Exploring breast cancer diagnosis and treatment experience among a sample of South African women who access primary health care

Despite the known impact of a cancer diagnosis and related treatments on quality of life, and the complexity of patient journeys in low-resource settings, there has been little published research into the relevant issues faced by South African women living with breast cancer. In this study, we aimed to understand the experiences of breast cancer diagnosis and treatment among a sample of South African women who access primary health care. A convenience sample of 12 women between the ages of 48 and 66 years attending a primary health care facility took part in our study. Women undergoing breast cancer treatment were invited to take part in face-to-face interviews. The interviews were semi-structured and guided by an interview schedule. Interviews were analysed thematically using ATLAS.ti v 8 computer software. We identified three important themes that explained how women experience diagnosis and treatment, namely, (1) reactions to the diagnosis experience, (2) the importance of faith, and (3) the value in having a sense of agency. Women’s initial reaction to their cancer diagnosis was one of shock and disbelief. Despite these reactions, faith and agency played an important role in how women in this study made sense of their illness experience and how they coped. Our findings demonstrate that women’s experiences of breast cancer diagnosis and treatment were accompanied by some psychological distress for which they need support. Furthermore, supporting women to make positive choices about coping and valuing the role of religion when appropriate should form part of any therapeutic engagement, medical or otherwise.</p

Towards establishing the equivalence of the IsiXhosa and English versions of the Woodcok Munoz language survey : an item and construct bias analysis of the verbal analogies scale

Magister Artium (Psychology) - MA(Psych)This study formed part of a larger project that is concerned with the adaptation of a test of cognitive academic language proficiency, the Woodcock Muñoz Language Survey (WMLS). The WMLS has been adapted from English into isiXhosa and the present study is located within the broader study that is concerned with establishing overall equivalence between the two language versions of the WMLS. It was primarily concerned with the Verbal Analogies (VA) scale. Previous research on this scale has demonstrated promising results, but continues to find evidence of some inequivalence. This study aimed to cross-validate previous research on the two language versions of the WMLS and improve on methodological issues by employing matched groups. It drew upon an existing dataset from the larger research project. The study employed a monolingual matched two-group design consisting of 150 mainly English speaking and 149 mainly isiXhosa learners in grades 6 and 7. This study had two sub aims. The first was to investigate item bias by identifying DIF items in the VA scale across the isiXhosa and English by conducting a logistic regression and Mantel-Haenszel procedure. Five items were identified by both techniques as DIF. The second sub aim was to evaluate construct equivalence between the isiXhosa and English versions of the WMLS on the VA scale by conducting a factor analysis on the tests after removal of DIF items. Two factors were requested during the factor analysis. The first factor displayed significant loadings across both language versions and was identified as a stable factor. This was confirmed by the Tucker&rsquo;s Phi and scatter plot. The second factor was stable for the English version but not for the isiXhosa version. The Tucker&rsquo;s phi and scatter plot indicated that this factor is not structurally equivalent across the two language versionsSouth Afric

The construction and validation of a health-related quality of life measure for women with endometriosis

