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Abstract Background This study aimed to assess the usefulness of the parent version of the KINDLR and the additional items of the Kiddy Parents questionnaire in the South-African context and to validate it as an appropriate tool for measuring health-related quality of life (HRQoL). Method The ExAMIN Youth SA study was designed to investigate lifestyle behaviours, including psychosocial factors that may adversely impact on cardiovascular health of children. Construct validity was examined by using exploratory and confirmatory factor analysis, while internal consistency was tested by Cronbach’s alpha. The final factor structure was confirmed by model fit indices. Results The study included children (n = 1088) aged between 5 and 10 years in North-West, South Africa. The reliability coefficients of the original factors could not be reproduced in this data set, with the Cronbach’s alphas ranging between 0.46 and 0.78. With exploratory factor analysis, including the additional items, our data supported a 7-factor structure with acceptable internal consistency (Cronbach’s alpha: 0.68–0.79; Omega: 0.75–0.85) and acceptable model fit indices (CFI: 0.91; TLI: 0.90; RMSEA: 0.05; SRMR: 0.07). Two factors (emotional wellbeing and everyday functioning) further split into separate factors for positive and negative experiences related to each of these dimensions. Conclusion We confirmed a new factor structure of the parent version of the KINDLR and the additional items of the Kiddy Parents questionnaire, which can be used in the African context. Although the new factor structure has great overlap with the original structure, some items did not contribute to the factors as expected. Language and cultural differences between the original German group and the current South African study group resulted in a different factor structure.

BackgroundThe self-management of adults with type 2 diabetes proves to be a continuous challenge. Within the South African context, socio-economic disparities, unequal access to healthcare and varying healthcare beliefs augment these challenges. CBT is a time-sensitive and structured intervention that has been effectively implemented for chronic diseases. CBT has been employed to improve psychological outcomes in adults with type 2 diabetes, but there is limited research on how this therapeutic intervention can enhance self-management outcomes of type 2 diabetes. Adaptable CBT-based interventions are needed to promote a holistic approach to type 2 diabetes self-management and empower a broader range of healthcare professionals to provide targeted interventions. Flexible interventions can promote patient engagement and be integrated into various healthcare settings where patients already access services.MethodThe study employed document analysis to develop CBT-informed guidelines. Data was analysed by means of content analysis. Two research studies formed the dataset, and categories and subcategories were identified. The categories were integrated and used to develop the CBT-informed guidelines.ResultsThese guidelines were based on core CBT components and divided into the introduction, working, and consolidation phases. The guidelines specified the roles of healthcare practitioners who would implement them and provided skills and techniques for healthcare professionals and patients within each phase.ConclusionThe CBT-based interventions aimed to provide a tool for healthcare practitioners and patients in terms of flexibility, accessibility, and personalisation.

AimThis study aimed to obtain an in-depth understanding of the experiences of adolescents with well-controlled type 1 diabetes who were adjusting to closed-loop technology.MethodInterpretative Phenomenological Analysis (IPA) was conducted. Five participants (aged 15–18) were recruited from the Centre for Diabetes and Endocrinology in Parktown, South Africa, to participate in semi-structured interviews about their experiences of adjusting to closed-loop technology.ResultsFive superordinate themes emerged (1): learning to trust the technology (2), making diabetes visible (3), building a relationship with diabetes (4), empowering support networks, and (5) transformative positive outcomes. The findings demonstrate that closed-loop technology positively impacts the adjustment to living with type 1 diabetes. However, as highlighted by all participants, the individual’s engagement and management are crucial. Based on the adolescents’ experiences, interventions should focus on psychological factors.

This qualitative research study explored the thoughts, emotions, and behaviours of adults aged between 35 and 45 who managed their type 2 diabetes effectively and adults who struggled with diabetes self-management in a South African setting. Semi-structured interviews were conducted with 17 adults who engaged in either successful self-management or who struggled with self-management. Effective management was characterised by an HbA1c level of 8% or lower. This group comprised of nine individuals. The participants who faced challenges with self-management had HbA1c levels ranging between 10% and 14%. This group consisted of eight participants. The data were analysed using inductive thematic analysis, and four main themes were identified: the emotional experience, prominent cognitions, practising acceptance and the mechanisms of behavioural change. These themes identified key determinants of individuals’ self-management practices and can contribute to providing information for future cognitive behaviour therapy interventions to be developed that target specific components to improve self-management practices.

