Browsing by Author "Valjee, Sachet Rabindranath."

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Church leaders' understandings of how Christian beliefs inform mental illness identification and remediation in effected members: a scoping review.
(2021) Nhlumayo, Lethukuthula Nkanyiso.; Valjee, Sachet Rabindranath.
Introduction: Christianity is the world’s leading religion with an estimated 2.3 billion followers, with evidence of influence both in the developing world and amongst developed nations throughout the globe. Literature has demonstrated that church clergy across varying contexts and communities serve the function of mental health gatekeepers and are often the first access point for their community, particularly among people living in low socio-economic settings without adequate access to professional mental health services.However, some issues raised by previous studies were that certain Christian beliefs have been linked with promoting stigma, internalized shame and delayed help-seeking. This study aims to synthesize and map past research that investigated church leader’s representation of how Christian beliefs inform mental illness identification and remediation (referral pathways) in vulnerable church members. Method and Analysis: A scoping review was performed to gain an overview of the available evidence from literature concerning this topic. The data was screened using the PRISMA-ScR flow diagram according to the inclusion and exclusion criteria. Relevant databases were sourced for literature and a total of 11 studies were eligible for final review. Results and Discussion: Data from the literature was synthesized in table format according to: Author(s) and Year, Study Title, Aims and Objectives, Operational Definition of Concepts, Methodology, and Results. Thematic analysis was used on the data to describe the existing literature and gaps in narrative format. Four themes were identified from the data; 1) Clergy’s conceptualisation of mental illness, 2) Role of Clergy in remediation/intervention regarding suspected cases of mental health issues (referral pathways) 3) Impact of socio-cultural context, 4) Reviewed Study’s Recommendation. These themes were found to be prominent dynamics among studies that investigated clergy’s representation and treatment of mental illness. Conclusion and Recommendations: Four overarching themes were identified among studies that investigated church clergy’s representation and remediation pathways of mental illness for vulnerable church members. Future research should focus on researching the usefulness of clergy and mental health practitioner collaborations in mental health treatment, which can benefit vulnerable church members.
Communication as a core competency : factors influencing health science students' attitudes toward developing communication as a core graduate competency.
(2016) Naidoo, Sheena.; Valjee, Sachet Rabindranath.; Naidoo, Sheena.
Communication is increasingly being recognized both nationally and internationally as a core graduate competency in the training of health professionals (HP). Initiated by the Canadian Medical Association as the now well-known CanMEDS; graduate competency frameworks represent a defining trend in medical training. This study concentrates on communication as a core competency. The aim of the study was to investigate factors influencing health science students’ (HSS) attitudes toward communication skills training (CST). Objectives of the study were to investigate the influence of 1) demographic factors of level of training, language and gender, 2) perceptions about training, 3) levels of social anxiety and 4) cultural orientation on HSS attitudes toward CST. Students’ from eight different health professional training programmes within the College of Health Sciences (CHS) at a South African university were surveyed using the Communication Skills Attitude Scale (CSAS); Liebowitz Social Anxiety Scale (LSAS) and the Individualism-Collectivism scale (INDCOL). Qualitative questions aimed at understanding students’ subjective views on learning communication were included in the questionnaire. Quantitative findings indicated that formal training, language and gender were each predictive of negative attitudes toward CST. Social anxiety was found to be associated to but not predictive of negative attitudes toward CST. Cultural orientation was found to be associated to and predictive of both positive and negative attitudes toward CST. Qualitative findings indicated that while students’ were able to identify the importance of learning communication, they could not clearly specify what training in communication entailed. The factors influencing HSS attitudes toward CST were understood according to Social Representations Theory (SRT) which explains how CST is framed according to students’ cultural and normative criteria until they emerge with either positive or negative positions towards it. The findings of this study have implications for the teaching and learning of communication, for curriculum review and development, and for furthering research in the area of communication skills among HP.
Emotion in chronic schizophrenia : qualitative and quantitative responses to affect-eliciting images.
(2007) Bernard, Warren John.; Valjee, Sachet Rabindranath.
Emotional stresses and coping among first year trainee clinical and counselling psychologists : a qualitative study of students' experiences and perceptions.
Ally, Zenat.; Valjee, Sachet Rabindranath.
