Browsing by Author "Meyer-Weitz, Anna."

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Access to antiretroviral treatment by children in KwaZulu-Natal Province : a qualitative exploratory study into factors influencing poor access.
(2009) Phili, Rogerio.; Meyer-Weitz, Anna.
South Africa and the province of KwaZulu-Natal (KZN) has one of the greatest HIV burdens in the world with an estimated 5.7 mHIion people living with HIV/AIDS. One of the interventions that the government introduced to address this situation was the provision of antiretroviral treatment (ART) to those individuals that are eligible for HIV treatment in order to reduce the morbidity and mortality. Despite widespread availability of ART in KZN, children do not access ART to the extent that adults do, and therefore continue to die because of HIV and AIDS. This qualitative study explored the psychosocial and health system factors that influence paediatric access to ART in KZN from parents and caregivers perspectives. The ecological theory and the social cognitive theory was used to formulate an interview schedule used in conducting the in-depth interviews with adults (parents or guardians) who were bringing their children for ARTservices and those attending these services themselves and not their children at Edendale and King Edward Hospitals in KZN. Purposive sampling was used to select clients for interviews and thematic was done in accordance with the aims and objectives of the study. A total of 42 participants were interviewed in this study. The low uptake of child ART was found to be influenced by several psychosocial and economic factors such as the poor knowledge about ART, stigma and disclosure associated with HIV, extent of support provided by parents/caregivers, parent's own ART was a determinant for bringing children for ART, use of traditional / alternative medicines, disintegrated families, especially the issue of multiple caregivers, complexity of paediatric ART, poor referrals of children from community institutions, unsatisfactory service at clinics, and some health policy and legislation with respect to health care for HIV-infected children that had an unintended effect of restricting child access to ART as well as poverty related Issues. Improving knowledge and self-efficacy related to ART, prevention of mother to child transmission ofHIV, re-training of health workers on child issues and addressing stigma and discrimination and other psychosocial and institutional problems and logistics could help to improve the low paediatric uptake of ART.
Adolescents' perceptions of parenting practices with respect to substance abuse.
(2008) Pillay, Yogovani.; Meyer-Weitz, Anna.
Substance use among adolescents in South Africa is a growing concern. While a growing body of research is outlining the ability of parents to influence and moderate the uptake of risk behaviours, limited literature is available in South Africa on the links between parenting practices and substance use. The present study explored adolescents’ perceptions of parenting practices with respect to their substance use behaviours. Eight focus group discussions were conducted with grade 8 and 9 school-going learners from four purposively selected public high schools in the eThekwini region of KwaZulu-Natal. The discussions were informed by constructions of the Integrated Model of Change (I-Change Model) and appropriate literature. Data was analysed thematically. This study provides further evidence that parenting behaviours can influence adolescent behaviour. The findings suggest that specific parenting practices pertaining to parent-child communication, parental support, warmth, and monitoring can have an influence on adolescent alcohol and tobacco use. Negative parenting may lead to disruptive behaviour, vulnerability to peer pressure and subsequent substance use. It is recommended that early intervention and prevention programs for substance use include aspects of parenting practices that influence adolescent substance use.
Alcohol and substance abuse among students at University of KwaZulu-Natal, South Africa : the protective role of psychological capital and health promoting lifestyle.
(2016) Tesfai, Aron Hagos.; Meyer-Weitz, Anna.
Alcohol and substance use prevalence has been high among youth and more alarmingly high among university students globally. The South African university students are not different from other students around the globe. Alcohol in particularly is a widely used psychoactive substance with dependence properties. Alcohol and other substance use and abuse are associated with serious physical and psychological consequences. It is therefore important to explore possible protective factors that may decrease the likelihood of substances use behaviours with detrimental consequence on the health and well-being of students. This study therefore aims to investigate the prevalence of substance use and abuse, the association between demographic and the likely protective role of psychological capital and the engagement in a health promoting lifestyle against substance use to gain a better understanding of the severity of substance use among students and possible substance use interventions for students at the University of KwaZulu-Natal in Durban, South Africa. The study utilized a cross-sectional survey design and collected data from a convenient sample of 515 students. The survey questionnaire included demographic, Psychological Capital (PsyCap), Health Promotion Lifestyle Profile II (HPLP II) and Alcohol, Smoking and Involvement Screening Test (ASSIST) measurements. Statistical Package for Social Sciences (SPSS 22) is used to analyse the data. Frequency and descriptive statistics were used to describe and understand prevalence of alcohol and substance use. Associations between variables were explored using Pearson’s and Spearman’s rho correlation coefficients, chi-square, independent sample t-test and ANOVA tests were used to assess difference among demographic groups and the measures while step wise logistic regression models were fitted to determine the best predictors of risky alcohol use and smoking behaviors. The study found that alcohol, smoking and cannabis use were as the most common substances used. Even though the life time alcohol usage (68%) and usage within the past three months (57%) was high, 17.5% of the students were found to be engaged on hazardous alcohol drinking. Male students were more at risk for risky substance use, and significantly different on smoking and cannabis use from female students. White and Coloured students were also found to be risky alcohol and smoking users. Association were found between most of the substances used. The students’ general Psychological capital (PsyCap) was high, but scores were low in self-efficacy. Male students’ PsyCap was significantly higher than of female students. The students’ participation in health promoting lifestyle was poor with lowest in physical activity, nutrition, health responsibility and stress management. There was a significant association between the PsyCap and HPLS. The result of Spearman rho’s showed significant and negative association between male students’ alcohol and smoking use in terms of PyCap and HPLS. Males and lower levels of resilience were found to be best predictors of risky alcohol use, White and Coloured race students and having poor HPLS were predictors for smoking. The study concluded that students should be made aware of the negative consequences of substance on their health and wellbeing and interventions need to be directed at enhancing resilience and engagement in more health promoting lifestyles through supportive environments and skills building opportunities. Limitation of the study pertain to convenient sampling and the inability to generalise the findings to all students at UKZN and therefore further studies could use representative samples to generalise, and qualitative studies to deepen the understanding of PsyCap and HPLS as protective factors against alcohol and substance use.
Alcohol use and abuse among female high school learners : a qualitative approach.
