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The use of drugs amongst adolescents and youth has become a global phenomenon and South Africa is no exception. This paper aims to explore the familial contexts and childhood experiences leading up to the drug-taking pathways of young drug users. A qualitative approach was utilized to gather demographic from a purposive sample of 41 young (14–19 years) drug users, at five drug treatment centres in the Western Cape of South Africa. Additionally, participants could agree to participate in an in-depth interview or to provide a written life history account. A thematic data analysis was applied, and the results uncovered a range of family-related risk factors such as family structure (single motherhood and absent fatherhood), and other negative family functioning and practices such as troubled parent-child relationships, poor family communication/interactions, parental/family substance abuse, and conflict-ridden, stressful and often violent and abusive family situations. The findings suggest that prevention initiatives should focus on strengthening family functioning by reducing high conflict, stress, violent and abusive family situations, as well as aim to enhance the caregiver-child relationship. Prevention strategies should encourage live-in and non-live-in fathers to be actively involved in the lives of their children and should aim to reduce parental/caregiver substance abuse. [ABSTRACT FROM AUTHOR]

This paper explores two orphaned girls' accounts of victimization and vulnerability to child sexual abuse in their family homes. Interviews with these girls revealed a trend of neglect, adversity and processes of adultification which involved accounts of sexual abuse within their family homes. According to the data, the participants are vulnerable and they experience victimization as they are routinely sexually abused by older male relatives and non‐related men and boys inside their family homes – where they are supposed to feel safe and protected. We argue that these two young girls' experiences need to be understood as consequences of the prevailing cultures of toxic heteropatriarchal masculinities which have produced and normalized the distribution of male power over girls. The kinds of interventions required to address toxic masculinities and to insulate orphan girls from sexual abuse and neglect are also discussed. [ABSTRACT FROM AUTHOR]

Background: Patients with chronic diseases (PWCDs) were severely affected by the coronavirus disease 2019 (COVID-19) pandemic, as they were prevented from making the necessary visits to health facilities for medical review and to collect their medication. The emergence of the health crisis and inadequate access to quality care affected chronic care management. The perspectives of PWCDs are not known, and therefore the research on which this paper is based sought to investigate the lived experiences of these patients during the COVID-19 pandemic. Methods: A qualitative phenomenological design was used to obtain the lived experiences of PWCDs identified for participation in the study by means of purposive sampling. Patients' experiences were obtained during individual structured interviews, and a checklist was used to gather patient characteristics from their files. Results: Three themes emerged from the study findings, namely poor healthcare services, the socio-economic impact of the COVID-19 pandemic, and the psychological impact of the COVID-19 pandemic. The COVID-19 pandemic had devastating effects on PWCDs, in that they experienced barriers to accessing quality chronic care services and suffered psychological and financial difficulties that affected their health, life, needs and expectations. Conclusion: Policymakers should consider PWCDs when responding to a public health concern in the future. Contribution: The study findings may have an impact on future policies regulating the management of chronic diseases during epidemics, in order to improve patient health outcomes and satisfaction with healthcare services and the chronic care model based on the experiences of PWCDs. [ABSTRACT FROM AUTHOR]