South African clinical and counselling training experiences occur in a context in which dealing with cultural diversity and a range of complex traumatic presenting problems is unavoidable, due to the legacy of the past and ongoing social transformation. Trainee psychologists are exposed to unfamiliar contexts and clients throughout their training process and are thus are confronted with clients whose cultural backgrounds are potentially very different from their own. There are also ethical and pragmatic requirements for trainees to offer services beyond a middle-class and culturally familiar client base. Thus the emotional impact of having to step out of their range of contextually experiential backgrounds as well the experience of intense professional development pertaining to formal supervision, skills development and skills evaluation can result in heightened trainee anxiety and vulnerability towards career specific occupational stress. Such anxiety may potentially disrupt learning and trainees may feel inadequate and this may inhibit their development as clinical or counselling psychologists (Eagle, Haynes & Long, 2007). A review of literature shows that the plight of the South African trainee psychologists is relatively unexplored. South African students are exposed to numerous stressors (Morgan & De Bruin, 2010) and there is a need for further research with regards to the intrinsic stressors that training in psychology present to trainees. Aim: The aim of this study is to explore the emotional challenges that confront students in their first year of Masters Level training as either Clinical or Counselling psychologists, the particular aspects that prompted personal difficulty for the trainee, why these aspects are particularly difficult for trainees and the mechanisms employed to overcome these difficulties. This research investigated the meaning of these experiences for trainee psychologists in order to determine whether these experiences contributed in any way to their emotional stress and level of coping. Modes of coping strategies employed by trainees as well as the effectiveness of selected coping strategies for the trainee were examined. Methodology: A qualitative methodological framework was selected in this research as it allowed for the uncovering of underlying and subjective experiences of the emotional stresses experienced by the trainees and the coping strategies that were employed to overcome these stresses. This study uses an interpretive approach guided by an interpretive paradigm which focuses on a detailed examination of the subjective meanings that individuals place on their social and personal world based on their personal perception or accounts of the phenomena. In this regard an interpretive approach has a particular potency and effectiveness in bringing out the subjects lived experiences and perceptions within a particular context, and can be applied to the study of the shared experiences of trainees. A total of nine clinical/counselling participants comprised the sample for this study. Semi-structured in-depth interviews were conducted with the participants. The interview schedule, based on the literature review and content areas relevant to this study, was compiled to facilitate an open discussion around understanding of trainee experiences. The data from this study were analyzed using thematic analysis to identify recurrent themes and patterns. Findings: The findings of this study is based on the relevant empirical cognitive-transactional model of stress and coping proposed by Lazarus and Folkman (1984). What has clearly emerged in this study is that the vast majority of the participants interpreted and evaluated the psychology academic training environment as stressful or threatening. Participants identified similar professional, academic and personal sources of stress as a result of the training conditions and experience. The multiple clinical, client-related and academic demands inherent in the professional training process were associated with the sources of stress that were experienced by the trainees. The majority of trainees in this study adopted emotion-focused coping strategies in order to mitigate the demands and realities of the emotional stress they are experiencing in the Masters programme and gain some degree of control over the environment. This research further demonstrated the different meanings (external or internal) attributed to the source of stress experienced by the trainee will evoke different reactions to the same stressor and these results thus suggests support for an interactional perspective of understanding the emotional stresses that are experienced by the trainees. It is thus critical that this process of stress and coping be understood to better understand the obstacles that the trainees face which may impede their professional development process. Recommendations: A range of pragmatic recommendations are suggested to assist trainees to function adequately and be given the best chance for professional development and growth. These include sensitivity to the needs of trainees and to the stressful challenges faced by the trainees and the implementation of early intervention strategies to target these challenges. The need for on-going informal feedback from trainees as well as providing timeous and thoughtful evaluation and performance feedback, is emphasized as a requirement for the establishment of a climate of mutual respect and tolerance and to promote less vulnerability in trainees. Other recommendations include introducing additional training programmes addressing issues such as resilience, career options and burnout are important considerations as well as the importance of promoting journaling for critical reflection. The possibility of offering support and therapy groups for trainees is recommended as an important factor for training institutions to consider. Finally, the importance of the need for training providers to actively encourage trainees to take care of themselves both physically and emotionally is included as a recommendation.