(2013) Hlomani, Thokozani J.; Meyer-Weitz, Anna.
The increasing levels and more frequent use of alcohol among females especially those in younger age groups has been noted with concern worldwide. However qualitative data on this problem is limited. This study therefore aimed to explore qualitatively factors contributing to female adolescents' alcohol use and abuse, their knowledge regarding risks associated with alcohol use and abuse and to understand the contextual and environmental factors that render female adolescents vulnerable to engage in drinking behaviours. This study was guided by the Prototype / Willingness model. The data was collected using two (2) focus groups and five (5) individual semi-structured interviews with Grade 9 female high school learners. Data analysis was done using thematic analysis. The findings of the study indicated that there are various individual, social as well as contextual factors contributing to alcohol use among female learners. These factors include age onset, low self-esteem, influence of significant others e.g. parents, peers, celebrities, media alcohol adverts especially through Television, easy availability and accessibility of alcohol as well as lack of law enforcement on selling of alcohol to minors. Protective factors emerged from the findings and these include parental monitoring, high self-esteem and good mother-daughter attachment. The study also indicated various positive perceptions why female adolescents use alcohol. These included perceiving alcohol use as fun, “cool” and glamorous, as a coping mechanism as well as a symbol of adult status and being “Western”. Although female adolescents have knowledge of most of the health and social consequences of alcohol most of them believe that they cannot be affected and they still continue to plan to use alcohol. Several recommendations are also presented. These could assist female learners, parents (and other caregivers), community members, policy makers, researchers, program developers especially those interested in adolescent health as well as other stakeholders e.g. South African Police Services (SAPS) and Department of Education etc.
Boys being boys : psychosocial factors associated with alcohol use among mid-adolescent males in a Durban boys' high school.
(2009) Payne, Kirsten L.; Meyer-Weitz, Anna.
The challenges of adolescence include negotiating risk behaviours such as alcohol use. The high prevalence and frequency of alcohol use among adolescents has been noted with concern, as has the rapidly decreasing age of initiation. Adolescent alcohol use has been found to be associated with numerous factors at intra-personal, inter-personal and contextual levels. This study aimed to explore qualitatively the perceived underlying factors related to alcohol use and binge drinking among adolescent boys, as identified and explained by the boys themselves. Exploration of these factors was guided by Brofenbrenner’s Ecological Systems Theory, the Prototype/Willingness Model and Bandura’s Social Cognitive Theory. The study population was comprised of male learners who were at that time in Grade 11 at the school and ranged in age from 16 to 18 years. Three focus group discussions were conducted, each comprising between 8-11 male learners, which were transcribed and analysed thematically in order to identify commonalties and variances among the responses of participants. The Nvivo software program was used to aid analysis. The findings of this study indicate that there are a variety of factors which influence adolescent alcohol use, and which operate individually as well as cumulatively. While adolescent boys are aware of the consequences of alcohol use and binge drinking, they often do not perceive themselves to be vulnerable to these risks. Protective factors include the school identity, team activities such as sports, and a sense of future. In conclusion, adolescent alcohol use is extremely complicated as it is impacted by multiple factors, and thus an awareness and greater understanding of the nature in which these factors interact are important for future interventions.
Career management complexities in a developing economy: an autoethnographic exposition of one inxile’s.
(2017) Gama-Chawana, Thabile.; Meyer-Weitz, Anna.; Mkhize, Nonhlanhla.
This reflexive study was conceptualised from the lens of a South African whereby as a developing economy political, educational and socioeconomic strangleholds persistently impinge on individuals’ career management processes. Eventual negative consequences impact on individuals’ career successes and the country’s economic success even after the demise of apartheid. The study benefited from a hindsight perspective that rationalised a perceived gap in dominant career theories that had limited capacity to model and explain lived-career experiences within a sociocultural environment like SA. The lived-career management experiences of the researcher as the subject and thus the inxile in the autoethnographic design within the qualitative research paradigm provided the framework to investigate the stated gap from a constructivist philosophical perspective. Four broad research questions guided the study from which it was derived 23 interview sub-questions and seven focus group sub-questions. A total of 13 participants were criterion sampled to engage in conversational interviews, 11 individually, and a combined five participants for one focus group session. They comprised three family members, three recent graduates, two peers, three self-proclaimed inxiles and two additional focus group members. All played a corroborative role on idiosyncratic yet persistent complexities that constrain career management imperatives, thus rendering the study as multi-voiced in its approach. It was rationalised in the study that: SA’s current policy document does not emphasise the pivotal role of individuals in taking ownership of personal career imperatives against argued complexities, also that career education was consistently poor and perpetuated disadvantage for the majority of black learners. Through the objectives of the study it was investigated the perceived gap towards indigenous knowledge development and to evaluate changes in the country as contextual to the poor education system. All stated objectives embedded intentions to derive elements from combined lived-career experiences from which career knowledge could be enriched while also deriving insightful input to enhance career education policy reformulation. The Systems Theory Framework provided philosophical and theoretical alignment for analysis towards culturally embedded interpretations and discussions whereby the study’s rationalisations were positively supported through fully achieved objectives.
Caring for adolescents by older carers in the context of HIV combination prevention interventions in rural KwaZulu-Natal: an ethnographic approach.
(2021) Gumede, Dumile Olivia.; Meyer-Weitz, Anna.
