Search

Within the framework of the current drive to transform psychology in South Africa, this paper highlights "other" axes of identity that are arguably largely overlooked within the field. The conversation exposes the discipline of psychology – specifically within the South African context – and its many unexamined assumptions concerning "expected" identities of psychologists – specifically, those along heterosexual and able-bodied lines. By engaging in an autoethnographic conversation, the two authors, both "other", practising psychologists – one queer, one disabled – share and reflect on some of their experiences of feeling othered in their chosen profession. Drawing on parts of queer theory, critical disability literature, as well as the theoretical framework of biopolitical power, we start to make sense of our experiences of difference, deviance, and defiance. How the field of psychology marginalises "other" psychologists, and the impacts on those who bear the oppressions, is exposed; and a conversation is begun in which the discipline's assumptions around compulsory forms of identity – straight, not disabled, among others – are disrupted in productive ways. [ABSTRACT FROM AUTHOR]

This paper challenges the view that, in the context of the HIV/AIDS pandemic, the African extended family is no longer able to care for and support orphaned children. The paper is based on a qualitative case study conducted in a South African urban area on the lived experiences of orphaned children aged 9–14. Data were collected from the children, their teachers as well as their main caregivers. The study found that, despite the poverty facing the extended family, emotional support, family cohesion and support for learning can serve to meet the educational needs of orphaned children. [ABSTRACT FROM AUTHOR]

It is timely to have this kind of study in South Africa as the country has an increasing number of people living with HIV and AIDS. While an extensive literature has documented factors associated with HIV and AIDS, psychosocial variables associated with the health of persons living with HIV (PLH) have only begun to receive attention recently. The objective of this paper was to explore the views of a group of people living with HIV and AIDS regarding HIV and AIDS and Self-Forgiveness. Theoretical base: To examine the role of self-forgiveness in people living with HIV and AIDS, George Engel's Biopsychosocial Model was adopted. Methods: Individual In-depth Interviews were conducted with 10 purposefully-selected participants in Ekurhuleni. Outcomes: Results showed that self-forgiveness has a huge role in the lives of people living with HIV and AIDS. For instance, it has been found that self-forgiveness leads to acceptance of HIV status, promote infected people to seek medical care, and eventually gain the confidence to disclose to friends and families. Work implications: In conclusion, self-forgiveness has micro, messo and macro implications as it promotes good health of people living with HIV and AIDS; enhance HIV status self-disclosure and adherence to HIV treatment. [ABSTRACT FROM AUTHOR]

Background:Indigenous health matters have largely been neglected in the speech-language pathology literature and have particular import for the aphasia clinician. The influence of culture on people’s experiences and expectations after an event such as stroke can vary widely and there is a need to understand the impact of context on assessment and therapy. Standard approaches may not be adequate or relevant, nor always ethical to apply. Examination of aphasia in contexts with Indigenous populations provides an opportunity to explore methods and approaches with socially complex and marginalised communities and to expand our understanding of the lived experience of aphasia. Aims:The goal of this paper is to explore the role of culture in aphasia in Indigenous populations and drawing from a body of emerging research, highlight relevant dimensions of understanding and practice for the aphasia clinician. Main Contribution:A series of qualitative studies undertaken with Indigenous people with aphasia in two separate contexts – Australia and South Africa – will be described and their findings considered along several dimensions. A consideration of methods of approach and understanding will be provided, followed by discussion of some central constructs. A series of conceptual and clinical propositions for culturally safe research and practice in aphasia will be derived from this evidence. Models of collaboration are derived which are decolonising and potentially transformative and supplement models of knowledge and intervention in a local community. Particular attention is paid to temporal and spatial issues, the role of family, identity and community, the notion of resilience in such communities and addressing some of the specific challenges that may be involved such as working with cultural brokers. A series of recommendations is provided which allows for a critical engagement with interdisciplinary frameworks of understanding aphasia in context. Conclusion:As a reflective piece, this paper has enabled a collation of knowledge about aphasia in two Indigenous cultures and has helped consolidate some novel principles and insights and the need for expanded skills, attitudes, insights, explanations and methodologies – ones that acknowledge and accommodate diversity and difference, and that are relevant to Indigenous communities. Language difficulties are only one cause of social exclusion and issues such as poverty and identity make a huge impact on the lives of our clients and their families, and on the approach we adopt. A shift from the primary framework of our profession is required to accommodate the central role of culture in communication. [ABSTRACT FROM PUBLISHER]