Identifying the benefits and barriers of providing feedback on psychological assessment results/concepts using the clients'/caregivers' primary language of communication : the clinicians perspective.
(2013) Makhaye, Philile Francisca.; Valjee, Sachet Rabindranath.
Aim: This study aimed at identifying the benefits and barriers of providing feedback on psychological assessment results/concepts using the clients/caregivers primary language of communication from the clinicians’ perspective, how these affect the feedback process and the strategies used by clinicians to achieve positive feedback outcome. Methodology: In this qualitative study purposive sampling was used in selecting the sample, data was collected through the use of semi-structure interviews with a group of 8 Clinical/Counseling Masters students from the University of Kwa-Zulu Natal. The data was analysed using thematic analysis. Conclusion: The findings showed that clinicians experience a number of language obstacles when communicating assessment results using the clients’ primary language. Obstacles reported were related to the lack of terms and concepts to appropriately explain psychological information to the client/caregiver. Concerns were raised about translating tests and content that was not standardized for IsiZulu speakers. Clinicians expressed concern with regards to their ability to efficiently communicate with clients and caregivers in their mother tongue. There were a number of perceived benefits for the client and the clinician. Clinicians were of the view that communicating with clients in their language facilitated the collection of history, establishment or rapport, while the perceived benefits for the client included ease of communication; the elimination of anxiety; possible improvement in test performance and the adequacy of presenting emotional states. In dealing with the effects of obstacles clinicians employed various strategies such as the use of counseling micro-skills, adopting a collaborative approach, beforehand preparation, going for supervision and consulting with other experienced clinicians.
Interventions and strategies for addressing behavioural effects of adverse childhood experiences: a scoping review.
(2023) Cramer, Athenea Faye.; Valjee, Sachet Rabindranath.
The long-term psychological and physiological effects of adverse childhood experiences (ACE) have been widely researched. Interventions that treat ACE have been less researched, but there are interventions that have shown efficacy in reducing the harmful effects of ACE. Objective: This study aims to explore the availability of evidence-based interventions for addressing the behavioural effects of adverse childhood experiences (ACE) and provides recommendations for applying them in the South African context. Methods and Analysis: A scoping review was conducted to synthesise available literature on evidence-based interventions that treat ACE. The data was charted according to author, year, study title, interventions and strategies utilised, and results. The data were screened through a PRISMA-ScR flow diagram according to the inclusion and exclusion criteria and a total of 12 studies were eligible for inclusion. Results and Discussion: Demonstrated themes were identified thematically to provide a narrative interpretation of the included literature. The interventions were reviewed according to their approach, including family, school-based, institution-led, and individual-focused. School-based interventions, parenting programmes and individual psychotherapy interventions show various levels of success as is discussed here. Gaps in the literature highlight limited research on interventions designed or tested for the South African population. Conclusion and Recommendations: Evidence-based interventions that treat the behavioural effects of ACE show efficacy in various settings and have proven to reduce the harmful effects of ACE. More interventions should be researched in the South African context as the diverse cultures, and high exposure to trauma and violence could impact the efficacy of interventions.
Let's talk about sex : "a qualitative investigation into obstacles experienced by trainee psychologists assessing sexual history of a client during the first interview".
(2014) Garnett, Dominique Dawn.; Valjee, Sachet Rabindranath.
Despite adequate training and sound theoretical knowledge a trainee psychologist faces challenges whilst attempting to gather a vast amount of information from a new client. Sexual health information, although required for a full history, is often avoided due to various obstacles regarding the topic. Managing such a complex topic raises a plethora of valuable insights into current ideologies connected to the sexual health. The social constructions and meanings attached to sex and sexuality tend to highlight a need to move the trainee psychologist towards challenging taken-for-granted-truths and a more reflexive position. An exploration of emerging themes highlights age-old obstacles when managing sexual health matters.
Psychometric assessments used as screening tools for complex post-traumatic stress disorder: a scoping review.
(2023) Striglia, Nina Ann.; Valjee, Sachet Rabindranath.