In South Africa and in many other developing countries, grandparents/older carers have taken the role of caring for children, even where the older carers themselves have no steady source of income and are suffering from chronic illnesses. While previous studies have documented the experiences of older carers who are raising young children, few researchers have examined the caring of adolescents and the care relationships from the perspectives of both the older carers and adolescents in South Africa. The study examined the caring of adolescents by older carers in a rural KwaZulu-Natal district in which HIV prevention interventions called DREAMS were implemented. Following an ethnographic approach, this study used repeat in-depth interviews, key informant interviews, and observations to elicit information from six adolescents aged 13 to 19, six older carers aged 50 and above, and two HIV programme facilitators (n=14) over 12 months, from October 2017 to September 2018, in the uMkhanyakude district, KwaZulu-Natal. Written informed consent was obtained from all individuals before participation. All data were collected in isiZulu and audio-recorded, transcribed, and translated into English. The researcher combined both thematic and dyadic analysis approaches to understand care relationships and the lives of adolescents and their older carers in order to add a deeper understanding of the data. A multitheoretical approach including the life course perspective, the social-ecological model, and the self-management framework was applied to examine and interpret data. The findings of the study indicated a dynamic process which influenced how older carers ended up taking the primary care responsibility of their grandchildren. The factors that positively or negatively affected the quality of relationships between adolescents and their older carers were adolescents’ difficult behaviours and carers’ behaviours (positive and negative). Gender was also used to frame the labels ascribed to the adolescents. The consequences of stigmatised labelling of adolescents negatively affected the adolescents in older carer families. Additionally, generational perspectives between adolescents and their older carers of romantic sexual viii relationships were highlighted. Further, the motivators and barriers to participation in DREAMS interventions of adolescents in older carer families were influenced by the four levels of the socio-ecological model namely individual, interpersonal, organisational, and community levels. The motivating factors included obtaining HIV and sexual and reproductive health information, perceived changes in risky behaviours, and improved care relationships and communication between adolescents and the older carers. The barriers to participation in DREAMS interventions included internalized stigma, negative peer pressure, and caregivers’ lack of information about the HIV prevention interventions as well as challenges related to the organisation responsible for implementing DREAMS interventions. Lastly, the older carers employed a range of self-management practices for chronic conditions to promote health and well-being; while, sometimes, putting their lives at risk. In conclusion, the adolescents and their older carers were emotionally distressed, thereby impacting their well-being and the quality of the care relationships. Furthermore, adolescents faced challenges as they explored their sexuality and transit to adulthood. The strenuous relationships with the adolescents, rather than chronic conditions, were the main stressors that undermined the older carers’ ability to selfmanage chronic illnesses. Further studies are required to understand the impact of COVID-19 on older carer families and its influence on self-management of chronic illnesses and caring for adolescents.
Caring for AIDS patients in a rural hospital setting : nurses' perspectives.
(2009) Zulu, Nhlanhla Dennis.; Meyer-Weitz, Anna.
The aim of the study was to explore nurses' experiences, attitudes and perceptions regarding the care of patients with the Acquired Immunodeficiency Syndrome (AIDS) before and after the introduction of Anti-Retroviral Therapy (ART) in a rural KwaZulu-Natal hospital .. A secondary aim was to investigate psychosocial stressors that nurses experience and the support they receive in this regard. A qualitative study was conducted and three focus group discussions were conducted before the introduction of ART and five individual interviews were used for in-depth exploration of the health care workers' perceptions of caring for AIDS patients after the introduction of ART. Special attention was paid to nurses' experiences with AI DS patient care and with attention to stress and coping. The AACN Synergy Model was used as a broad theoretical framework for the study to guide the exploration regarding the influence of both nurse and patient characteristics influence the care process within a rural South African context. The findings suggested that before the introduction of ARV-therapy most patients had limited knowledge and understanding of HIV/AIDS disease and its processes. They and other significant others who could be a family member or even friends were marginally involved in the care process. Voluntary Counseling and Testing (VCT) seemed to impact negatively on this situation, and patients were not willing to test and disclose their status to health workers. The knowledge around HIV/AIDS among nurses seemed to be inadequate due to the lack of support and training. They reported being inadequately equipped to deal effectively with caring for their AIDS patients. After the introduction of ARV-therapy, greater involvement of patients on ARV treatment was noted. The participation of significant others in patient management also improved possibly due to their involvement as treatment associates, a requirement of the ART programme. However, the nurses still reported inadequate knowledge not only around AIDS in general but also pertaining ART as well as in the provision of psychosocial support to their patients. The study also revealed that the Synergy Model for patient care, which compares the patient characteristics to nurse competencies can be used to gain insight into patient care and its demands. This model has also suggested weaknesses in nurses' training that need attention. Nurses are expected to use insight into patients needs to improve their competencies to meet the challenges of AIDS patient care and to fulfill their mandate as the key stakeholders on patient care. Lazarus and Folkman's (1984) views on stress and coping were useful in identifying the nurses' coping strategies. The study highlighted specific areas in need of intervention. Formal and informal teaching for both nurses and the patients on HIV and AIDS management needs to be introduced. Patients and families' involvement in decision making and HIV/AIDS disease management should be expanded. HIV counseling and all its components, which are pre- and post-counseling as well as on-going disease management counseling needs to be re-evaluated. There is a need to advocate for a more patient orientated counseling rather than test orientated counseling. Psychosocial support to nurses should be a priority to help them cope with their stressful AIDS caring work. Advocacy for a worker friendly Employee Assistance Program (EAP) should be encouraged by the managers of the institution. Intra-disciplinary and inter-disciplinary communication needs to be improved through innovative strategies. The address of the AI DS stigma within the healthcare system remains a priority and this aspect needs to be incorporated at different levels i.e. basic training, in counseling and within the psychosocial support efforts directed at nurses.
A community based study of the relationship between HIV knowledge, perceived risk and perceptions about HIV vaccines.
(2010) Adebowale, Taiwo Olayemi.; Meyer-Weitz, Anna.
