Perceived decision making factors in the use of traditional and alternative medicine for people living with HIV and AIDS
- Authors: Muromo, Tinashe
- Date: 2016
- Subjects: Decision making , HIV-positive persons -- Attitudes , Social influence
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/5687 , vital:20963
- Description: AIDS is one of the most destructive diseases humankind has ever faced and also brings with it profound social, economic and public health consequences, making it one of the most serious health and development challenges in the world today. Zimbabwe, situated in southeastern Africa, is not spared from the pandemic. It continues to be one of the Sub-SaharanAfrican countries mostly heavily impacted by the AIDS epidemic, with almost 1.2 million people infected and over 1.1 million orphans. It ranks, therefore, as fifth highest in the world in the impact HIV and AIDS has had on the country. The most effective response has been to introduce programmes to reduce the number of new infections. Recent research has demonstrated treatment as a preventative measure to be very effective. This approach involves targeting those who are infected so that they are not able to transmit the disease. The decision that has to be made by an infected person, however, is whether to look for traditional treatment, conventional treatment or a combination of the two. Herbal medicine use is becoming very common in many countries, especially in the developing world, where public health safety has become a concern. It has become common to use herbal medicine concomitantly with allopathic or conventional medicine. The present study focused on investigating perceptions leading to the choice of treatment with the traditional alternative medicines (TAM) as (a)/n alternative or compliment to the conventional or allopathic option. This is a qualitative study that explores and describes participant’s perceptions, beliefs, attitudes and feelings around the use of traditional medicine, within the context of the Integrative Behaviour Model (IBM). Data was collected from 20 people living with HIV and AIDS from urban and rural settings of different ethnicities (Shona and Shangani). The data analysis was informed by The Interpretive Phenomenological Analysis with the aid of NVivo (V.10), a computer-assisted Qualitative Data Analysis Software. As predicted by the IBM, both perceived individual and environmental factors were found to be key in influencing decision-making on the use of TAM by people living with HIV and AIDS. Although there were a number of incidents in which either individual or environmental factors were perceived as independently influencing the TAM-use decision-making process, there was a lot of mutual influence between the environment and the individual. Such mutual causation was abstracted as reciprocal determinism. The IMB model assumed a unidirectional causation in which the environment could affect the individual factors. While the present study identified and demonstrated these environmental effects on the individual, it also identified and presented a reverse causation in which the individual would also affect the environment with respect to motivation for TAM use. Individual factors were psychological properties that drove the individual to use TAM. Attitude, social influence and personal agency emerged as the three dimensions of individual factors. Attitudes helped in identification of orientations that located objects of thought on dimensions of judgment about the use of TAM. Social influence explained social pressure experienced and expected regarding the use of TAM. The study demonstrated the importance of both the descriptive and injunctive norm with participants indicating that they perceived important others to be using traditional medicine and that they felt perceived expectations from others to do the same and hence the motivation to comply. Personal agency pointed to the participants’ capacities to originate and direct actions for the purposes of TAM use. All these constructs were found to be very important as perceived determinants of the behavioral intentions of people living with HIV and AIDS to use traditional medicines. In experiential attitude, generally the respondents showed more perceived positive evaluations of pleasurable experiences in their use of traditional medicines. However, there were other outcome evaluations that seemed to be ambivalent and which appeared to cause a lot of tension. The comprehension of experiential attitude was found therefore found to be trichotomous rather than dichotomous as per the IBM. The effects of the instrumental attitude were revealed in the ratings of the extent to which the use of traditional medicine was perceived as useful or rewarding, with the study revealing high ratings of usefulness. It becomes clear, therefore, that for people living with HIV and AIDS social influence, perceived attitudes and personal agency are important decision-making factors in their use of traditional and alternative medicine. Efforts towards education, integration and behaviour change programmes should design messages targeting these behavioral determinants. Understanding of these perceived determinants is crucial to influencing policy as well as the adoption of health practices through education, marketing and other modes of health promotion.