Thesis (PhD)--Stellenbosch University, 2017.ENGLISH SUMMARY: The purpose of this study was to construct and validate a health-related quality of life (HRQOL) measure for patients with endometriosis. The study employed an exploratory, sequential mixed methods research design, consisting of a qualitative phase, followed by a quantitative phase. The study consisted of three aims. The first aim was to describe and understand the QOL-related experiences of women with endometriosis. This qualitative phase of the study involved in-depth, semi-structured interviews with 25 women diagnosed with endometriosis. I recorded and transcribed the interviews. I used thematic analysis to code the data and identify themes. Eleven themes emerged from the data, namely psychological functioning, sexual functioning, financial impact and considerations, healthcare and medical treatment, reproductive functioning, information and knowledge, interpersonal functioning, menstrual characteristics, occupational functioning, somatic features and physical functioning. The second aim of the study was to construct items for the instrument based on data collected during the first phase. The initial item pool consisted of 314 items. I then consulted with two experts in psychometry, who provided feedback relating to the clarity, conciseness, wording and ambiguity of items. This process resulted a reduced pool of 184 items. I asked five endometriosis experts to review the items in terms of relevance. Items that the experts regarded as highly relevant were retained in the measure and items that were not regarded as highly relevant were removed from the measure. The review resulted in the retention of 64 items. I piloted these items among seven women with endometriosis in order to assess the readability of the items. The final aim of the study was to determine the test reliability, validity and factor structure of the measure. This formed the quantitative component of the study. I administered the 64-item HRQOL measure, Endometriosis Health Profile 30, Short Form Health Survey World Health Organization Quality of Life Brief scale and the Beck Depression Inventory to 203 patients with endometriosis. I conducted an item analysis and removed 16 items that displayed corrected item total correlations below .35. I then conducted an exploratory factor analysis (EFA) on the remaining 48 in order to establish the factor structure of the measure. The factor analysis identified thirteen items that either cross-loaded on more than one factor or that did not significantly load on any factor. These items were removed. The remaining 35 items produced an eight-dimension factor structure. A second EFA produced the same factor structure. I named the measure the Stellenbosch Endometriosis Quality of life (SEQOL) measure and the named the dimensions as follows: (1) Psychological well-being; (2) Income; (3) Sexual functioning and romantic relationships; (4) Reproductive functioning; (5) Vitality; (6) Occupational functioning; (7) Menstrual characteristics and (8) Support. The SEQOL and its subscales demonstrated excellent internal consistency reliability. The SEQOL produced a Cronbach’s α of .92 and the Cronbach’s α for the subscales ranged from .72 to .88. Correlations between scores on SEQOL, its subscales and other measures indicated promising validity. The initial validation indicates that the SEQOL may be a useful assessment of HRQOL in women with endometriosis, both in research and clinical practice.AFRIKAANS OPSOMMING: Die doel van hierdie studie was om ’n meetinstrument saam te stel om die gesondheidsverwante lewensgehalte (GVLG) van pasiënte met endometriose te meet. Die studie het gebruik gemaak van ’n ondersoekende, sekwensiële gemengde metode-ontwerp bestaande uit ’n kwalitatiewe fase, gevolg deur ’n kwantitatiewe fase. Die studie het drie doelstellings nagestreef. Die eerste doelstelling was om die KVL-verwante ervaringe van vroue met endometriose te beskryf en te verstaan. Hierdie kwalitatiewe fase van die studie het in-diepte, semigestruktureerde onderhoude met 25 vroue wat gediagnoseer is met endometriose behels. Ek het die onderhoude opgeneem en getranskribeer. Ek het tematiese analise gebruik om die data die te kodeer en temas te identifiseer. Ek het elf temas uit die data geïdentifiseer, naamlik sielkundige funksionering, seksuele funksionering, finansiële gevolge en oorwegings, gesondheidsorg en mediese behandeling, reproduktiewe funksionering, inligting en kennis, interpersoonlike funksionering, menstruele eienskappe, werksverwante funksionering, somatiese kenmerke en fisiese funksionering. Die tweede doelstelling van die studie was om items vir die meetinstrument te identifiseer op grond van die data wat gedurende die eerste fase ingesamel is. Ek het ’n aanvanklike kombinasie van items saamgestel bestaande uit 314 items. Ek het daarna twee kenners in psigometrie geraadpleeg en hulle het terugvoer verskaf rakende die duidelikheid, bondigheid, bewoording en dubbelsinnigheid van items. Die proses het uitgeloop op 184 items. Ek het vyf endometriose-kenners gevra om die items te hersien met betrekking tot relevansie. Die items wat die kenners beskou het as hoogs relevant is behou as deel van die meetinstrument en items wat nie beskou is as hoogs relevant nie, is verwyder. Dit het die behoud van 64 items tot gevolg gehad. Hierdie items is getoets tydens ’n toetsopname onder sewe vroue met endometriose om die leesbaarheid van die items te toets. Die finale doelstelling van die studie was om die toetsbetroubaarheid, geldigheid en faktorstruktuur van die meetinstrument te bepaal en te toets. Dit het die kwantitatiewe komponent van die studie uitgemaak. Ek het die 64-item GVLG meetinstrument, die EHP 30, die SF12v2, die WHOQOL Bref en die BDI by 203 pasiënte met endometriose afgeneem. Ek het ’n item-analise gedoen en 16 items wat gekorrigeerde itemtotaal-korrelasies onder .35 vertoon het uitgehaal. Daarna het ek ’n ondersoekende faktoranalise (OFA) gedoen van die oorblywende 48 om die faktorstruktuur van die meetinstrument vas te stel. Die faktoranalise het dertien items uitgewys wat hetsy met meer as een ander faktor oorkruis gelaai het, of wat nie beduidend gelaai het op enige faktor nie. Hierdie items is verwyder. Die oorblywende 35 items het ’n agt-dimensie faktorstruktuur gelewer. ’n Tweede OFA het dieselfde faktorstruktuur gelewer. Ek het die meetinstrument die Stellenbosch Endometriose Lewensgehalte (SELG) genoem en die dimensies soos volg benoem: Psigologiese welstand; (2) Inkomste; (3) Seksuele funksionering en romantiese verhoudings; (4) Reproduktiewe funksionering; (5) Vitaliteit; (6) Werksverwante funksionering; (7) Menstruele eienskappe; en (8) Ondersteuning. Die SELG en sy subskale het uitstekende interne internekonsekwentheid getoon. Die SELG het ’n Cronbach α van .92 gelewer en die Cronbach α vir die subskale het gewissel van .72 tot .88. Korrelasies tussen tellings op SELG, sy subskale en ander meetinstrumente het belowende geldigheid getoon. Die aanvanklike geldigheid het aangedui dat die SELG ’n bruikbare meting van GVLV in vroue met endometriose kan wees in beide navorsingkontekste en kliniese praktyk