To date, the HIV/AIDS pandemic remains a global disaster. The sheer scale of the pandemic and the limited success of prevention programmes in controlling its spread have necessitated an urgent need for the development of a safe, effective and affordable HIV preventive vaccine. However, perceptions of HIV vaccines and the relationships between HIV/AIDS knowledge, perceived risk and existing views on HIV vaccines are minimum characteristics required to make future HIV vaccines a worthwhile public health tool. This study reports findings among representatives of the ethnic groups aged between 18 and 49 in the Rustenburg community of Bojanala district (N = 351). The study utilized some of the data collected by the Aurum Institute of Health Research representative household survey that forms part of a range of HIV vaccine preparedness studies in the Bojanala area, Rustenburg. Descriptive statistics were applied to all items. Independent samples T- tests and Analysis of variances (ANOVAs) were used to compare means. Correlational statistics (Pearson‘s product moment) was used to explore relationships between pairs of variables. A standard multiple regression analyses was applied to assess and explore the factor(s) that predict the likelihood that respondents would report supportive perceptions for HIV vaccines while the hierarchical model fitted was done to control for the influence of demographic variables. About 74% of the study participants had good knowledge of HIV/AIDS-related issues and the same percentage of respondents identified self and their community to be at risk of HIV/AIDS infection (measured as fatalism regarding risk of contracting HIV infection). Positive view-points regarding participation in vaccine trials and belief in a future HIV vaccine to protect from contracting HIV infection was reported by almost 90% of the study participants. Meanwhile, a majority (60%) had low levels of knowledge on HIV vaccines. The results of standard and hierarchical multiple regressions showed that knowledge on HIV/AIDS transmission, prevention and treatment (in particular) are the best predictors of perceptions of an HIV vaccine. Furthermore, with the exception of the duo of perceived HIV risk and perceptions of HIV vaccine, positive correlations were found among knowledge, perceived HIV risk and vaccine perceptions, as well as among these and exposure to the media. Race (being Black in particular) and low levels of education seem to be profound challenges facing HIV/AIDS related issues, particularly perceived HIV risk. The findings from this study have implications for strategies in HIV prevention, viz. education, service delivery, advocacy and policy among others at institutional, national, regional, and global level in both public and private sectors. Political will, unprecedented collaborative effort among stakeholders and review of the existing Expanded Programme of Immunization schedule are all required to make the future HIV vaccine globally available. In addition, deductions highlight several key areas where research is urgently needed.
Cultural values and happiness of leaders in mining company : implications for diversity and inclusion.
(2016) Zungu, Thomzonke.; Meyer-Weitz, Anna.; Madlabana-Luthuli, Cynthia Zandile.
Modern organisations are increasingly becoming culturally diverse. This may present difficulties for employers as they struggle to effectively manage these differences and ensure a workplace with happy employees. Issues and challenges which are said to hinder effective inclusion of employees, includes, stereotypes, discrimination, and prejudice. Nevertheless, many diversity management initiatives which are designed to tackle these issues, seem marginally effective due to little insight into the complexity of diversity particularly in terms of cultural orientations that might not necessarily be linked to ethnicity. Cultural diversity among different ethnic groups and within these groups imply different behaviours, values, and experiences shaped by various factors such as socio-economic context, levels of education, experiences and acculturation over time. Employers are not only faced with overt diversity in terms of ethnicity, language and other differences, but they are also faced with underlying different orientations which contribute to the complex cultural dynamics that modern organisations experience. The positive organizational movement globally has emphasized an inclusive workplace where people can function optimally and flourish with positive outcomes for individuals and the organisation. The main aim of this study was to understand the different cultural orientations and orientations to happiness impacting diversity and inclusion in a South African workplace. In order to understand this, four objectives were set in this study. Firstly, this study was aimed at exploring the factor structure and the psychometric properties of the Cultural Values Scale (CVS) and the Orientations to Happiness Scale (OHS). Secondly, it was aimed at exploring demographic group differences on cultural dimensions and orientations to happiness. Thirdly, it was aimed at examining the associations between cultural dimensions and orientations to happiness. Lastly, it was aimed at determining which cultural dimensions predict employees’ orientations to happiness within a mining company with great diversity in terms of ethnicity, language, level of education and acculturation experiences. This study made use of a quantitative approach to achieve the above research objectives. A cross-sectional survey design was used to gather information from the employees in some leadership positions in a mining organisation, at one point in time. The CVS was used to document cultural dimensions, which includes Individualism/Collectivism; Power Distance; Uncertainty Avoidance; Masculinity/Femininity and Long-term Orientation/Short-term Orientation, whereas the OHS was used to document three orientations to happiness, which includes Meaning, Pleasure and Engagement. The statistical analyses were carried out by means of the IBM Statistical Package for Social Sciences (SPSS Version 22). Firstly, descriptive statistics was computed to obtain the participant’s demographic characteristics. Thereafter, inferential statistics was computed, and this included the Exploratory Factor Analysis (EFA), the One-way between groups Analysis of Variance (ANOVA), Independent Samples t-tests and Pearson Correlation Coefficients. Lastly, models were fitted using Hierarchical Multiple Regression. The results of the study indicated significant demographic group differences on cultural dimensions and on the orientations to happiness. When looking at the correlations, Power Distance and Masculinity/Femininity were reported as negatively correlated with Meaning, whereas, Collectivism/Individualism, Uncertainty Avoidance and Long-term Orientation/Short-term Orientation were reported as positively correlated with Meaning. Uncertainty Avoidance was reported as positively correlated with Pleasure. Lastly, Engagement was positively correlated with two cultural dimensions namely: Uncertainty Avoidance and Individualism/Collectivism. Four hierarchical multiple regression models fitted were based on these associations to demonstrate different predictors of happiness, and the OHS sub-scales (i.e. Pleasure, Meaning and Engagement). Research findings revealed that Collectivism/Individualism, Uncertainty Avoidance and Gender were the significant predictors of happiness. Uncertainty Avoidance, and Race were the significant predictors of Pleasure, where high Uncertainty Avoidance employees were presented as having high Pleasure levels, and Indians as having lower Pleasure levels than other racial groups. Collectivism/Individualism, Long-term/Short-term Orientation; Masculinity/Femininity and Race were presented as significant predictors of Meaning and lastly, Collectivism/Individualism and Uncertainty Avoidance best predicted Engagement. Positive organizational scholarship created insight into aspects that create meaning among a diverse group of employees that are likely to experience challenges regarding diversity and inclusion. The recommendations stemming from the study findings suggest that quality interpersonal relationships contribute to employee happiness in particular, meaning making. However, most interestingly was the low meaning levels of the older people in the organisation. This may present implications for the organization, and thus require urgent attention. The results of this study can be utilized to develop leadership development programmes to create better understanding of employees with different cultural orientations in fostering a happier workplace.
Customer service challenges in a South African casino : a participatory intervention.
(2019) Govender, Praneschen.; Meyer-Weitz, Anna.