People living with HIV facing impairments and subsequent disabilities related to the virus and its treatment require involvement of a collaborative team of healthcare professionals to ensure reintegration into daily life and community living. Healthcare teams responsible for this care include doctors and physiotherapists. This paper explores the collaboration of doctors and physiotherapists in the rehabilitation of people living with HIV in a semi-rural healthcare setting in KwaZulu-Natal, South Africa. Six doctors and two physiotherapists were interviewed using a semi-structured interview guide. The qualitative approach led to the emergence of five themes, namely a biomedical versus biopsychosocial approach; scope of practice challenge; multidisciplinary team enigma; institutional structure limitations; and recommendations from healthcare professionals. Both groups of professionals believed that a lack of understanding of the scope of practice and role of the associate profession in the multidisciplinary team led to poor referrals and lack of communication. Furthermore, shortage of personnel and resource limitations posed barriers to effective team interaction. Timely referrals, good communication and understanding of roles were suggested as endorsements to improved collaboration. [ABSTRACT FROM AUTHOR]

This paper focuses on the role of 'social support' in the experience of fibromyalgia (a musculoskeletal pain disorder) in South Africa. In-depth semi-structured interviews were used to collect narratives from 15 participants. Sources of social support constitute important mechanisms for coping with the illness experience of fibromyalgia. In providing a space for consultation and validation of the diagnosis of fibromyalgia, and the person living with the condition, people giving support fulfil a critical role in shaping the experience. The findings show how support from family, partners, and peers plays an integral role in the process of accepting fibromyalgia diagnosis, adapting to the demands of the condition, and seeking help from healthcare providers. The findings also show the ways in which people with fibromyalgia provide support for others with the condition, and the importance of this peer network in shaping the paths and outcomes of this illness experience. The findings of this study corroborate existing evidence that show fibromyalgia to be a complex condition to manage, due to the multiplicity, uncertainty and contestation that feature in the experience of the illness. Additionally, this study presents the challenges related to the limitations of access to healthcare in the South African context, and the utility of narrative approaches in garnering insight into the ways in which social support is harnessed in this environment. [ABSTRACT FROM AUTHOR]

Men and women living with HIV with access to ARVs are living longer, healthier lives that can and often do include bearing children. Children occupy a key space in men and women's personal and social lives and often play a fundamental role in maintaining these relationships, irrespective of illness concerns. Couples living with HIV need to balance prevention needs and ill-health while trying to maintain healthy relationships. Health-care providers serving the reproductive needs of HIV-affected couples need to consider the social and relational factors shaping reproductive decisions associated with periconception risk behaviors. This paper based on qualitative research at three hospital sites in eThekwini District, South Africa, investigates the childbearing intentions and needs of people living with HIV (PLHIV), and the attitudes and experiences of health-care providers serving the reproductive needs of PLHIV, and client and provider views and knowledge of safer conception. This research revealed that personal, social, and relationship dynamics shape the reproductive decisions of PLHIV, and “unplanned” pregnancies are not always unintended. Additionally, conception desires are not driven by the number of living children; rather clients are motivated by whether or not they have had any children with their current partner/spouse. Providers should consider the relationship status of clients in discussions about childbearing desires and intentions. Although many providers recognize the complex social realities shaping their clients' reproductive decisions, they have outdated information on serving their reproductive needs. Appropriate training to enable providers to better understand the relationship and social realities surrounding their clients' childbearing intentions is required and should be used as a platform for couples to work together with providers toward safer conception. The adoption of a more participatory approach should be employed to equalize client–provider power dynamics and to ensure clients are more involved in decision-making about reproduction and conception. [ABSTRACT FROM AUTHOR]