Introduction: The International Classification of Diseases version 11 (ICD-11) saw the inclusion of Post-Traumatic Stress Disorder (PTSD) and a newly conceptualized addition of Complex Post-Traumatic Stress Disorder (CPTSD) as an independent diagnosis. Recent literature supports the inclusion and distinction of CPTSD. However, with the development of new psychological constructs, contemporary psychometric instruments are required to assess such novel constructs. This study aims to synthesise and map studies that examine various psychometric instruments used as screening tools for CPTSD. Methods and Analysis: A scoping review was conducted to “scope” the breadth of the available literature within this research topic. This was achieved by providing an overview and map of available literature published on various online databases. The data underwent intensive screening processes using the PRISMA-ScR flow diagram in accordance with the chosen inclusion and exclusion criteria. Identified databases were searched, and a total of 15 studies were eligible for final review. Results and Discussion: The data yielded from the searches were charted in table format and summarised by: Author(s) and Year and Validation Study and synthesised into a comprehensive report. Gaps and trends evident in the literature base were identified and analysed thematically to provide a narrative interpretation of existing literature. Studies that investigated and assessed various screening assessments for CPTSD were categorised in relation to four overarching themes: construct validity of ICD-11 PTSD and CPTSD, evidence of existing psychometric measures used to screen for CPTSD, the measures’ psychometric properties, the prevalence of PTSD/CPTSD and severe psychopathology, and study design. Conclusion and Recommendations: Four specific themes emerged in relation to the evidence of various screening assessments for CPTSD. Future research could aim to incorporate qualitative studies that serve to understand the lived experiences of individuals diagnosed with complex trauma disorders, particularly in developing and under-resourced contexts. Further research could drive potential opportunities to develop culturally sensitive standardised measures to reduce and remediate generalisability issues.
A qualitative investigation into the determinants of perceived stress by intern clinical/counselling psychologists in consultation with a non-fatal suicidal client.
(2007) Hepker, Natalie.; Valjee, Sachet Rabindranath.
Aim: This study aims to investigate the experience of stress and the factors that impact on the intern psychologist in relation to first consultation with a non-fatal suicidal client. Intra and interpersonal factors, as well as institutional/environmental factors that influence/impact on intern clinical/counselling psychologist level of stress when assessing and managing a non-fatal suicidal client were identified. Methodology: The research methodology chosen for this study is based on the aim of the study, which is to investigate the experience of stress perceived by intern clinical/counselling psychologists in relation to consultation with a non-fatal suicidal client. A qualitative methodological approach will be used in this study as it allows for greater in-depth investigation and understanding of the experiences of intern clinical/counselling psychologists towards suicidal clients than would be generated by quantitative research methods. Five intern clinical/counseling psychologists were used in this qualitative study. They were interviewed using a semi-structured in- depth interview. The data was transcribed and analysed using thematic analysis. Findings: A variety of stressors were identified by the interns, but the majority described common variables. The main sources of stress for the interns was first contact with suicidal clients and lack of practical training and experience. The working environment, which included work load, administrative work and academic and competency based requirements, was also deemed stressful. In terms of personal stress, interns reported family and friends to be a source of stress at times. Personality also contributed to the interns levels of stress. Socio-cultural factors which impacted on the interns experience of stress in relation to consultation with non-fatal suicidal clients included, language difficulties and cultural differences. Recommendations: The internship was generally described as stressful. Recommendations included more practical experience and training prior to the commencement of the internship. This will equip interns with the skills and abilities necessary in successfully assessing and managing high risk clients. Organisational and professional factors can also be modified and include support as well as an understanding of the policies and procedures of the institution in which the internship is being done.
"A qualitative investigation into the perceived benefits and barriers in accessing psychological services amongst first year university students".
(2015) Matabane, Pebetse Rahab Garlie.; Valjee, Sachet Rabindranath.
Aim: This study aimed at investigating the perceived benefits and perceived barriers in accessing psychological services amongst 1st year humanities‟ students from University of KwaZulu-Natal (Howard College). Methodology: Purposive sampling was employed to select the 16 participants in this study. Semi-structured interviews were conducted. The sample was stratified according to race and thematic analysis was used to analyse data. Results: The findings from this study suggest that the participants do not have sufficient knowledge regarding the purpose of psychological services and the psychologists‟ scope of practice. Gender roles, cultural belief and language were identified as barriers in accessing psychological services. Furthermore, participants indicated that denial, stigma and shame were perceived as indirect threats regarding their decisions to access psychological services and this was most likely the case when their illness had physical symptoms and appeared severe. The majority of the participants preferred other forms of interventions such as traditional healing, ancestral offerings and prayer. However these were dependent upon the participant‟s socio-cultural context. Conclusion: The results from this study suggest that even though the participants are aware of some of the benefits of utilising psychological services they often prefer sources of help that they are familiar with while the perceived barriers served as justification for not utilising these services even when they could easily access them within the university setting.