Background: In an era of global competition, customer service (CS) remains a key differentiating factor for organisations to gain a competitive advantage. Due to heighted emotions experienced by customers when winning and losing, customer mistreatment and difficulties associated with cross-cultural interactions, the casino environment remains a challenging context for the provision of excellent CS on the frontline. Literature is scarce regarding the development of interventions to improve CS within the South African casino industry. The aim of this study was to gain an understanding of CS challenges facing frontline staff within a South African casino, and develop, implement and evaluate a participatory intervention to address these challenges. The main objectives were to: 1) To identify challenges facing slots staff in providing excellent CS and generating solutions these challenges; 2) To equip slots hosts with observational skills to identify body language to pre-empt a customers’ need for assistance; 3) To equip slots hosts with skills on how to deal with difficult customers and communicate effectively when dealing with customers; 4) To improve the cultural awareness of slots hosts to enhance their ability to deal with diverse customers 5) To determine the effectiveness of the intervention in addressing CS challenges, motivate slot hosts to exceed customer expectations and provide recommendations to management for improving CS. Method: A case study using intervention research and a multi-phase mixed method design was used. Intervention research was conducted over three phases including a situation analysis, implementation of the intervention and process evaluation. For the qualitative aspect of the study, purposive sampling was used to conduct semi-structured interviews, focus groups and observations in the situation analysis to identify CS challenges facing frontline staff. These findings were thematically analysed and used to develop the CS intervention using Lewin’s Unfreeze-Move-Refreeze Change Management Model as a theoretical framework. The researcher used the participatory action research approach to both develop and facilitate the intervention. At the end of the intervention, a training evaluation questionnaire was implemented for the quantitative aspect of the research. Three indexes were developed based on face validity including learnings gained, perceptions of learning and evaluation of facilitation. In addition, T-tests and One Way ANOVA were used to analyse the quantitative data. In the process evaluation phase, a second round of semi-structured interviews, focus group and observations were conducted to determine the effect of the CS intervention. Results: The qualitative results showed that poor equipment, inadequate CS processes and high workloads were highlighted as key factors impeding service. In addition, the study found that frontline staff from disenfranchised groups responded to perceived discrimination from customers through disengagement, withdrawal or slowing down of service behaviours. These responses were interpreted as poor CS, but were found to be defensive behaviours to reduce expected discrimination. In line with emotion contagion theory, positive or negative interactions with customers were found to shift the mood states of frontline staff, which in turn affected subsequent service interactions. The quantitative results of the workshop evaluation questionnaire suggested increased skills efficacy from learners in terms of learnt CS techniques such as identifying body language leading to customer complaints, as well as being better equipped to deal with difficult customers and customers from different cultures. The intervention also motivated staff to provide better CS with a series of interventions being recommended in future for encouraging sustainable CS behaviours. Conclusion: The study established clear guidelines for management to develop, implement and evaluate a participatory intervention to address CS challenges within a casino context. The participatory approach of the intervention was found to beneficial for knowledge-sharing, allowing for co-creation of workshop content, providing a forum for open communication on CS issues and building ownership of CS issues amongst staff. Further research is recommended to better understand the dynamics and effects of cross-cultural interactions on the frontline, so as to develop tools and techniques to assist staff to respond constructively in such situations and improve frontline CS in the organisation.
The effects of endometriosis on South African women's perceived quality of life.
(2005) Orator, Romy.; Meyer-Weitz, Anna.
Endometriosis is a painful and debilitating chronic gynaecological condition experienced by women in their reproductive years. This illness impacts on their fertility rate and on their general quality of life. Current research into the lived experience and perceived quality of life of women living with Endometriosis is lacking. Considering the prevalence of this condition, an understanding of women's lived experiences and the processes from which meaning is generated is essential to assist women and their families in coping with Endometriosis. Illness representation theory provided some insight into the meaning making processes involved in understanding and coping with a chronic illness. A phenomenological study was conducted to explore women with Endometriosis' lived experiences and the pervasiveness of this condition in terms of their perceived quality of life. I argued that dynamic relationships exist between the women's personal, social and medical worlds and that these interactions provide the context for the creation of women's lived experiences of Endometriosis.
Exploring employees' social constructions of affirmative action in a South African organisation : a discursive perspective.
(2013) Reuben, Shanya.; Magojo, Thandekile Sylvia.; Meyer-Weitz, Anna.
The contoured logic of apartheid in South Africa constructed racial, economic, social and political segregation, the consequences of which are still experienced today. In an attempt to alter the demographic weighting of disadvantage, the South African government has made concerted efforts to ‘deracialise’ South Africa most notably through Affirmative Action (AA) measures. Subjective, contextualised approaches to AA have received little attention both locally and internationally. This study aimed to explore AA from a social constructionist orientation with a focus on Potter and Wetherell’s discursive psychology. Semi-structured interviews were used to collect the data from 17 participants. The sample included both male (5) and female (12) participants and representation from all major race groups in South Africa. The findings illustrate how participants engage in discursive devices that rationalise a racial order of competence. The discourses also reflected polarised views of affirmative action. By and large, Black participants maintain that racial inequality still exists. White participants, on the other hand, continue to feel marginalised and discriminated against, by the policy. Furthermore, the results identify the various flavours in which redress can be realised. As new knowledge, the study also suggests that despite the negative experiences associated with AA, participants were generally in favour of the principles embedded within the policy. Ultimately this study suggests that AA continues to be a controversial subject which traverses many segments of life.
Exploring migration experiences and mental health among refugees and asylum-seekers in Durban, South Africa: guidelines for mental health promotion interventions.
(2020) Tesfai, Aron Hagos.; Meyer-Weitz, Anna.
