combining individual and group work in order to dive deeper into individual stories.Item A Systematic Review of Literature and Meta-Analysis of the Cognitive Performance of Children with Autism Spectrum Disorder using the Wechsler Intelligence Scale for Children(University of the Witwatersrand, Johannesburg, 2023) Barnard, Helen; Vorster, AdriAutism Spectrum Disorder, which includes previous diagnostic terms such as Asperger Syndrome, Pervasive Developmental Disorder and High Functioning Autism, is a lifelong neurodevelopmental disorder that is characterised by persistent deficits in social communication, difficulties in interaction across multiple contexts, difficulties in non-verbal communicative behaviours, and the exhibition of unusual behaviours. Given that Autism Spectrum Disorder is a spectrum disorder, Autism Spectrum Disorder individuals experience different degrees of signs and symptoms. Given the nature of Autism Spectrum Disorder and the differing levels of severity, individuals also present with varying cognitive capabilities and subsequently cognitive abilities (strengths and weaknesses) when assessed on individual intelligence measures such as the Wechsler Intelligence Scale for Children, which has been revised multiple times since its inception in 1949. The purpose of this research study is to investigate the cognitive performance of Autism Spectrum Disorder children assessed on the Wechsler Intelligence Scale for Children. First, a systematic review was conducted of available literature and research studies focused on the cognitive performance of Autism Spectrum Disorder children who have been assessed on the Wechsler Intelligence Scale for Children, followed by a meta-analysis to investigate the extent to which the performance differences observed between Autism Spectrum Disorder children and typically developing peers, when measured on the Wechsler Intelligence Scale for Children, is meaningful. Although a systematic review of 49 published research studies was undertaken, the meta-analysis included only 12 studies which focused on comparing the cognitive performance of Autism Spectrum Disorder and typically developing children. The results revealed that children diagnosed with Autism Spectrum Disorder, Asperger Syndrome and High Functioning Autism performed the highest on the Perceptual Reasoning Index and the lowest on the Processing Speed Index. Although limited data are available on individuals diagnosed with Pervasive Developmental Disorder, they performed the highest on the Perceptual Organisation Index and the lowest on the Verbal Comprehension Index. The results also revealed that when taking into account all the diagnostic terms used, Autism Spectrum Disorder children performed the highest on the Block Design subtest, followed by the Similarities subtest. They performed the lowest on the Coding subtest, followed by the Comprehension subtest. The meta-analysis revealed that the means and standard deviation differences found among the various Wechsler Intelligence Scale for Children indices between Autism Spectrum Disorder and typically developing children revealed that the typically developing children who participated in the various studies iii performed higher than Autism Spectrum Disorder children across all the Wechsler Intelligence Scale for Children indices except for the following: The High Functioning Autism children obtained a slightly higher mean Full-Scale IQ score than typically developing peers, with a higher mean Verbal Comprehension Index found on the part of the High Functioning Autism children. There is practical value in supporting Autism Spectrum Disorder children to reach their potential and minimising the impact of their diagnosis, as well as its accompanying difficulties on their scholastic progress and performance.Item A transpersonal approach to drama therapy techniques for embodied grief work with women who experience loss and distress from an abortion(University of the Witwatersrand, Johannesburg, 2024) Brollo, Gillian Susan; Pankhurst, MargieAbortion as a lived experience is not often explored in research or therapy, particularly when women are distressed as a result of an abortion. This research addresses the scarcity of such explorations through developing and testing a workshop model based on transpersonal drama therapy in order to examine how women who are distressed after an abortion express and manage their experience, and also how women can integrate an abortion into their life story in order to find healing. The two key questions are concerned with firstly, how embodied activities can bring unconscious feelings to the surface, and secondly how narrative can work to integrate a distressing experience into a life story so that its emotional impact is managed and the individual finds ways to move forward from the traumatic event. Chapter One is an introduction to the context, one in which women who experience a sense of loss or grief after an abortion find few places for support, healing and most importantly, for expressions of distress. The introduction touches briefly on the hyper-politicised nature of abortion as a phenomenon and how difficult it is to communicate nuance within such a polarised context. Chapter Two is a description of the theoretical framework of the transpersonal approach which also serves a literature review. The literature drawn on includes models of drama therapy, griefwork, embodied grief activities such as rituals, transpersonal philosophies which present a world where the material and the immaterial are connected and draws these theories together within an Afrocentric paradigm. Chapter Three describes the methodology and explains how the workshop was designed and its aims. Chapters Four and Five are concerned with how data was obtained and a data analysis and discussion flowing from that analysis. The final