Correlates of premenstrual dysphoric disorder among female university students

CITATION: Roomaney, R. & Lourens, A. 2020. Correlates of premenstrual dysphoric disorder among female university students. Cogent Psychology, 7(1):1823608, doi:10.1080/23311908.2020.1823608.The original publication is available at https://www.tandfonline.comENGLISH ABSTRACT: We investigated dysmenorrhea, rumination, substance use and perceived stress as predictors of PMDD among women. We used a cross-sectional design and convenience sampling to recruit participants at a university in South Africa. A total of 1329 female students participated in the study. Data was collected using an online survey. Participants completed a demographic questionnaire, Premenstrual Screening Tool, Drug Use Disorders Identification Test, Adapted Ruminative Response Scale, Menstrual Symptom Questionnaire, and the Perceived Stress Scale. Descriptive analysis, correlations and logistic regression analysis were conducted using Statistical Package for the Social Sciences. A total of 135 participants screened positive for PMDD symptoms, indicating a prevalence rate of 10.2% for PMDD symptoms. The model predicted 90% of the cases correctly. Congestive dysmenorrhea, brooding, reflection and worry were identified as significant predictors of positive PMDD symptoms. Oral contraceptive use, spasmodic dysmenorrhea, perceived stress and drug use were not significant predictors. We recommend the development of a CBT based intervention targeting rumination in women with PMDD and education-based interventions regarding dysmenorrhea and PMDD among university students.Publisher's versio

Ekonomi mikro : Pendekatan kontemporer

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Students’ self-reported fears and the perceived origins thereof

The objective of this study was to explore the five most frequently reported fears in a sample of university students, and investigate the origins of these fears. The study employed a cross-sectional design with convenience sampling. Data were collected using a self-report questionnaire and analysed using a combination of descriptive statistics and content analysis. Participants consisted of 544 first-year psychology students. This study identified academic failure, animals, general failure, losing loved ones to death, and violence/crime as the top five fears among a sample of university students. ‘Conditioning experiences’ was one of the most prominent pathways in the acquisition of all these fears. ‘Negative information transmission’ was also a dominant pathway relating to the origin of fear such as academic failure and violence/crime. However, ‘modelling experiences’ was not identified as a prominent pathway in the present study. These findings contribute to identifying the origins of first-year students’ self-reported fears by using the three pathways theory. These findings may contribute meaningfully to the development and implementation of prevention and intervention programmes at higher education institutions

Predictors of burnout among HIV nurses in the Western Cape

CITATION: Roomaney, R., Steenkamp, J. & Kagee, A. 2017. Predictors of burnout among HIV nurses in the Western Cape. Curationis, 40(1):1-9, doi:10.4102/curationis.v40i1.1695.The original publication is available at http://www.curationis.org.zaPublication of this article was funded by the Stellenbosch University Open Access Fund.Background: Burnout has been implicated as one of the reasons for key healthcare personnel, such as nurses, leaving their profession, resulting in insufficient staff to attend to patients. Objective: We investigated the predictors of three dimensions of burnout, namely emotional exhaustion, depersonalisation and personal accomplishment, among nurses in South Africa attending to patients living with HIV. Method: Participants were recruited at a large tertiary hospital in the Western Cape region, with the help of the assistant director of nursing at the hospital. They completed the Maslach Burnout Inventory, the Quantitative Workload Inventory, the Interpersonal Conflict at Work Scale, the Organisational Constraints Scale, the Death and Dying subscale of the Nursing Stress Scale, and the HIV and AIDS Stigma Instrument – Nurse. Results: We found elevated levels of burnout among the sample. Workload, job status and interpersonal conflict at work significantly explained more than one-third of the variance in emotional exhaustion (R² = 0.39, F(7, 102) = 9.28, p = 0.001). Interpersonal conflict, workload, organisational constraints and HIV stigma significantly explained depersonalisation (R² = 0.33, F(7, 102) = 7.22, p = 0.001). Job status and organisational constraints significantly predicted personal accomplishment (R² = 0.18, F(7, 102) = 3.12, p = 0.001). Conclusion: Factors such as workload, job status and interpersonal conflict in the work context, organisational constraints and stigma associated with HIV were found to be predictors of burnout in the sample of nurses. Our recommendations include developing and testing interventions aimed at reducing burnout among nurses, including reducing workload and creating conditions for less interpersonal conflict at work.AFRIKAANSE OPSOMMING: Geen opsomming beskikbaarhttp://www.curationis.org.za/index.php/curationis/article/view/1695Publisher's versio