Background: Refugees and asylum seekers flee war, state violence, persecution and economic hardships. They tend to be very poor, vulnerable and are often excluded from the health and socio-economic activities of the hosting communities. In these contexts, refugees and asylum-seekers are found to be among high-risk groups for mental health problems, especially those that resettle in Low-and-Middle Income Countries. Further, mental health issues of refugees are worsening in light of the sustained conflict and forced migration the world is witnessing. For a long time now, the need for mental health promotion among refugees has been a public health concern. However, it seems there has been limited research undertaken in Africa, particularly in South Africa regarding the migration experiences and mental health of refugees. This study therefore aimed to explore refugees’ and asylum-seekers’ migration experiences particularly the stressors, psychological problems and coping strategies at pre-, transit-, and post-migration stages. Understanding migration experiences provides an essential background for developing mental health intervention guidelines to promote psychological wellbeing among refugees. Methodology: The study utilised a sequential exploratory mixed-method strategy that allows first qualitative data collection and analysis followed by a second phase of quantitative data collection and analysis that builds on the results of the first qualitative phase. The main purpose of utilising this design was to initially explore the migration experiences of refugees and to understand their explanations and descriptions of migration and mental health experiences qualitatively. Then the quantitative phase aimed at expanding the initial qualitative results using a much larger sample. Based on a descriptive phenomenological method, qualitative data was collected from 14 purposefully selected participants using face-to-face interviews. The data was analysed using the five steps phenomenological descriptive analysis. A cross-sectional survey was utilised to collect data from 195 conveniently sampled respondents. A survey questionnaire was used to collect data and it included demographic questions and the following measures: Refugees Stress Scale (RSS), Post- Migration Living Difficulties Questionnaire (PMLD), Refugees’ Defenceless Scale (RDS), Connor-Davidson Resilience Scale (CD-RS), General Health Questionnaire (GHQ - 28) and Post-Traumatic Stress Disorder Checklist - civilian version (PCL -5). The data was analysed using the Statistical Package for the Social Science (SPSS version 25). Techniques of exploratory factor analysis, independent samples t-tests, ANOVA, Pearson- moment correlation coefficient and regression models were used to analyse the quantitative data. Results: The qualitative results revealed that throughout migration refugees have experienced life-threatening events and gross violation of human rights emanating from state-organized-violence, conflict and xenophobic violence or criminal attacks. Further, refugees also suffered from economic hardships mostly due to lack of employment opportunities, not knowing where they were going, travelling alone, lack of basic necessities, persecution and lack of security. As a result, their mental health experiences attest emotional and psychological distress resulting from the immediate stressors and lingering migration stressors. The participants described experiencing symptoms of PTSD, anxiety and depression throughout the migration process and beyond. The psychological distress of refugees who fled recently and experienced traumatic events have been further stressed by the lack of basic necessities in South Africa, is notably worrisome. Refugees were dealing with very negative experiences using different coping mechanisms, mainly, faith and religiosity, escaping danger, using hopeful thoughts and relying on some social support. The quantitative results revealed threats to life, forced separation from family, not having a clear vision about ones’ future, limited freedom and police or military follow-ups or beating as most common pre-migration stressors. The post-migration stressors are mainly insecurity and vulnerability that includes xenophobic threats, lack of job opportunity/ unemployment, worries about their children, discrimination, separation from family, unable to return to their original home in an emergency time and fear of repatriation. Regarding psychological distress, anxiety and insomnia are found as the most prevalent symptoms of distress, followed by social dysfunction, somatic complaints and depression. About one third of the participants are experiencing major symptoms of PTSD. Conclusion: The prevalence of psychological distress is relatively lower in this study when compared to other studies among African refugees, however, refugees who fled recently from traumatic experiences are found to be notably stressed with major PTSD symptoms. Further, lack of basic needs, minimal financial income and insecurity are found to be determinants of mental health of refugees. Mental health promotion interventions for refugees should consider their primary needs, health inclusive of mental health screening at entry and to follow-up by addressing their psychological problems through both individual and community-based psychosocial interventions to enable refugees to take better control of their health and wellbeing within an supportive and enabling environment.
Exploring the environmental causes of stress and coping mechanisms amongst township entrepreneurs: the case of Tembisa.
(2020) Mpangane, Thulani Ceryl.; Meyer-Weitz, Anna.
The significance and impact of township enterprises has proven to be undeniable both on a global scale and on a local scale. However, very little research has been conducted regarding the psycho-social background of the township entrepreneurs. This is because most research has chosen to place primary focus on the urban and formalized enterprises. Therefore, the aim of the current study was to explore the socio-cultural experiences of township entrepreneurs, the environmental factors that cause stress among entrepreneurs, as well as the adaptive and maladaptive coping mechanisms implemented by township entrepreneurs when they are confronted with stress. The study was conducted among entrepreneurs located in Tembisa South, Ivory Park, and Hospital View. The theoretical framework which guided the study is the transactional model of stress and coping theory. The study was conducted using a sample of 20 township entrepreneurs using a semi-structured interview schedule. The findings of the study indicate that there is a difference regarding the causes of stress among South African entrepreneurs when compared to foreign township entrepreneurs. The causes of stress among foreign entrepreneurs included factors such as xenophobia, being disliked by community members, business restrictions caused by the fact that they do not have legal citizenship, as well as police harassment and bribery owing to lack of South African citizenship. In contrast, the causes of stress among South African township entrepreneurs included factors such as delayed grant payments by South African Social Security Agency(SASSA), high interest rates on loans, as well as the high influx of Somali national’s businesses which results in increased competition. The common causes of stress among South African township entrepreneurs and foreign township entrepreneurs included factors such as poor access to finance; customer dynamics; management of stock; lack of equipment and infrastructure; role overload;work-life balance;high levels of competition; employee challenges;crime;violence and drug abuse;having insufficient operating space, as well as various other factors which have been highlighted in the study. The study also highlighted the various coping mechanisms used by entrepreneurs in order to deal with stress, these include emotion based coping strategies, problem-based coping strategies, maladaptive coping strategies as well as spiritual forms of coping. The study also explored some of the recommendations made by the township entrepreneurs to other entrepreneurs and township economy stakeholders. In addition, based on the findings of the current study, recommendations were made to government and other relevant stakeholders that are involved in the agenda to uplift and develop the township economy. The study also explored some of the recommendations made by the township entrepreneurs to other entrepreneurs and township economy stakeholders. In addition, based on the findings of the current study, recommendations were made to government and other relevant stakeholders that are involved in the agenda to uplift and develop the township economy.
Eye movement desensitisation and reprocessing therapy in the treatment of sugars addiction (a derivative of heroin) : gaining control over cue reactivity and cravings.
(2021) Dawood, Naseema Hoosen.; Meyer-Weitz, Anna.