chapter looks at findings including a deep sense of relief and healing in being offered a space to explore their personal experiences of abortion, and in the affirmation iv provided by witnessing other women’s stories and telling of their own; and recommendations for future research such as trying the model with a rural cohort, and extending the process in combining individual and group work in order to dive deeper into individual stories.Item The Audiological Profile of Singers’ and Musicians’ in South Africa(University of the Witwatersrand, Johannesburg, 2023) Flowers, Aimee Lee; Pillay, DhanashreeIntroduction: Excessive exposure to loud music is shown to have a negative impact on hearing, necessitating studies that explore the impact of music on the audiological profile of musicians and singers. The tonotopic arrangement of the cochlea plays an important role in the perception of music. Audiological testing can provide insight into the functioning of the auditory system of musicians and singers and it can provide information about the possible noise/music induced impact of music on the auditory system. The rationale for this study was to fill in the gaps in knowledge pertaining to the effects of noise/music induced hearing loss on musicians and singers in South Africa Methodology: The study aimed to document the audiological profile of musicians and singers in South Africa. The participants were recruited using purposive and snowball sampling. The study consisted of 57 participants. The age range was 13 years to 75 years of age. The design of the study was exploratory and data were collected via a case history questionnaire and a diagnostic audiological investigation. The data were analysed using qualitative and quantitative analyses. Results: Music induced hearing loss (MIHL) is present among musicians and singers however, age and years of experience are influential factors in this result. The results of the current study indicated that 88% of the participants did not use HPDs for various reasons such as stigma or lack of awareness. Participants showed knowledge related to ear cleaning and high noise levels, however, there was a lack of insight into the importance and good ear hygiene practices. Fifty-one participants indicated that there is a need for the implementation of programs to inform the general public about good ear hygiene. The results of the diagnostic audiological testing indicated age was a significant factor in relation to pure tone thresholds and distortion product otoacoustic emissions(DPOAEs). Noise notches were evident at 3000Hz and 6000Hz and correlated with both the pure tone threshold and DPOAE results. The DPOAE results indicated that being a professional singer was also a significant factor. Conclusion: The current study highlights the effects of music on the auditory system. The effects of music can be detrimental to a musician and singer’s hearing, and the incorrect ear care can have devastating effects for performers. Therefore, the need 7 for the implementation of programs to educate musicians and singers about ear hygiene, the correct ear hygiene practices and the effects of music on the audiological system as well as the correct way to mitigate these effects is imperative.Item Caregiver experiences of Attachment and Bonding Practices in Neonatal Intensive Care Units in Gauteng, South Africa(University of the Witwatersrand, Johannesburg, 2024) Prinsloo, Engela Maria; Neill, Joanne; Sawasawa, CynthiaBackground: Infant attachment and bonding are crucial within the early post-natal period to ensure a secure and healthy relationship from which the infant can explore the world thereby allowing for the development of a variety of skills. Context and culture are known to influence attachment and bonding practices. Then considering the challenging Neonatal Intensive Care Unit environment it is crucial to explore how this environment might influence attachment and bonding with a specific focus on context and culture. Objectives: This study aimed to describe the experiences of caregivers regarding attachment and bonding practices in the Neonatal Intensive Care Unit in central Gauteng, South Africa. Methods: A qualitative design was used to explore caregiver experiences around attachment and bonding practices concerning context and culture in the Neonatal Intensive Care Unit. An advertisement was posted on online forums for caregivers in South Africa who have had infants admitted to the Neonatal Intensive Care Unit. Non-probability, purposive sampling and snowball sampling was used to collect data. Both in-person and remote semi-structured interviews took place and were used to collect data. Thematic analysis was used as data analysis. Results: The following themes and subthemes were identified; the act of mothering in the NICU (with subthemes loneliness and disempowerment of caregivers, the emotional roller coaster ride, and the need for psychological/emotional support), Culture in the NICU (with subthemes care in the NICU, the influence of culture and caring for a baby in the NICU, and limited information-giving practices in the NICU), and a Sense of missing out (with subthemes unexpected pre-term birth, feeling estranged, and the tension between society’s image and the reality of having a baby in the NICU). While context and culture influence attachment practices amongst caregivers, in the case of an infant being admitted to the NICU, these practices do not take precedence, but rather the health of the infant. Implications: Methodological recommendations include alternative sampling and data collection methods than online advertised snowball sampling that allow for a larger and more diverse sample size. Policy and practice recommendations for NICUs include improving accessibility to psychological support services and orientating information on the NICU for caregivers.