Background: A major disparity exists in access to specialised healthcare between rural and urban areas. Specialist outreach programmes are one of the ways in which rural specialist healthcare inequality is being addressed. A number of rural district hospitals (RDH) employ local, private specialists (LPS) to supplement public specialist outreach. Limited research exists on private specialist outreach and support (PSOS) in sub-Saharan Africa or South Africa. Methods: This was a descriptive, exploratory, qualitative study using thematic analysis of semi-structured interviews. Non-probability, purposive sampling was used to obtain a sample size of 16 participants. The audio recordings were transcribed verbatim and analysed with the framework method and ATLAS.ti version 8© software. Results: Four major themes emerged, namely roles of LPS, effects, sustainability and feasibility of PSOS. Overall PSOS was considered sustainable, feasible and had positive effects in and beyond the sub-districts. The value of PSOS was supported by improved access and timeliness of services, improved competency of RDH medical practitioners, improved coordination, comprehensiveness and continuity of care. Private specialist outreach and support was, however, associated with increased burden on the RDH resources and required a basic level of RDH infrastructure to function effectively. Conclusion: The perceived contribution of private specialist outreach services was positive overall. Implementation in RDHs is feasible, but should involve consideration of factors in the hospital, town, sub-district and district prior to implementation. Contribution: This paper provides evidence that private specialist outreach and support services are feasible in the state health sector, provided that certain considerations are taken into account. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Several studies explore and describe the role of family dynamics in dementia care.However, few focus specifically on the diversity of family relationships that influence family caregivers' experiences of providing care to a relative with dementia.The role of family caregivers engaging in unpaid care of relatives with dementia is becoming more and more critical as the numbers of people living with dementia increase across the globe.Family caregivers are a diverse group of people as there are different categories of kinship relations and thus cannot be viewed as a single collective.They are linked intricately to their family and social support systems, however, they often experience limited family support, and tensions between family members can be a major source of stress.Hence, health professionals need to deepen their understanding of family relationships to enable them to provide effective advocacy and clinical support to family caregivers. What the paper adds to existing knowledge?: This study is unique in that it focuses on a range of family relationships in which a person with dementia finds themselves. It highlights that this network of complex connections influences the caregiving process.The study demonstrates the important role that siblings can play in sharing the caregiving load. However, this sharing is rarely balanced or fair and there is always someone in the family who carries the heaviest load.Communication between family members is frequently a challenge, with family members experiencing denial or an inability to understand the challenges encountered by the family caregiver.Most studies focus on the relationship between the family caregiver and the relative with dementia alone, rather than the family network of the family caregiver and how it influences the caregiving process.This study is unique as it focuses on family dynamics and the family network, particularly the range of family relationships in which family caregivers and their relative with dementia find themselves.Other studies tend to focus on a specific kinship category and the family network, such as an adult child, caring for their parent, but this study presents a wide variety of kinship categories to demonstrate the diversity of family caregiving contexts.The family caregivers in this study all highlighted the need or desire for effective support from the family network.Challenges of communication between family members and the caregiver were also evident and were framed within the existing family dynamic of each family. What are the implications for mental health nursing?: The findings suggest the need for communication (training and therapeutic) interventions between family caregivers and other family members (secondary caregivers). Mental health nurses are often well positioned to offer the family caregiver the option to undertake such an intervention.The findings emphasize the diversity of family caregiving situations and argue that mental health nurses can assess the nature of the care situations and work with families on how best to address the needs of the relative with dementia and the main caregiver.However, tensions frequently exist between family members, some of which existed prior to the relative acquiring dementia and other tensions as a consequence of the relative acquiring dementia. Mental health nurses could assist as a mediator between family members in order to assist families to become more cohesive. Introduction: This article explores the diverse nature of family caregivers, focusing on the different categories of kinship relations. Family caregivers are linked intricately to their families, but often experience limited family support, causing stress and tension between family members. Aim: The article aims to explore the family relationships of family members caring for relatives with dementia in order to provide an insight into the role of such relationships on the caregiver relative with dementia dyad. Method: A phenomenological, exploratory‐descriptive design was used. Eight participants took part and data were obtained using collages and semi‐structured interviews. Results: A range of family relationship patterns was highlighted including sibling involvement in the caregiving process; spousal involvement in supporting a caregiver of a parent; and spousal involvement in caring for their spouse. Discussion: The family caregivers highlighted the need or desire for effective support from the family network. Challenges of communication between family members and the caregiver were also evident and were framed within the existing family dynamic of each family. Implications for Practice: Mental health nurses need to deepen their understanding of family relationships to enable them to provide effective advocacy and clinical support to family caregivers and assist families to become more cohesive. [ABSTRACT FROM AUTHOR]