Background: Living with diabetes is challenging, especially for adolescents at risk of poor glycaemic control. Understanding the illness perceptions of this group is important to be able to develop interventions for this growing population in need. Aim: This study explored the illness perception amongst adolescents living with type 1 diabetes (T1D) and how these perceptions interacted with the management of T1D. Setting: This study was conducted at a medical centre providing care for adolescents living with T1D in Parktown, South Africa. Methods: A qualitative, explorative design with semi-structured interviews was followed. A non-random purposive sampling method was utilised. The illness perception amongst eight adolescents, aged 12–18 years, at risk of poor glycaemic control, was analysed through thematic analysis. Results: Two subthemes related to illness perception were generated, namely (1) illness perception of T1D is negative and (2) living with T1D leads to a sense of being different. Furthermore, two subthemes were generated in relation to how illness perceptions interacted with diabetes management, namely (3) management of T1D is challenging and (4) management of T1D is motivated by fear. Conclusion: This group of adolescents with at-risk glycaemic control believed that T1D is difficult to manage, leading to a largely negative perception of the disease. This study contributes to the body of literature on adolescents where illness perception may play a role in adhering to diabetes care plans. This research may give additional insights into the awareness of illness perception in designing successful interventions.

Background: The impact of a sedentary and unhealthy lifestyle on cardiovascular health is well-documented, however the current obesity and hypertension trends among children is concerning. The ExAMIN Youth SA study aims to investigate the impact of lifestyle behaviors (physical fitness/activity, dietary intake and psychosocial factors) involved in early vascular aging among South African children.Methods: This study is an analytical, multidisciplinary, observational cohort study in a school-based setting. We aim to phenotype a cohort of ~1,000 primary school children (black and white boys and girls between ages 5–9 years) based on current clinical childhood conditions including hypertension and obesity. The primary phenotype is large artery stiffness and retinal microvascular diameters, both biomarkers of early vascular aging. The risk factors and mediators of early vascular aging and also responsible for the clinical conditions include physical inactivity, unhealthy diet, and life stress. Additionally, urinalysis and salivary analyses will be performed to identify biomarkers related to the pathophysiology of early vascular aging.Discussion: In line with the growing prevalence of obesity and hypertension responsible for the development of early vascular aging from childhood to adulthood, this study will address the critical areas in which we observe unfavorable arterial modulation related to dietary behaviors, physical inactivity, and early life stress. Implementation of novel biological markers may further contribute to our understanding of early cardiovascular adaptations in childhood, and aid in the development of primary prevention programs.Trial registration: The study was retrospectively registered on ClinicalTrials.gov on 15 August 2019 (NCT04056377).

In this study, nine parents of children living with well-controlled diabetes participated in semi-structured interviews to explore how they make meaning of living with a child with diabetes. Creating a state of normalcy that incorporates the diabetes care plan, empowering their children to successful transition to independent care, positive relationships with their medical team as well as acquiring and sharing diabetes-related knowledge and skills add to the meaning in life of these parents. Health practitioners should facilitate conversations with parents to help them realise their motivation for adhering to the diabetes care plan.

Orientation: Worldwide transformation and change in education has placed increased demands on teachers, which has resulted in teachers experiencing a potentially negative work attitude. Research purpose: The aim of this article was to expand the understanding of the relationship between a sense of calling, work attitude and meaningful work. Motivation for the study: The international community has rated the quality of education in South Africa as being substandard. Therefore, work attitudes and the impact of meaningful work in the current educational system was investigated. Research approach, design and method: A quantitative, cross-sectional survey was used with a representative sample of teachers in South Africa (N = 270). Data were gathered by means of questionnaires and analysed through structural equation modelling. Main findings: A significant positive relationship was found between a sense of calling and work attitude. Meaningful work was found to mediate the relationship between a sense of calling and positive work attitude. Practical/managerial implications: Retention of teachers displaying a positive work attitude as well as those finding meaning in their work is paramount. Communication pertaining to the broader mission and common goals of the Department of Education should transpire. Support and training should be provided and teachers should be allowed autonomy in a school atmosphere that is pleasant and disciplined. Contribution/value-add: Sufficient support to enhance meaningful work may contribute to the delivery of quality education.