This paper reports on participants' views regarding factors contributing to the vulnerability of teenagers with intellectual disability to sexual abuse. The study took place at two special schools located in a village of KwaZulu-Natal. Data were gathered using by individual interviews, which were conducted in a face-to-face manner with life orientation teachers (8), school nurses (2), a clinical psychologist at the local hospital, and social workers (2). The interviews were also conducted with two parents, a traditional healer and spiritual diviner. Data was thematically analysed. The vulnerability factors were grouped into three broad categories, namely: individual, family and community factors. The existence of a number of vulnerability factors suggests that efforts to mitigate the problem should occur at various levels, with which an individual is interacting. [ABSTRACT FROM AUTHOR]

Mixed methods are becoming increasingly popular in social science research. There has recently been a groundswell of literature suggesting that mixed methods should be viewed as a unique form of social enquiry with its own set of philosophical, methodological and practice guidelines, as opposed to the simple combination of quantitative and qualitative methods in one study. In response to three critiques of South African psychological research, this paper argues that regardless of whether we agree that mixed methods is a unique form of social enquiry, the current literature offers useful insights into conceptualising both mixed and mono methods research. It is hoped that this article will stimulate further interest in mixed methods research in South African psychological research. [ABSTRACT FROM AUTHOR]

A rumour that emerged during a microbicide gel trial tells the tale of clinic staff purchasing trial participants' blood. This paper documents the rumour and explores its divergent interpretations and meanings in relation to the context of the trial and the social and economic setting at two of the trial sites (Soweto and Orange Farm) in South Africa. The article is based on qualitative research conducted during the Microbicides Development Programme (MDP) 301 trial to evaluate a microbicide vaginal gel for HIV prevention in women. The research incorporated in-depth interviews with female trial participants and their male partners, focus group discussions with male and female community members, and participant observation in the trial clinic and community setting at the two sites. The article analyses the different perspectives among the clinic staff, community and trial participants in terms of which the rumour about the exchange of blood for cash is seen as: 1) the result of ignorance of the clinical trial procedures; 2) the exploitation of poor and vulnerable women; 3) an example of young women's desire for material gain; and 4) a reciprocal exchange of 'clean blood' for cash between women trial participants and the health services. We suggest that the rumours about selling blood verbalise notions of gender and morality while also providing an appraisal of the behaviour of young women and a critique of social relationships between foreign researchers and local participants. Through stories about the clinical trial procedures and its potential reimbursements, the participants were creating and reconfiguring social relationships. Ultimately, rumours are one way in which foreign enterprises such as a clinical trial are rendered local. [ABSTRACT FROM AUTHOR]

We have found that community health workers (CHWs) with appropriate training are able to accurately identify people at high cardiovascular disease (CVD) risk in the community who would benefit from the introduction of preventative management, in Bangladesh, Guatemala, Mexico, and South Africa. This paper examines the attendance pattern for those individuals who were so identified and referred to a health care facility for further assessment and management. Patient records from the health centres in each site were reviewed for data on diagnoses made and treatment commenced. Reasons for non-attendance were sought from participants who had not attended after being referred. Qualitative data were collected from study coordinators regarding their experiences in obtaining the records and conducting the record reviews. The perspectives of CHWs and community members, who were screened, were also obtained. Thirty-seven percent (96/263) of those referred attended follow-up: 36 of 52 (69%) were urgent and 60 of 211 (28.4%) were non-urgent referrals. A diagnosis of hypertension (HTN) was made in 69% of urgent referrals and 37% of non-urgent referrals with treatment instituted in all cases. Reasons for non-attendance included limited self-perception of risk, associated costs, health system obstacles, and lack of trust in CHWs to conduct CVD risk assessments and to refer community members into the health system. The existing barriers to referral in the health care systems negatively impact the gains to be had through screening by training CHWs in the use of a simple risk assessment tool. The new diagnoses of HTN and commencement on treatment in those that attended referrals underscores the value of having persons at the highest risk identified in the community setting and referred to a clinic for further evaluation and treatment. [ABSTRACT FROM AUTHOR]