"A qualitative investigation into the perceived benefits and barriers in accessing psychological services amongst first year university students".
(2015) Matabane, Pebetse Rahab Garlie.; Valjee, Sachet Rabindranath.
Aim: This study aimed at investigating the perceived benefits and perceived barriers in accessing psychological services amongst 1st year humanities‟ students from University of KwaZulu-Natal (Howard College). Methodology: Purposive sampling was employed to select the 16 participants in this study. Semi-structured interviews were conducted. The sample was stratified according to race and thematic analysis was used to analyse data. Results: The findings from this study suggest that the participants do not have sufficient knowledge regarding the purpose of psychological services and the psychologists‟ scope of practice. Gender roles, cultural belief and language were identified as barriers in accessing psychological services. Furthermore, participants indicated that denial, stigma and shame were perceived as indirect threats regarding their decisions to access psychological services and this was most likely the case when their illness had physical symptoms and appeared severe. The majority of the participants preferred other forms of interventions such as traditional healing, ancestral offerings and prayer. However these were dependent upon the participant‟s socio-cultural context. Conclusion: The results from this study suggest that even though the participants are aware of some of the benefits of utilising psychological services they often prefer sources of help that they are familiar with while the perceived barriers served as justification for not utilising these services even when they could easily access them within the university setting.
A qualitative investigation into the risk and protective factors that mediate non-fatal suicidal behaviour in Indian adolescents.
(2008) Beekrum, Rakhi.; Valjee, Sachet Rabindranath.
Considering the escalating rate of suicidal behaviour in adolescents, not much is known about the risk and protective factors that mediate non-fatal suicidal behaviour among this group. This study has focused on exploring the subjective worlds of Indian adolescents who have engaged in non-fatal suicidal behaviour in order to identify such factors, which are crucial in the designing of effective intervention programmes. The sample consisted of 10 adolescent patients who were admitted to R.K. Khan Hospital in Chatsworth, Durban after non-fatal suicide attempts. The emergent risk and protective factors were conceptualised according to Bronfenbrenner’s (1979) Social Ecology Theory, which facilitated an understanding of the multiple levels of risk and protective factors that mediate NFSB in adolescents. The results of this study highlight the collective influences of individual, familial, cultural and societal factors on adolescents’ decisions to engage in non-fatal suicidal behaviour. A number of clear priorities for prevention programmes emerged from the results of this study. As such, recommendations were made to facilitate prevention and intervention programmes at a site, familial, peer and community level.
A qualitative study exploring participant perceptions of familial connectedness following medically boarded police officers’ experience of a work-related traumatic event.
(2019) Sunder, Kiara Suren.; Valjee, Sachet Rabindranath.
Considering the nature of police work and the deleterious effects it has on police officers, limited research has been published regarding the dynamics of social support (particularly family support) with employees in high risk professions. This study focused on exploring the perceptions that participants (husbands/wives) of police officers have about the police officers’ functioning in both the pre- and post-medical-boarding phases, as well as the participants’ perceptions about the family’s state of connectedness in the relative phases. The study sample was comprised of eight participants who were husbands/wives of medically-boarded police officers in the Durban area. A total of eight semi-structured interviews were conducted with eight participants, comprising of seven females and one male. A qualitative methodological approach was utilized as it allowed for in-depth interviews to explore participants’ perceptions of police officers’ functioning and connectedness. A non-probability sampling method was employed whereby the sample was selected using purposive sampling. The sample was accessed via a private psychiatrist and permission was sought respectively from: the practitioner, police officer and the participant. The data transcripts were analyzed thematically in order to identify commonalities and variances among the responses of participants. The Family Adjustment and Adaptation Response Model (FAAR) was used as the theoretical framework in guiding the analysis of data. Specific constructs of the model were highlighted in order to conceptualize the data. The results of this study highlighted the collective influence of the participant, police officer, family and South African Police services on the overall connectedness of families in both the pre- and post-boarding phases. In the pre-boarding phase connectedness was deemed adequate and the main demands faced whereby police officers related to logistically managing work commitments. In the post- boarding phase there was decreased connectedness and ramifications for participants and police officers. Participants directed their capabilities towards exercising support in relation to the police officers’ post-trauma reactions (psychological and emotional). A number of clear strategies for improved familial connectedness emerged from the results of this study. As such, recommendations were suggested, followed by recommendations for future research and an appraisal of the limitations of this study were provided.
