An analysis of the experience of the acute phase of traumatic spinal cord injury in a South African spinal unit
- Authors: Gaitelband, Philip Joseph
- Date: 1996
- Subjects: Spinal cord -- Wounds and injuries -- Psychological aspects , Spinal cord -- Wounds and injuries -- Patients -- Rehabilitation
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:2978 , http://hdl.handle.net/10962/d1002487 , Spinal cord -- Wounds and injuries -- Psychological aspects , Spinal cord -- Wounds and injuries -- Patients -- Rehabilitation
- Description: This study aims to explore, and to a certain extent to clarify, what it means psychologically to experience Traumatic spinal cord injury (TSCI) in a South African spinal unit. The target time chosen for analysis is the acute medical period. The study presents a review of the literature on psychological adjustment to TSCI and then proceeds to introduce and extensively articulate the hermeneutic approach and methodology. Subsequently, an interpretive research strategy is presented for the purpose of studying the acute phase of TSCI. The data for the study was obtained by means of three dialogical interviews which were tape recorded, transcribed and analyzed with~n a cyclical framework consisting of three interdependent levels. The interpretive procedure is modeled upon the 'reading guide' developed by Brown, Tappan, Gilligan, Miller and Argyris (1989). The analysis follows a course from the individual psychological descriptions of the experience to the generation of a general, nomothetic narrative account of the acute phase. The findings are then discussed in relation to the existing literature and evaluated on the basis of the goals of the study. The study highlights the value of some of the 'stage' ways of thinking about SCI adjustment, while simultaneously stressing the need for placing adjustment within a more personalized, and individually meaningful context. Significant differences between the psycho-physical experiences of patients in the categories of complete and -incomplete SCI were found, which suggests that a sharper distinction be made in the literature between these two groups, in order to account for the marked variations in their experiences.-- The study also contains a number of shortcomings, such as a lack of understanding about certain historical and contextual factors which may have mediated the experiences of the trauma for the individuals concerned. These shortcomings and some suggestions fro their resolution are then discussed. The study concludes with an evaluation of the research strategy and methodology and also offers some suggestions for future research.
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- Date Issued: 1996
The Bender Gestalt Test: an investigation into problems concerning administration and scoring and its application to low-educated adults
- Authors: Dyall, Kate
- Date: 1996
- Subjects: Bender-Gestalt Test , Psychological tests , Brain-damaged children -- Psychological testing
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:2968 , http://hdl.handle.net/10962/d1002477 , Bender-Gestalt Test , Psychological tests , Brain-damaged children -- Psychological testing
- Description: The study investigates .the use of the Bender Gestalt Test (BGT) amongst low-educated adults. Three versions of the BGT are used in this study; the original 'copy' version as well as the 'immediate' and 'delayed'recall versions. This is done so as to expand the ability of the BGT to identify neurological impairment and to differentiate between this and functional impairment. A literature review explores the problems of standardization in the administration, scoring and application of all three versions of the test Suggestions are made to correct the problems identified and a novel system of scoring the recall versions are proposed, which allows for the comparison of results of the three versions of the test and which is based on Lacks's (1984) and Weiss's (1970) systems. Administration procedures were also developed to suit the context of the study. The copy, immediate and delayed versions of the BGT were administered to a group of 184 low-educated adults. Statistical analyses revealed significant education effects for the sample tested with regards to both test scores and performance time. The finding of an education effect for performance time is discussed at length, as some literature regards excessive time as a neurological indicator. An anomaly for the group with no education was found to exist, with the scores of these subjects not Significantly different from those with 4-6 years of education. Possible reasons for this were explored. In addition, the findings of this research revealed a plateau effect with those having less than 6 years of education scoring substantially lower than those with 7 years and more. The scores of adults with 7 and more years of education level out with no significant differences between educational levels. This appears to suggest that education effects rather than the developmental maturity level proposed by Koppitz, are involved. In addition, the scores of low-educated adults on the expanded Bender Gestalt Test were significantly lower than those of children with similar educational levels, in other studies. These findings and possible explanations are discussed. The study concludes by suggesting new research areas and emphasizing the urgent need for separate normative data on the expanded BGT for low-educated adults, and the establishment of appropriate 'cut-off' points.
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- Date Issued: 1996
The interface between Western mental health care and indigenous healing in South Africa: Xhosa psychiatric nurses' views on traditional healers
- Authors: Kahn, Marc Simon
- Date: 1996
- Subjects: Mental health services -- Research -- South Africa , Traditional medicine -- South Africa , Black people -- Mental health -- South Africa , Mental health -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:2999 , http://hdl.handle.net/10962/d1002508 , Mental health services -- Research -- South Africa , Traditional medicine -- South Africa , Black people -- Mental health -- South Africa , Mental health -- South Africa
- Description: Xhosa psychiatric nurses stand unique at the interface between Western mental health care and indigenous healing in South Africa. They stem from a cultural history that is embedded within traditional health care discourses and yet are trained and work within a Western psychiatric model. In embodying the intersection between these two paradigms, they are faced with the challenge of making sense of such an amalgamation. These nurses' views are thus valuable in reflecting this intersection and illustrating many of the central concerns that surround it. This study explicates the views of these nurses toward traditional healers and their potential role in mental health care in South Africa. In addition, it illuminates some of the cultural dynamics at work amongst these subjects as they struggle to make sense of their unique cultural position. Using a questionnaire-based methodology, the views of Xhosa psychiatric nurses in a psychiatric hospital in the Eastern Cape, toward traditional healers and their role in mental-health care, were examined. The findings reveal that the vast majority of these nurses believe in traditional cosmology, involve themselves in traditional ritual practices and regularly visit traditional healers as patients. In suggesting ways in which indigenous healing and Western mental health care can work together, 75% of the nurses were in favour of a general referral system between the hospital and traditional healers, most (77%) agreed that certain patients would be better off being treated by both the hospital and traditional healers than they would if they were only being treated by the hospital alone, and 85% of the subjects agreed that patients who are already seeing traditional healers should check if psychiatric medication might help them. These findings indicate that these nurses operate across two healing systems which are at this point not conceptually compatible. This results in deep cultural tension for the nurses. In being entangled in the dialectical tension created in this context, the nurses manage the incongruencies in three general ways: a) Most, in one form or another, incorporate beliefs from both systems into an integrative model, b) some assimilate their cultural belief system into the Western mental health paradigm, throwing off their beliefs in traditional healing, and c) others remain ambivalent in the dialectic between traditional and Western health care discourses. Although this may suggest that these nurses reside within a cultural milieu that is somewhat unhealthy, at another level, in managing and containing the incompatibility between the two systems, these nurses ensure a space for on-going and healthy critique of the underlying assumptions involved in this health care malaise.
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- Date Issued: 1996