Eye movement desensitization and reprocessing therapy (EMDR) developed by Francine Shapiro is an integrative psychotherapeutic approach that has been described as one of the most well researched forms of psychological treatment, however there are few empirical studies investigating the effects of EMDR therapy on addiction. The purpose of this study was to investigate the effects of EMDR therapy on cravings and cue reactivity in sugars “heroin based” addicted persons and to determine whether the EMDR therapy process is useful in reducing or extinguishing the psycho physiologic intensity of a craving. This research attempted to fill the hiatus in the literature related to EMDR therapy in craving management, as well as a clearer understanding and management of the sugars scourge in KwaZulu-Natal. A quasi-experimental study with a control and experimental arm was conducted and supported with clinical interviews over different time periods. Seventy participants from the two inpatient rehabilitation facilities in KwaZulu-Natal were assigned to one of two therapeutic conditions, viz. EMDR therapy and relaxation training, of which 35 participants from one of the rehabilitation facilities received two sessions of EMDR therapy (experimental group) and 35 participants from an alternate facility received two sessions of relaxation training (control group). Non-parametrical statistics were used to analyse and compare the craving experiences of the experimental and control groups. The superiority of one treatment over the other could not be demonstrated suggesting that EMDR therapy and relaxation training tend to be equally efficacious in managing cue reactivity in sugars addicted persons. Whilst there were no statistical differences between the experimental and control group, the clinical interviews revealed that the EMDR therapy group participants were more confident about their recovery and more knowledgeable about the addictive processes that encouraged their continued use of sugars. Further research is needed with larger and varied samples to determine the superiority of the one treatment over the other. Whilst the findings of the present study cannot be generalized due to the small sample size, it has important clinical implications for craving management. It is hoped that the study will not only contribute to a greater understanding of the effects of the therapeutic processes in the treatment and management of cravings in sugars addicted persons but will also stimulate further research in this field.
Factors influencing intention and uptake of COVID-19 vaccines on the African continent: a scoping review.
(2022) Naidoo, Damian.; Meyer-Weitz, Anna.
The COVID-19 pandemic is a severe concern worldwide, particularly in Africa. Vaccines are crucial in the fight against the COVID-19 pandemic. This scoping review examined existing literature on factors influencing intention and uptake of COVID-19 vaccines in Africa. Arksey and O'Malley's five-stage methodological paradigm was applied. A comprehensive search was undertaken from October 1st to 13th, 2021, using EBSCOhost, PubMed, Web of Science, and Google Scholar regarding the factors influencing intention and uptake of COVID-19 vaccines for studies conducted in Africa. A total of fifty published academic articles were reviewed, with many conducted in Nigeria and Ethiopia. The data analysis revealed five themes: attitudes & perceptions towards COVID-19 vaccines, intention to uptake COVID-19 vaccines, factors associated with acceptance/non-acceptance, socio-demographic determinants affecting the intention and uptake, and information sources for COVID-19 vaccines. The intention for uptake ranged between 21% and 90.1 %. Factors that promoted vaccine acceptance included confidence in the COVID-19 vaccine and the desire to protect vulnerable people. Age and sex were the most common factors significantly associated with vaccine acceptance. In contrast, most studies revealed that respondents' primary reasons for non-acceptance were safety and effectiveness concerns. The primary source of knowledge for the COVID-19 vaccines came from mass and social media. The vast majority of studies examined revealed that considerable barriers to vaccine uptake exist in Africa, contributing to the public's apprehension in this regard and resulting in a suboptimal uptake intention. To encourage vaccine uptake, governments should pay attention to refuting misinformation through integrated community-based approaches.
Health and well-being of homeless youth in Ghana.
(2015) Asante, Kwaku Oppong.; Meyer-Weitz, Anna.; Petersen, Inge.
Background: Homeless youth have been described as being resilient, and vulnerable to poor mental and behavioural health. However, literature on factors promoting resilience of these homeless youth in an African context, especially in Ghana, is scarce. The main aim of the present study was to examine the mental and behavioural health and well-being of homeless youth and the protective factors that could be strengthened to promote their mental health and reduce risky health related behaviours. Specifically this doctoral thesis investigated: 1) factors fostering resilience among homeless youth, 2) the experiences of homeless youth in relation to their health and well-being, 3) the validation of the factor structure of Connor-Davidson Resilience Scale (CD-RISC), 4) the prevalence of health risk behaviours and status of psychological well-being, and 5) the relationship between resilience and health risk behaviours among homeless youth in Ghana. Method: An exploratory mixed method approach was adopted in which qualitative data was first collected followed by a quantitative survey. For the qualitative study a purposive sample of 16 homeless youth from the Central Business District of Accra were interviewed using a semi-structured interview schedule. A cross-sectional study with an interviewer-administered questionnaire was used to assess the mental health variables from a relatively large sample of 227 conveniently selected homeless youth. The participants were between the ages of 9-19 years, and had lived on the street for a period of between 6 months to 8 years. Interpretive Phenomenological Analysis (IPA) was used to analyse the interview transcripts in the qualitative study whilst exploratory factor analysis, One-Way ANOVA, independent samples t-tests, Chi-Square tests for independence, Pearson- moment correlation coefficient, standard multiple regression and logistic regression models were used to analyse the quantitative data. Data collection lasted for 8 and 12 weeks for the qualitative and quantitative phases of the study respectively. Results: The qualitative results showed that strong religious beliefs, engagement in meaningful activities, peer group support, adherence to cultural norms and support from community-based organizations were important factors that promote resilience among participants. The quantitative results showed that participants exhibited poor mental health with high levels of psychological distress, substance use and suicidal ideation. Clustering of health risk behaviours was found in this study among homeless youth who were using substances and engaging in unprotected sex with multiple sexual partners. Some evidence for the engagement in survival sex was also found. Overall poor psychological functioning was predicted by experiences of perceived stigmatization and discrimination, self-stigma, suicidal ideation and exposure to violence. The results also showed that perceived resilience served as a protective factor for suicidal ideation and having multiple sexual lifetime partners, suggesting that youth with higher perceived resilience were less likely to engage in health risk behaviours. Conclusion: These findings seem to suggest that homeless youth are resilient, but nevertheless are susceptible to various mental health problems, with substance use acting as a gateway for sexual risk behaviours. Development of multilevel prevention interventions are recommended to build resilience in youth through access to psychological counselling and to develop better coping strategies at the individual level; facilitate health enhancing social networks that provide homeless youth with an alternative network to that of gains in social support at the interpersonal level and to address the social determinants of poor mental health at community and societal levels.