Background: Managing diabetes is especially challenging for adolescents, and they often struggle to believe they can manage the condition. Illness perception has been widely associated with better diabetes management outcomes, but the influence of continuous glucose monitoring (CGM) on adolescents has been largely neglected. Aim: The study aimed to explore the illness perception of a group of adolescents living with type 1 diabetes (T1D) using CGM. Setting: The study was conducted at a medical centre that provides diabetes care services to youth living with T1D in Parktown, South Africa. Methods: A qualitative research approach using semi-structured online interviews was used to gather data that was thematically analysed. Results: Themes emerging from the data confirmed that CGM creates a sense of control over diabetes management as blood glucose measures were more visible. A sense of normalcy was established as CGM influences a new routine and a way of life, integrating diabetes into a young person’s identity. Despite the users’ awareness of being different due to diabetes management, CGM assisted in creating a sense of belonging, contributing to developing a better quality of life. Conclusion: Findings of this study support the use of CGM as a means of empowering adolescents struggling with diabetes management to achieve better treatment outcomes. The important role of illness perception in facilitating this change was also evident. Contribution: By listening to the adolescent’s voice, CGM was identified as a possible intervention to empower adolescents to improve diabetes management.

AimAdolescents have been identified as the group who struggle most with successful adjustment to closed loop technology. This study aims to identify the psychological constructs that should form part of a positive psychology intervention to assist with the adjustment to closed loop technology among adolescents living with type 1 diabetes.MethodQualitative document analysis was employed to integrate findings from two documents: a published ongoing intervention study and a recent phenomenological study by the authors. Reflexive thematic analysis was used to identify themes from the documents.FindingsThe following themes were identified as important psychological constructs that aid adjustment: the importance of knowledge and education; the process of positive adjustment to closed loop technology; a positive outlook; and building a relationship with diabetes.ConclusionInterventions are needed to assist adolescents in their adjustment to closed loop technology. The psychological constructs identified served as a starting point in designing an effective, evidence-based intervention grounded in data and theory. Knowledge and education, responsibility, identity, positive affect, gratitude, support, and trust are psychological constructs that need to be included in an intervention program.

Background: Type 2 diabetes has been recognised as a global health concern: one that requires intervention to lessen the incumbrance caused by the chronic illness. This rapid review was conducted to determine the scientific evidence available on how Cognitive Behaviour Therapy (CBT) interventions improved the self-management of individuals with type 2 diabetes. Aim: The aim of the review was to synthesise current scientific evidence regarding CBT-based interventions and self-management practices. Method: The rapid review served as a framework to appraise current national and international literature. The researchers used Google Scholar, Journal Storage (JSTOR), PsycINFO, APA PsycArticles, SAGE journals and EBSCO Discovery Services to search for relevant studies. This was performed by employing keywords. Nine relevant studies were identified. The studies were heterogenous in methodology. Seven of the nine studies were conducted in developing countries. Results: The study found that the context of developmental countries plays a significant role in the development of type 2 diabetes and requires tailored intervention because of socio-economic variabilities. The main themes identified in relation to improving self-management included: the characteristics of the CBT-based interventions, namely the format, duration, and outcomes, and identifying the techniques and components used in the CBT-based interventions. Conclusion: The review emphasised the need to further investigate the role of CBT in improving self-management of type 2 diabetes, especially in a South African context. Contribution: The review summarised the techniques that have proven to be effective for the self-management of type 2 diabetes.

BackgroundThe association between illness perception and diabetes management has been well established in adults but is not clearly understood for adolescents. This article reflects on qualitative findings on illness perception from the perspective of adolescents, and suggests future research to operationalize findings.MethodsQualitative document analysis was conducted on four research projects forming part of the Smile with Diabetes project, which aims to investigate psychosocial variables in diabetes management, including illness perception, within the adolescent and youth populations. Thematic analysis was used to derive four themes from the qualitative and review studies examined in the document analysis.ResultsThe voices of the adolescents were evident as four prominent themes: 1) living with diabetes leads to a sense of being different; 2) integration of diabetes into identity is critical, but difficult to achieve; 3) fear of potential negative consequences motivates adherence to treatment; 4) diabetes management is difficult, but possible.ConclusionThe findings not only confirmed the importance of illness perception in the management of diabetes by adolescents, but also indicate that illness perceptions should be investigated from a developmental perspective, specifically taking identity development into consideration in this group. Adolescents should be made aware of how their thinking about diabetes and its management affects their experience of living with diabetes and its future management. This study further contributes to the literature by focusing on the patient’s voice in understanding living with a chronic condition, and reassures that positive outcomes are possible when living with a chronic condition such as diabetes.