- Full Text:
- Date Issued: 2016
- Authors: Muromo, Tinashe
- Date: 2016
- Subjects: Decision making , HIV-positive persons -- Attitudes , Social influence
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/5687 , vital:20963
- Description: AIDS is one of the most destructive diseases humankind has ever faced and also brings with it profound social, economic and public health consequences, making it one of the most serious health and development challenges in the world today. Zimbabwe, situated in southeastern Africa, is not spared from the pandemic. It continues to be one of the Sub-SaharanAfrican countries mostly heavily impacted by the AIDS epidemic, with almost 1.2 million people infected and over 1.1 million orphans. It ranks, therefore, as fifth highest in the world in the impact HIV and AIDS has had on the country. The most effective response has been to introduce programmes to reduce the number of new infections. Recent research has demonstrated treatment as a preventative measure to be very effective. This approach involves targeting those who are infected so that they are not able to transmit the disease. The decision that has to be made by an infected person, however, is whether to look for traditional treatment, conventional treatment or a combination of the two. Herbal medicine use is becoming very common in many countries, especially in the developing world, where public health safety has become a concern. It has become common to use herbal medicine concomitantly with allopathic or conventional medicine. The present study focused on investigating perceptions leading to the choice of treatment with the traditional alternative medicines (TAM) as (a)/n alternative or compliment to the conventional or allopathic option. This is a qualitative study that explores and describes participant’s perceptions, beliefs, attitudes and feelings around the use of traditional medicine, within the context of the Integrative Behaviour Model (IBM). Data was collected from 20 people living with HIV and AIDS from urban and rural settings of different ethnicities (Shona and Shangani). The data analysis was informed by The Interpretive Phenomenological Analysis with the aid of NVivo (V.10), a computer-assisted Qualitative Data Analysis Software. As predicted by the IBM, both perceived individual and environmental factors were found to be key in influencing decision-making on the use of TAM by people living with HIV and AIDS. Although there were a number of incidents in which either individual or environmental factors were perceived as independently influencing the TAM-use decision-making process, there was a lot of mutual influence between the environment and the individual. Such mutual causation was abstracted as reciprocal determinism. The IMB model assumed a unidirectional causation in which the environment could affect the individual factors. While the present study identified and demonstrated these environmental effects on the individual, it also identified and presented a reverse causation in which the individual would also affect the environment with respect to motivation for TAM use. Individual factors were psychological properties that drove the individual to use TAM. Attitude, social influence and personal agency emerged as the three dimensions of individual factors. Attitudes helped in identification of orientations that located objects of thought on dimensions of judgment about the use of TAM. Social influence explained social pressure experienced and expected regarding the use of TAM. The study demonstrated the importance of both the descriptive and injunctive norm with participants indicating that they perceived important others to be using traditional medicine and that they felt perceived expectations from others to do the same and hence the motivation to comply. Personal agency pointed to the participants’ capacities to originate and direct actions for the purposes of TAM use. All these constructs were found to be very important as perceived determinants of the behavioral intentions of people living with HIV and AIDS to use traditional medicines. In experiential attitude, generally the respondents showed more perceived positive evaluations of pleasurable experiences in their use of traditional medicines. However, there were other outcome evaluations that seemed to be ambivalent and which appeared to cause a lot of tension. The comprehension of experiential attitude was found therefore found to be trichotomous rather than dichotomous as per the IBM. The effects of the instrumental attitude were revealed in the ratings of the extent to which the use of traditional medicine was perceived as useful or rewarding, with the study revealing high ratings of usefulness. It becomes clear, therefore, that for people living with HIV and AIDS social influence, perceived attitudes and personal agency are important decision-making factors in their use of traditional and alternative medicine. Efforts towards education, integration and behaviour change programmes should design messages targeting these behavioral determinants. Understanding of these perceived determinants is crucial to influencing policy as well as the adoption of health practices through education, marketing and other modes of health promotion.
