The design and evaluation of a short-term group psychotherapy model for survivors of a first myocardial infarction
- Authors: Frewen, Sharon H
- Date: 2005
- Subjects: Health -- Psychological aspects , Medicine and psychology , Coronary heart disease -- Psychological aspects , Type A behavior , Stress (Psychology)
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:3247 , http://hdl.handle.net/10962/d1015041
- Description: There is extensive evidence that the rehabilitation of individuals with coronary heart disease needs to include psychological components to complement the exercise and dietary recommendations that are normally provided. However, psychological aspects have not been integrated into medical care in South Africa to any significant degree. Psychological interventions overseas have included the modification of the Type A behaviour pattern, stress management, cognitive restructuring, relaxation techniques, improved communication skills, the identification and expression of emotions, and emotional support. The aim of the present study was to design a short-term group intervention which incorporated these aspects and which included an exploration of the mind-body experience post infarct. In addition, the intervention aimed to increase participants' awareness of the compensatory dynamics of the Type A behaviour pattern. The intervention was tailored to South African conditions and was evaluated by means of a multiple case study design. The intervention was delivered to a group of nine coronary heart disease patients which included six survivors of myocardial infarction, the remaining participants having undergone a by-pass operation. Data included weekly feedback sheets evaluating each session, repeated measures on the Profile of Mood States, the Jenkins Activity Survey, a Spouse Rating Scale and extensive qualitative data on each participant including tape recordings of each session and data collected from a series of interviews before, during and after the programme. The feedback sheets and recordings of the sessions were used as a basis for recommendations for revising the content and structure of the programme for future use. Case narratives were written for three of the participants and provided an in-depth look at how and why individual changes did or did not occur in response to the intervention. In addition, the case narratives revealed the role played by the compensatory dynamics of the Type A behaviour pattern in complicating rehabilitation for survivors of myocardial infarction. Two participants were offered a series of individual sessions at 18-month follow-up and the material from these sessions was also used to aid in the interpretation of the data. The content of the 18-month follow-up sessions provided evidence for the importance of conducting a developmental analysis of the origins of low self-esteem and insecurity that maintain and drive the Type A behaviour pattern. In these sessions, this analysis provided the basis for a brief focused psychodynamic psychotherapy that facilitated marked changes that had not been achieved in the 12-week structured group intervention. It is recommended that future research investigate the use of brief psychodynamic psychotherapy on an individual basis as a complement to a group intervention focusing on psycho-education, building social support and management of problematic emotions in everyday situations.
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- Date Issued: 2005
A history of the Thembu and their relationship with the Cape, 1850-1900
- Authors: Wagenaar, E J C
- Date: 1989
- Subjects: Tembu (African people) -- History Missions -- South Africa -- Cape of Good Hope South Africa -- History -- Frontier Wars, 1811-1878 Cape of Good Hope (South Africa) -- Politics and government Land tenure -- South Africa -- Cape of Good Hope
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:2569 , http://hdl.handle.net/10962/d1002422
- Description: Present day Thembuland is situated roughly between the Mthatha and Kei rivers. It lies within the south-western portion of the political unit which has been known since 1976 as the Republic of Transkei. It comprises the territories formerly known as Emigrant Thembuland (now the districts of Cala and Cofimvaba) and Thembuland Proper, i.e. the districts of Mqanduli, Umtata, Engcobo and Bomvanaland. We have evidence that Thembu people had already settled in Thembu land Proper, at the Mbashe river, by the beginning of the 17th century. Pioneering clans many have entered the territory at a much earlier date. In the 1830's some clans broke away from the Mbashe settlement, and moved to the region of present day Queenstown. In 1853 their lands were included in the so-called Tambookie Location, which in 1871 became the district of Glen Grey. Emigrant Thembuland came into existence in 1865 when four chiefs from Glen Grey accepted Sir Philip Wodehouse's offer to settle on the lands across the White Kei whence the Xhosa chief Sarhili had been expelled in 1857. This thesis deals with the history of the people who lived in these territories between 1850 and 1900.
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- Date Issued: 1989