The psychological experience of women who survived HELLP syndrome in Cape Town, South Africa

Background: Haemolysis, elevated liver enzymes and low platelet count (HELLP syndrome) is a high-risk pregnancy condition that could be fatal to mother and/or baby. It is characterised, as the acronym indicates, by haemolysis, elevated liver enzymes and low blood platelets. Objective: This study explored women in Cape Town’s psychological experience of HELLP syndrome. Method: Six participants who previously experienced HELLP syndrome were interviewed. Using a grounded theory approach, themes emerged and a model illlustrating the psychological experience of HELLP syndrome was constructed. Results: The major themes that emerged were the perceived lack of information, a need to assign blame and a shift in focus. Themes of not knowing and trance and/or surreal experience underpin the cognitive aspects of the HELLP syndrome experience. Themes that expressed feelings of an inability to control, whirlwind and/or rapid pace and support acted together to bind the experience. Finally, emotions such as anger, ambivalence, disbelief, anxiety, guilt, loneliness and fear were present throughout the experience. Conclusion: This study developed an initial exploratory model representing the psychological experience of HELLP syndrome in a sample of South African women. Underlying this entire experience was a perceived lack of information which had a profound effect on numerous aspects of the experience ranging from where to locate blame to the varied emotions experienced.   Agtergrond: Die HELLP sindroom is ‘n hoë-risiko swangerskap toestand wat kan dodelik vir moeder en/of baba wees. Dit word gekenmerk deur hemolise, verhoogde lewerensieme en lae bloedplaatjies. Doelwit: Hierdie studie het Suid-Afrikaanse vroue se sielkundige ervaring van die HELLP sindroom ondersoek. Metode: Ses deelnemers wat voorheen HELLP sindroom ervaar het is ondervra. Met die gebuik van gefundeerde teorie as ‘n teoretiese raamwerk en ontleding het temas na vore gekom en ‘n model wat die sielkundige ervaring van HELLP sindroom illustreer, is gebou. Resultate: Die vernaamste temas wat na vore gekom het was die oënskynlike gebrek aan inligting, ‘n behoefte om skuld toe te skryf en ‘n verskuiwing in fokus. Die tema van nie weet en beswyming en/of surrealistiese ervaring ondersteun die kognitiewe aspekte van die HELLP sindroom. Temas wat gevoelens van geen beheer, warrelwind en/of vinnige tempo en ondersteuning uitgesprek het, het saam opgetree om die ervaring te bind. Ten slotte, emosies soos woede, teenstrydigheid, ongeloof, angs, skuldgevoelens, eensaamheid en vrees was teenwoordig in die hele ervaring. Gevolgtrekking: Hierdie studie het van’n aanvanklike ondersoekende model van die sielkundige ervaring van HELLP sindroom tot ‘n steekproef van die Suid-Afrikaanse vroue ontwikkel. Onderliggend aan hierdie hele ervaring was ‘n oënskynlike gebrek aan inligting wat ‘n diepgaande uitwerking gehad het op talle aspekte van die ervaring wat gewissel het van waar om die blaam te plaas tot die uiteenlopende ervaarde emosies

Scoping review of the psychosocial aspects of infertility in developing countries: protocol

Introduction Infertility is a widespread social phenomenon. For both women and men, there are several psychosocial issues associated with infertility. Numerous systematic reviews have focused on individuals’ psychosocial issues pertaining to infertility, however, these have been conducted in developed countries. Thus, there is a gap in the current literature to analyse individuals’ psychosocial issues associated with infertility in developing countries. Given that there are various contextual factors to consider for appropriate interventions to be implemented, it is vital to explore this topic in a developing context.Methods and analysis A scoping review will be conducted. A total of 12 databases were identified and a search string including terms related to infertility, psychosocial aspects and developing countries was developed. The inclusion and exclusion of each article will be determined through the guidelines provided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow chart. Quantitative and qualitative data will be collated. The findings will summarise existing research on psychosocial aspects of infertility in developing countries and identify gaps in the research corpus.Ethics and dissemination Data will not be collected from participants. Instead, data will be extracted from published studies and therefore no ethical approval is required. The findings will be published in a peer-reviewed journal