- Full Text:
- Date Issued: 2016
Managerial decision making processes and affective outcomes as a function of individual factors and self-efficacy beliefs
- Authors: Myburgh, Wim
- Date: 2010
- Subjects: Decision making
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:9893 , http://hdl.handle.net/10948/1141 , Decision making
- Description: Making decisions in the business environment is arguably the most challenging aspect of managers' yet also the easiest to fail in. Unlike individual decisions managers as agents for their organizations make decisions amidst high levels of ambiguity, incomplete information and mostly under time pressure. These are the very conditions that make managers vulnerable to the volition-undermining potential of decision-generated affect precisely when they are feeling over-extended to deal with such demands. Effective managerial decision making (MDM) involves more than applying a set of individual abilities. Managers face numerous obstacles, failures, and setbacks that often carry perturbing self-evaluative implications as well as social consequences that undermine their self-evaluations in ways that impair good use of their decision making skills (Bandura, 1997). Given the absence of a coherent theoretical framework in the literature the conceptual model of relations put forward attempts to organize and simplify how managers make decisions as agents of their organizations. Most conceptualizations apply oversimplified models that focus attention on one or a few variables, neglect the joint constellations of individual variable factors and the influence of individual self-generated influences as a contributing factor in MDM. As an ex post facto explanatory-predictive study the present research offers evidence of these links among the theoretically relevant constructs in order to formulate an account of their relations in a parsimonious framework that could guide future insights to explain and predict the intentions and direction of managerial decision behaviour. Conceptual research has outpaced empirical research in decision making of managers in organizations. A number of mini-theories exists that focus on a few variables using linear, antecedent-consequence relations with manipulations in laboratory environments that deal with decisions in contexts that are very different to those faced by managers. There is limited research on managers as research participants and empirical findings based on non-managerial samples and students may not generalize to managers in real life decision making. The present research used a non-probability, purposive sample (N = 196) of experienced managers in the Western Cape region of South Africa, all employed in private and public organizations (mean age 38.9 years, SD of 7.49, ethnic black managers constituted 15.8 percent of the sample). As part of the study it was necessary to construct and validate custom indicator measures in an independent pilot study from the same population. The pilot study determined the factor structures of the dimensionality and internal consistency of the custom-designed measures by way of both convergent, as well as, discriminative validity. The exploratory factor (EFA) and internal reliability analyses succeeded to provide both a comprehensive and empirical grasp on the constructs as was defined. Further, analyses of both standardized and custom-designed also revealed no significant difference between black and other managers across the pilot samples which provided confidence of the substantive relations of interest (i.e., the associations among the variables). Structural equation modeling (SEM) was chosen as the data analysis strategy of choice and a confirmatory factor analysis (CFA) demonstrated that the operational measures by and large succeeded in providing both a comprehensive and empirical grasp on the constructs as defined. The inter-construct relations were also consistent with expectations. Evidence for convergent validity however proved that the indicator measures for the allocation of attentional resources were less than adequate in order to provide an uncontaminated measure as a latent variable. The structural model was subjected to further scrutiny by way of a spectrum of goodness-of-fit statistics. The analyses revealed that the model was not adequate and the null hypothesis that the model fitted the population data was subsequently, rejected. It was also sensible to assess the degree of lack of fit of the model with reference to RMSEA which revealed a value of .08, that suggested a reasonable model fit. The poor structural model fit could however be attributed to the failure of the measured indicators used to provide an acceptable grasp of the allocation of attentional resources as a latent variable. The inherent structural flaws in the model could however not be unequivocally be ruled out as an additional possibility of poor fit. One conclusion is the possibility of an expanded model that requires additional indicator measures and additional paths. Notwithstanding these limitations, the present research provided support for social cognitive theory that underlies the model. In accordance with the literature and empirical findings the present research demonstrated mangers' decision making is much more than reason-based behaviour. The present research demonstrates the interdependencies and cumulative effects among individual factors, self-efficacy beliefs and temporal volitional processes, as psychological iv mechanisms through which social-structural factors are linked to the quality of MDM processes. The present research also presents an argument for the independent contributions of self-efficacy beliefs as causal influences on "hot temporal processes" that promote accuracy in decision making. Although present research demonstrates that the estimates were greater for cognitive ability than for both self-efficacy beliefs and social self-confidence it does not suggest that personality traits and self-efficacy beliefs have no utility. The present research demonstrates that cognitive ability combines with personality traits, self-efficacy beliefs and temporal processes (decision-generated affect and the allocation of attentional resources) in a complex manner through multiple pathways.