A qualitative study exploring psychologists’ experiences of establishing cross-cultural therapeutic alliances.
(2019) Barker, Lauren.; Valjee, Sachet Rabindranath.
The therapeutic alliance has been found to be an important component for the successful outcome of psychotherapy. Much research has been dedicated to uncovering the attributes and techniques that aid in the establishment of meaningful therapeutic alliances. However, there is a lack of qualitative research focused on the influence of cross-cultural dynamics on the establishment of therapeutic alliances. Thus, this study aims to explore psychologists’ experiences of establishing cross-cultural therapeutic alliances in South Africa and to uncover the attributes and techniques that influence cross-cultural alliances through the use of an explorative, cross-sectional design. In this study, eight clinical/counselling psychologists were purposively selected via an online registry of practicing psychologists in the Durban area of Kwa-Zulu Natal. The participants were interviewed about their experiences of establishing cross-cultural therapeutic alliances through the use of open-ended, semi-structured interviews. The data was interpreted and analyzed thematically with Bordin’s (1979) Working Alliance Model as a theoretical framework in mind. The results of this study highlight that there are some limitations to this model, with cultural sensitivity not being acknowledged as an important component of the working alliance. The psychologists’ experiences of culturally different client-therapist pairings illustrate how cross-cultural dynamics (i.e., race, gender, language, age, beliefs about mental health, and worldviews) complicate the process of forming meaningful therapeutic alliances in intercultural therapeutic dyads. Cultural knowledge, interpersonal sensitivity, structural flexibility, and conscious awareness of personal/cultural biases were found to be essential when working cross-culturally. Based on these findings, this study suggests that cross-cultural experiences meaningfully influence the establishment of a therapeutic alliance in the South African context and psychologists practicing cross-culturally should continue to reflect on how the complex dynamics of culture infiltrate their therapeutic relationships.
A qualitative study exploring the challenges experienced by trainee psychologists when conducting a formal mental status examination during the clinical interview.
(2019) Greener, Marc David.; Valjee, Sachet Rabindranath.
Trainee Psychologists in South Africa undergo comprehensive theoretical and practical postgraduate training within their respective disciplines (Clinical, Counselling, Educational, Industrial and Research Psychology). An aspect of training involves developing competencies in implementing and interpreting the Mental Status Examination. Research in the area of postgraduate professional training has been restricted to disciplines such as medicine and social work. Very little research has been done to understand mental health trainees‘ experiences regarding their professional development. Specifically, training as a mental health professional involves an evolution of the self as a working apparatus in the assessment and management of a client/patient. The aim of the current study was to explore the challenges faced by trainee psychologists when conducting a mental status examination with an adult client. Data was collected through interviewing trainee psychologists who, at the time of the study, were currently enrolled at the University of KwaZulu-Natal for their Clinical or Counselling Psychology Master‘s Degree. Eight Participants were interviewed, and the data was analysed using Thematic Analysis. Results indicated that the trainees experienced a number of different challenges when it came to administering the MSE such as difficulty transitioning from theory into practice. This included, but was not limited to, difficulties such as personal challenges and managing the various elements of the MSE. A number of process issues also arose whilst administering the MSE, including difficulties managing the structured and unstructured elements of the MSE and dealing with discomfort surrounding specific MSE questions. In addition to this, trainees described how the characteristics of the clients either aided them in their ability to conduct the MSE (through shared understandings or experiences) or resulted in increased difficulty (differences in age, gender or race were found to negatively impact MSE administration). Similarly, culture and language was found to play both a positive and negative role when it came to administering the MSE. Some trainees found that cultural similarities enhanced their ability to conduct the MSE, whilst others found that it hindered them in conducting the MSE. Enhanced understanding of these challenges allows for training institutions to reflect on their Psychology Master‘s training programmes, which in turn allows for Professional programme co-ordinators to take cognisance of these challenges when engaging in skills development training.