Health care service delivery to refugee children from the Democratic Republic of Congo living in Durban, South Africa : a care giver's perspective.
(2016) Bukenge, James Lukobeke.; Meyer-Weitz, Anna.; Asante, Kwaku Oppong.
Background: Access to health care for refugees remains a challenge because of the various personal and health system obstacles they may face i.e. language barriers, poverty, negative attitudes of health care providers and their lack of understanding of the legal status of refugees in South Africa. Psycho-social and economic factors impact negatively on refugees’ general health status including their children (new born and young children). Children’s health vulnerability includes preventable and treatable conditions such as malnutrition and infectious diseases, and conditions related to their experiences of threat to safety, violence and accompanied uncertainties followed fleeing to and settling in the new host country. These children have a greater health and wellbeing vulnerability than the average child. Little information is available about the challenges that refugee care-givers experience regarding child health care services in South Africa. Objectives: The main aim of this study was to investigate refugee caregivers’ perceptions of their children’s health care problems and challenges regarding accessibility and quality of health service delivery to their young children. Methods: This study used an explanatory mixed method design in which a quantitative cross-sectional survey was followed with a small qualitative study to enable a deeper understanding of the quantitative responses. The approach therefore allowed for the examination of the prevalence of health problems reported by caregivers, and exploration of caregiver’s experiences when seeking health care for their children. The research instrument assessed some background information i.e. socio-demographic characteristics, sources of social support and perceived health status of refugee children and perceptions and experiences with health care services. Frequencies were calculated, Chi-square (χ2) test were used to explore the factors associated with refugees’ satisfaction of health care provided as well as non-parametric tests i.e. Mann-Whitney U Tests and Kruskal-Wallis tests to assess the median scores on the satisfaction with health care clinics and private doctors measures for different demographic groups i.e. gender, level of education and English proficiency as well as household resources. Thematic analysis were used for the open ended questions Results: The majority (89%) of the caregivers were women with over 70% of them between 30-35 years. The majority (80%) of the caregivers were married, 65% of them had 3 to 4 children and over two-thirds (74%) reported to have problems in communicating in English. Most caregivers (74%) visit public clinics for their children’s health care needs because it was free of charge (79%) as they were not able to afford private health care (17%). However, over 95% of the participants revealed that most of the health care workers were not receptive of refugees, making access to health care difficult. Satisfaction of health care service delivery was very poor as only 7% indicated to be somewhat satisfied. Despite demographic group differences the caregivers’ level of satisfaction were very similar across the different groups. Caregivers with no English language proficiency reported slightly more positive attitudes towards clinic health care services. Conclusion: The refugees seemed to have very limited household resources making general daily survival challenging. Their strong social networks and cohesion enable them to cope, but also seem to reinforce negative views about public health care service delivery. The existing xenophobia in the South African society play a role in negative perceptions regarding access to health care and their experiences of health care service delivery. Health care workers need to be made aware of their responsibility to deliver quality care not only South Africans alone, but to refugees as well. Refugee caregiver’s should be made aware that many complaints directed at health care workers might be system related and not necessarily addressed at refugees. Greater efforts should be made to foster mutual respect and greater integration.
Health-related quality of life among women living with breast cancer in Ghana.
(2018) Kugbey, Nuworza.; Meyer-Weitz, Anna.; Oppong Asante, Kwaku.
Background: Health-related quality of life has become an important determinant of the effectiveness of medical treatments among persons living with chronic illnesses including breast cancer. Living with breast cancer is associated with several physical, psychosocial and economic challenges that could negatively impact on the health and wellbeing of women receiving treatment for breast cancer. Breast cancer in the second most diagnosed cancer type among women in Ghana and has several implications for the health of these women due to late diagnosis. However, there is lack of comprehensive social science evidence on the health-related quality of life and its associated factors among women living with breast cancer in Ghana. This study examined the predictors of health-related quality of life among women living with breast cancer and further explored the lived experiences of the women with regards to their challenges, illness representation, coping strategies and healthcare satisfactions. Methods: An explanatory sequential mixed method was employed where quantitative data collection precedes qualitative data collection. For the quantitative phase, a total of 205 women living receiving treatment for breast cancer at a Tertiary Hospital in Ghana were conveniently sampled and administered a set of questionnaires measuring the study variables. For the qualitative phase, a total of 11 women were purposively and conveniently sampled. Individual in-depth interviews were conducted with the participants using a semi-structured interview guide. Descriptive statistics, Pearson Product Moment correlations, multiple regression and mediational analyses using PROCESS were used to analyse the quantitative data whereas the interpretative phenomenological approach was used for the qualitative data analyses. Results: Quantitative results showed that access to health information, health literacy, shared decision making, doctor-patient relationship, social support, having a fighting spirit, the use of cognitive avoidance and fatalistic attitude were significant protective factors for improved quality of life. On the contrary the depression, anxiety, the use of hopeless-helpless coping and anxious preoccupation were significant risk factors for poor quality of life. These predictors had both direct and indirect effects on quality of life among the women through other variables. Findings from the qualitative analyses showed that bio-psychosocio-economic challenges such as the burden of medical treatment, alternative/herbal medicine use and breast cancer stigma were the major lived experiences of the women. There was general inadequate knowledge and understanding of breast cancer. Spirituality, social support, diversion coping and breast cancer self-care practices were identified as the main coping strategies among the participants. There was a varied perception about the satisfaction with interaction and communication with the healthcare professionals. Conclusion: The findings from this study suggest that there are several and complex interlinked challenges faced by women living with breast cancer. These challenges could negatively impact on the health and wellbeing of these women if a holistic approach with professionals from different health disciplines to address their needs. The findings underscore the need for cost-effective cognitive-based psychosocial interventions to deal with the psychosocial challenges which affect their emotional states and ultimately their health-related quality of life.