The social work profession has become critical in assisting victims of violent crime at social service agencies in South Africa. Social workers have been spearheading efforts to help trauma victims at the expense of their mental health. For Black South African social workers, the mental burden of working with victim collides with historical trauma to create new ways of experiencing mental health challenges. The study aimed to explore the experiences of social workers working with victims of violent crime at select social service agencies in Johannesburg. The study was qualitative in nature and a case study design was used. Data was collected using in-depth interviews. The researchers used purposive sampling and data was analyzed using thematic analysis. Results from the study showed that Black South African social workers working in the field of violent crime face challenges such as prolonged sadness, emotional exhaustion and vicarious trauma. All these psychological problems are amplified by the fact that social workers in South Africa work under strenuous conditions. This increases the impact of psychological problems on social workers. Therefore, this paper argues that when the psychological effects of working with victims of violent crime, intersect with historical trauma, it produces unique ways of experiencing trauma for Black South African social workers. This study has strong implications for research about the health and wellbeing of social work practitioners working with trauma victims. The study exposes the need to prioritize the wellbeing of social workers especially those working in contexts with a traumatic past. [ABSTRACT FROM AUTHOR]

With a shift in moving towards the 4th industrial revolution, digital storytelling has been identified as a novel way of facilitating teaching and learning. This paper will be aimed at offering an understanding of the experience and perspective of occupational therapy students in using digital storytelling as a reflective tool as an assignment as part of their undergraduate and masters occupational therapy curriculum at a university in South Africa. A descriptive qualitative study was undertaken, and five participants were purposively recruited. Individual semistructured interviews were conducted as well as a focus group with participants. An inductive analysis revealed two themes: Reflections on relevance within the occupational therapy curriculum and Is technology the new direction? The findings conclude that digital storytelling as a medium to showcase reflections on identifying formation was an innovative and novel way of documenting the reflective experiences of occupational therapy students. [ABSTRACT FROM AUTHOR]

The aim of this qualitative study was to explore how individuals living with multiple sclerosis experience their disorder in the South African working environment. In this paper we present the experiences of office-based workers living with multiple sclerosis, their challenges, and coping mechanisms. We purposively recruited seven participants who have been diagnosed with multiple sclerosis in the last five years. Participants were interviewed telephonically. Interviews were guided by a semi-structured interview schedule which was supplemented with additional probes. Interviews were analysed thematically using a qualitative software programme. We identified two superordinate themes: bringing multiple sclerosis into the workplace and adapting to multiple sclerosis in the workplace. The findings demonstrated the diverse manner in which participants chose to disclose their multiple sclerosis and manage co-workers' perceptions of multiple sclerosis. Participants employed practical strategies, such as making using of mobility aids, taking notes, conserving energy, and adapting responsibilities. Participants also negotiated accommodations, such as changing working hours, to overcome their unique challenges. Participants emphasised the importance of keeping a general positive attitude but showed reluctance to prepare for their future decline. Our findings indicate that participants manage the disclosure of their diagnosis of multiple sclerosis in order to maintain a favourable relationship with the workplace. Further, despite various physical and psychological limitations, participants were mostly able to adapt to their work environment. Although further research is required, employers and clinicians should consider focusing on the current needs of individuals living with multiple sclerosis to mitigate work-related challenges, rather than planning for future decline. For individuals living with multiple sclerosis and in employment in South Africa, disclosure, management of perceptions and providing accommodations are key aspects in the experience of multiple sclerosis in the workplace. Finding ways to help those in employment disclose their MS diagnosis to employers and co-workers, is an important avenue and next step for intervention research in this field. Early adjustment and adaptation to MS in the workplace is challenging and further negotiation with line-managers regarding accommodations is often required. Employers and clinicians should focus on accommodating the needs of those diagnosed with multiple sclerosis as they arise, rather than focusing solely on the accommodations needed in the future. [ABSTRACT FROM AUTHOR]