A qualitative study exploring the dynamics of patient adherence to psychotropic medication use amongst adult patients with bipolar mood disorder.
(2018) Colton, Elizabeth Jane.; Valjee, Sachet Rabindranath.
This study explored the perceived barriers of patient adherence to psychotropic medication use amongst adult patients with Bipolar Mood Disorder. Particular attention was paid to the personal experiences of each participant in relation to their mental illness, their treatment regimen and the private health care system. Two main theories were employed as a means to give the questions asked of each participant direction, namely the Theory of Reasoned Action and the Theory of Planned Behaviour. These theories were employed as a means to help interpret the results of the data gathered since they provide a broad canvas for the exploration of health-seeking behaviour. A qualitative approach was used with a semi-structured, individual face-to-face interview being conducted with each participant. The data gathered from this research was analysed using thematic analysis. Each participant was acquired through a private psychiatrist and contacted telephonically by the researcher, who then organised a face-to-face interview with each participant in a place of their choice. Each interview was audio-recorded with the permission of each participant. A total of 6 participants took place in this research, comprising of 3 males and 3 females who all met the selection criteria for this research. All participants were over the age of 18 years and had been diagnosed with Bipolar Mood Disorder (either type I or II) and had been on treatment for many years. Three core themes emerged from this research: perceived barriers to medication adherence (medication side-effects, cost and availability of medication, alcohol and substance use), behavioural beliefs and attitudes toward taking medication (psychoeducation from mental health care practitioners, phases of illness, societal and social pressure, nature and complexity of treatment regimen), as well as self-efficacy (self-learning research, ways of remembering medication). Although this research mainly focused on factors that influence non-adherence, it also sheds light on the way in which self-efficacy was enabled. This study supported previous research conducted regarding non-adherence to medication to which factors such as medication side-effects and social stigma were determined to act as barriers to adherence, however, this research attempts to explore the personal beliefs and attitudes of people who experience these barriers to their mental health treatment regimen on a daily basis.
A qualitative study exploring the psycho-social experiences and difficulties of parents who have a child with Autism Spectrum Disorder (ASD) : within a South African context.
(2019) Glinski, Charne Dee.; Valjee, Sachet Rabindranath.
ASD is a neuro-developmental disorder that is associated with lifelong deficits in social and communicative abilities as well as ability to function independently. A diagnosis of ASD also has major consequences for the parents, with the potential to radically change and affect the entire family. It has been suggested that amongst childhood developmental disorders, ASD may be one of the most stressful for parents to manage. The evidence of increasing prevalence rates worldwide and of the burden of care associated with ASD emphasises the need for further exploration of parental experiences. This study investigated the experiences and challenges of parents who have a child with ASD within a South African context,specifically the Western Cape. Methodology: The study examined parental difficulties qualitatively, through semi-structured interviews and analysed the results using thematic analysis. The results were discussed within the theoretical context of the Resiliency Model of Family Stress, Adjustment and Adaptation proposed by McCubbin and McCubbin (1993). Findings: An analysis of the interviews revealed a number of significant themes which offer insights into the psychosocial experiences of parents of a child with ASD as well as the factors that impact family resilience and coping. Emerging themes highlighted two contending and yet interlinked trends (vulnerability and resilience) that permeated the experiences of parents of children with ASD, thus expanding the insights into parental experiences beyond that of a deficit-based understanding to a multi-faceted perspective. The findings suggest a multi-dimensional perspective on resilience in these parents may be beneficial in order to fully understand their experiences and in turn support them appropriately. ASD research remains limited in South Africa despite growing interest in expanding the research base within this context. This research study provided the opportunity for in-depth exploration of parental experiences and challenges relating to raising a child with ASD in a South African setting.The findings highlight the value further research in this area could hold and therefore emphasises the need for further exploration.
A qualitative understanding of the health-seeking behaviour of adult in-patients with multi-drug resistant tuberculosis in a public health sector setting.
(2000) Valjee, Sachet Rabindranath.; Bhagwanjee, Anil Mohanlal.; Stewart, Rene.