- Full Text:
- Date Issued: 2010
- Authors: Myburgh, Wim
- Date: 2010
- Subjects: Decision making
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:9893 , http://hdl.handle.net/10948/1141 , Decision making
- Description: Making decisions in the business environment is arguably the most challenging aspect of managers' yet also the easiest to fail in. Unlike individual decisions managers as agents for their organizations make decisions amidst high levels of ambiguity, incomplete information and mostly under time pressure. These are the very conditions that make managers vulnerable to the volition-undermining potential of decision-generated affect precisely when they are feeling over-extended to deal with such demands. Effective managerial decision making (MDM) involves more than applying a set of individual abilities. Managers face numerous obstacles, failures, and setbacks that often carry perturbing self-evaluative implications as well as social consequences that undermine their self-evaluations in ways that impair good use of their decision making skills (Bandura, 1997). Given the absence of a coherent theoretical framework in the literature the conceptual model of relations put forward attempts to organize and simplify how managers make decisions as agents of their organizations. Most conceptualizations apply oversimplified models that focus attention on one or a few variables, neglect the joint constellations of individual variable factors and the influence of individual self-generated influences as a contributing factor in MDM. As an ex post facto explanatory-predictive study the present research offers evidence of these links among the theoretically relevant constructs in order to formulate an account of their relations in a parsimonious framework that could guide future insights to explain and predict the intentions and direction of managerial decision behaviour. Conceptual research has outpaced empirical research in decision making of managers in organizations. A number of mini-theories exists that focus on a few variables using linear, antecedent-consequence relations with manipulations in laboratory environments that deal with decisions in contexts that are very different to those faced by managers. There is limited research on managers as research participants and empirical findings based on non-managerial samples and students may not generalize to managers in real life decision making. The present research used a non-probability, purposive sample (N = 196) of experienced managers in the Western Cape region of South Africa, all employed in private and public organizations (mean age 38.9 years, SD of 7.49, ethnic black managers constituted 15.8 percent of the sample). As part of the study it was necessary to construct and validate custom indicator measures in an independent pilot study from the same population. The pilot study determined the factor structures of the dimensionality and internal consistency of the custom-designed measures by way of both convergent, as well as, discriminative validity. The exploratory factor (EFA) and internal reliability analyses succeeded to provide both a comprehensive and empirical grasp on the constructs as was defined. Further, analyses of both standardized and custom-designed also revealed no significant difference between black and other managers across the pilot samples which provided confidence of the substantive relations of interest (i.e., the associations among the variables). Structural equation modeling (SEM) was chosen as the data analysis strategy of choice and a confirmatory factor analysis (CFA) demonstrated that the operational measures by and large succeeded in providing both a comprehensive and empirical grasp on the constructs as defined. The inter-construct relations were also consistent with expectations. Evidence for convergent validity however proved that the indicator measures for the allocation of attentional resources were less than adequate in order to provide an uncontaminated measure as a latent variable. The structural model was subjected to further scrutiny by way of a spectrum of goodness-of-fit statistics. The analyses revealed that the model was not adequate and the null hypothesis that the model fitted the population data was subsequently, rejected. It was also sensible to assess the degree of lack of fit of the model with reference to RMSEA which revealed a value of .08, that suggested a reasonable model fit. The poor structural model fit could however be attributed to the failure of the measured indicators used to provide an acceptable grasp of the allocation of attentional resources as a latent variable. The inherent structural flaws in the model could however not be unequivocally be ruled out as an additional possibility of poor fit. One conclusion is the possibility of an expanded model that requires additional indicator measures and additional paths. Notwithstanding these limitations, the present research provided support for social cognitive theory that underlies the model. In accordance with the literature and empirical findings the present research demonstrated mangers' decision making is much more than reason-based behaviour. The present research demonstrates the interdependencies and cumulative effects among individual factors, self-efficacy beliefs and temporal volitional processes, as psychological iv mechanisms through which social-structural factors are linked to the quality of MDM processes. The present research also presents an argument for the independent contributions of self-efficacy beliefs as causal influences on "hot temporal processes" that promote accuracy in decision making. Although present research demonstrates that the estimates were greater for cognitive ability than for both self-efficacy beliefs and social self-confidence it does not suggest that personality traits and self-efficacy beliefs have no utility. The present research demonstrates that cognitive ability combines with personality traits, self-efficacy beliefs and temporal processes (decision-generated affect and the allocation of attentional resources) in a complex manner through multiple pathways.
- Full Text:
- Date Issued: 2010
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