AimThis study aimed to assemble and critically reflect on previously acquired insights from investigations that have already been conducted into the role of self-compassion in diabetes and its management.MethodsThis study implemented a rapid review approach to assess the pre-existing knowledge in a time-sensitive manner. A rapid review involves the synthesis of existing knowledge using a simplified systematic review process.ResultsA total of 16 articles were identified for this rapid review. The main findings from these articles included that self-compassion is associated with improved outcomes (psychologically and medically), self-compassion can be improved through interventions, and that many extraneous factors influence levels of self-compassion.ConclusionIt is apparent that self-compassion plays a rather significant role in the management of diabetes, and that interventions aimed at developing self-compassion showed success in improving health-related outcomes. It is suggested that future research should build on the possibility of using positive psychology interventions to improve the quality of life of those living with diabetes, and work to better understand the influence of aspects such as gender and diabetes duration on self-compassion.

Type 1 diabetes mellitus (T1DM) is a chronic and lifelong condition that requires adequate behavior management in order to meet desired health outcomes. The effects of T1DM on the neurocognitive functioning of affected individuals raise concerns about how the disease may influence executive functioning. Inhibition is a core component of executive functioning, and plays a vital role in self-regulation and the restriction of impulsive behaviors. Inhibition may thus play a vital role in the behavior management of people with T1DM. The aim of this study was to identify current gaps in existing knowledge regarding the relationship between T1DM, inhibition, and behavior management. This study employed a critical review design to analyze and synthesize the current scientific literature. Twelve studies were identified through an appraisal process, and the data extracted were thematically analyzed and integrated. The findings of this study indicate that a possible cycle arises between these three constructs, in which T1DM affects inhibition, inhibition affects behavior management, and poor behavior management affects inhibition. It is recommended that future research should focus more specifically on this relationship.

In this study, to explore the illness perceptions of adolescents with well-controlled type 1 diabetes mellitus in South Africa, semi-structured interviews were conducted with nine, purposively selected adolescents (mean = 13.9 years; median = 12). Themes that emerged from the thematic analysis include the following: accepting diabetes and the diabetes care plan as part of their lives; viewing diabetes as manageable and as their responsibility; and the important role of gaining information on diabetes and diabetes management. These perceptions contributed to adherence to diabetes care plans and should be explored and developed among adolescents with type 1 diabetes mellitus to improve their diabetes management.

In order to identify specific, shared sources of meaning and mechanisms with which individuals attempt to make meaning, the objectives of this study were to explore the way in which secondary school teachers perceive, conceptualise and attain meaning in their work. A qualitative design with a phenomenological strategy was used with a convenience sample (n = 20) of teachers. Semi-structured, one-to-one interviews with open-ended questions were used to gather data. Participants were asked to diarise related issues for five working days following the interview, in order to strengthen and validate the interviews' results. The results showed that the participants conceptualise meaning as purpose and significance, and that the main sources of meaning related to work include the transfer of knowledge, and making a positive difference in the learners' lives. Forming relationships based on trust and receiving feedback was also important. The main mechanisms identified were putting effort into preparations, while this group of participants reported that meaning leads to the experience of happiness and personal satisfaction. Although most of these findings support those in the broader literature, there are differences in the emphasis placed on some of the findings, due to the context of education in South Africa. From the results, recommendations were made to create opportunities for teachers to experience more meaning in their work.

Orientation: The work of industrial/organisational (I/O) psychologists presents an interesting and relevant context for studying meaning and engagement as components of happiness. Research purpose: The aim of this study was to determine how I/O psychologists experience the meaning of their work and to investigate the relationships between their experiences of work-role fit, meaning of work, psychological meaningfulness and work engagement, utilising the happiness framework proposed by Seligman (2002). Motivation for the study: I/O psychologists spend more than 88% of their working day with people, and they are primary role models for happiness in the workplace. Information about their work engagement and experiences of meaning is therefore needed. Research design, approach and method: A survey design was used. A convenience sample (n = 106) was taken of I/O psychologists in South Africa. A biographical questionnaire, the Work-Role Fit Scale, the Work-Life Questionnaire, the Psychological Meaningfulness Scale, the Work Engagement Scale and a survey measuring the actual and desired time spent on six broad categories of work were administered. Main findings: Work-role fit predicted psychological meaningfulness and work engagement. The calling orientation to work predicted both psychological meaningfulness and work engagement. Work-role fit mediated the relationship between the meaning of work and psychological meaningfulness. Work-role fit partially mediated the relationship between a calling orientation to work and work engagement. Practical implications: A calling orientation to work should be fostered in I/O psychologists because it contributes to experiences of work-role fit, psychological meaningfulness and work engagement. Contribution/value-add: The results of this study contribute to scientific knowledge about work-role fit, engagement and meaning as components of happiness of I/O psychologists.