Aim: This study aims to provide a qualitative understanding of the health-seeking behaviour of adult in-patients with multidrug-resistant tuberculosis in a public health sector setting. Methodology: A qualitative methodological approach was used in this study since it allows for an in-depth investigation and understanding of the health-seeking behaviour of MDR-TB patients. The study is seated in the arena of ethnographic inquiry, since ethnography investigates human behaviour as it is understood and experienced within a particular subtext and given reality, as it is created by the people of concern. In this regard, ethnography deals with developing an understanding of shared systems of meaning in societies that share similar social and cultural characteristics and can be applied to the study of any isolated group who have something in common. A total of four (4) 90-minute focus groups discussions were conducted with adult MDR-TB in-patients, comprising two male and two female groups. The data transcripts were analysed thematically in order to identify commonalties and variances among the responses of participants. Comparative analyses were made across the variable gender. Findings: The findings are discussed within the context of relevant empirical literature and theory, including the Health Belief Model, Health Locus of Control Theory and the Theory of Reasoned Action. These findings were constructed temporally in terms of pre-admission, admission and post-admission behaviour. What has emerged in this study is that health-seeking behaviours that are traditionally defined as "poor patient adherence" and " treatment delay" are mediated by a number of variables operating in both institutional and community contexts. At a community level, large-scale community ignorance and lack of knowledge of MDR-TB, social stigma, conflation of TB and MDR-TB and the lack of recognition of symptoms coalesce to produce poor treatment adherence and treatment delays. This situation is exacerbated by cultural practices that result in patients using dual healing systems and multiple remedies. The net result for TB sufferers is the advent of MDR-TB. At an institutional level a hierarchical biomedical bureaucracy conspires to produce a hostile, disempowering and inhumane experience for MDR-TB in-patients, which further compromises adherence behaviour and positive health actions. Recommendations: Within the context of a number of systemic recommendations, a range of practical patient-centered and staff centered interventions are suggested, followed by recommendations for future research and an appraisal of the limitations of this study.
What motivates to medicate? : a qualitative study exploring the factors that influence a parent's decision to select psycho-stimulants as first-line treatment for their ADHD child.
(2012) Cornell, Elspeth.; Valjee, Sachet Rabindranath.
This research seeks to explore and identify the factors that influence a parent’s decision to initiate psycho-stimulant treatment for their ADHD child. It is the intention of this research to gain insight into how parents make decisions about treatment for their child with ADHD and specifically, what motivates a parent to medicate. A qualitative methodological approach was employed. This research is informed by a critical, interpretive approach. An extended personal interview was conducted, using a semi-structured interview guide, with ten parents of ADHD diagnosed children. Children with comorbid conditions (both psychological and medical) were excluded from the sample to control for drug interaction mediating treatment choice. Sample selection included a combination of purposive, quota and snowball sampling techniques. The Health Belief Model and the Theory of Planned Action provide a useful theoretical framework guiding the analysis of data. Findings show that factors influencing the decision making process include: The information parents have and where that information comes from; the role of the teacher in the identification of issues; ADHD being the observer’s interpretation of the child’s behaviour and the beliefs, attitudes and perceptions parents hold regarding all aspects of ADHD. Factors that motivate a parent to choose medication in treating their child diagnosed with ADHD include: The failure of alternatives including their inconsistent treatment effects; having faith in the expert opinion of the prescribing doctor; being encouraged to ‘just try it’; a specific defining moment triggering a cue to action and pressure from a variety of sources. Conclusions of this research confirm there are many diverse factors that influence both the decision making process of parents as well as a definitive decision to choose psycho-stimulants as treatment and that there is no single factor that can be identified as a motivator to medicate. Other conclusions made include: Parents make ADHD treatment decisions based on misinformation from unqualified sources; diagnosis of ADHD remains contentious; the beliefs, attitudes and perceptions parents hold of ADHD and its treatment options play a role in their decision making process but these beliefs, attitudes and perceptions may be related to the misinformation parents have regarding aspects of ADHD and the decision to initiate stimulant treatment is both complicated and intricately related to the individual experiences. Identifying and understanding the factors that motivate treatment decisions can assist physicians and other healthcare professionals in addressing the concerns parents have in managing ADHD. In addition to this, an awareness of the factors influencing parental decisions regarding medication magnifies the important role healthcare professionals have in providing accurate and current information to parents and families when they are faced with making decisions about treatment for their child with ADHD.