Psychometric Properties of the Stellenbosch Endometriosis Quality of Life (SEQOL) Among Endometriosis Patients in the United Kingdom.

Background and Purpose: We aimed to determine the reliability and validity of the Stellenbosch Endometriosis Quality of Life (SEQOL) among patients with endometriosis in the United Kingdom. Methods: We used a cross-sectional research design that featured online data collection. We administered several measures to 596 participants. Data analysis included confirmatory factor analysis, exploratory factor analysis, reliability analysis, and correlations. Results: The data did not fit the original eight-factor structure, but rather a six-factor structure. Six items were removed. The measure produced strong internal consistency reliabilities. The SEQOL also demonstrated promising validity, producing strong correlations with another health-related quality of life (HRQOL) measure. Conclusion: In summary, we conclude that the United Kingdom version of the SEQOL is a viable measure of HRQOL.

Stakeholders' perspectives on the development of an Africa-focused postgraduate diploma to address public mental health training needs in Africa: a qualitative study.

BACKGROUND: Despite the significant contribution of mental health conditions to the burden of disease, there is insufficient evidence from Africa to inform policy, planning and service delivery. Thus, there is a need for mental health research capacity building, led by African public mental health researchers and practitioners, to drive local research priorities. The aim of African mental health Researchers Inspired and Equipped (ARISE) was to develop a one-year postgraduate diploma (PGDip) in public mental health to address the current gaps in public mental health training. METHODS: Thirty-six individual interviews were conducted online with three groups of participants: course convenors of related PGDips in South Africa, course convenors of international public mental health degree programmes and stakeholders active in public mental health in Africa. The interviewers elicited information regarding: programme delivery, training needs in African public mental health, and experiences of facilitators, barriers and solutions to successful implementation. The transcribed interviews were analysed by two coders using thematic analysis. RESULTS: Participants found the Africa-focused PGDip programme acceptable with the potential to address public mental health research and operational capacity gaps in Africa. Participants provided several recommendations for the PGDip, including that: (i) the programme be guided by the principles of human rights, social justice, diversity and inclusivity; (ii) the content reflect African public mental health needs; (iii) PGDip faculty be skilled in teaching and developing material for online courses and (iv) the PGDip be designed as a fully online or blended learning programme in collaboration with learning designers. CONCLUSIONS: The study findings provided valuable insight into how to communicate key principles and skills suited to the rapidly developing public mental health field while keeping pace with changes in higher education. The information elicited has informed curriculum design, implementation and quality improvement strategies for the new postgraduate public mental health programme.

Lived experiences of adolescents admitted for first-episode psychosis in South Africa.

Background: First-episode psychosis is common in adolescents and can be distressful to the person experiencing it for the first time. However, there is limited research globally and specifically in Africa about the lived experiences of adolescents admitted into a psychiatric facility for first-episode psychosis. Aim: To understand the adolescents' experiences of psychosis and receiving treatment in a psychiatric facility. Setting: Adolescent Inpatient Psychiatric Unit, Tygerberg Hospital, Cape Town, South Africa. Methods: This was a qualitative study that used purposive sampling to recruit 15 adolescents with first-episode psychosis and admitted to the Adolescent Inpatient Psychiatric Unit, Tygerberg Hospital in Cape Town, South Africa. Individual interviews were audio recorded, transcribed and analysed using thematic analysis consisting of both inductive and deductive coding. Results: The participants described negative experiences of their first episode psychosis, provided varying explanations for their first episode psychosis and had the insight that cannabis precipitated their episodes. They described both positive and negative interactions with both the other patients and staff. They did not wish to return to the hospital again following their discharge. Participants stated that they wanted to change their lives, return to school and try to prevent a second episode of psychosis. Conclusion: This study provides insights into the lived experiences of adolescents presenting with first-episode psychosis and calls for future research to delve deeper into factors that support or enable recovery among adolescents with psychosis. Contribution: The findings of this study call for improving the quality of care in the management of first-episode psychosis in adolescents.

Determinants of Post-Traumatic Growth and Quality of Life in Ghanaian Breast Cancer Survivors.

This study assessed the psychosocial factors associated with post-traumatic growth (PTG) and health-related quality of life (HRQoL) in women breast cancer survivors. Women (N = 128) completed questionnaires on social support, religiosity, hope, optimism, benefit-finding, PTG and HRQoL. Structural equation modeling was used to analyze the data. Results showed that perceived social support, religiosity, hope, optimism, and benefit finding were positively associated with PTG. Religiosity and PTG were positively associated with HRQoL. The results suggest that interventions aimed at increasing religiosity, hope, optimism, and perceived support can help survivors cope better with breast cancer.

Psychosocial correlates of symptoms of depression among patients with endometriosis in the United Kingdom.

A recent study found high levels (43%) of moderate to severe symptoms of depression among patients diagnosed with endometriosis in South Africa (SA) and identified several psychosocial predictors of these symptoms of depression. However, there is limited research on predictors of symptoms of depression in other settings. Considering the contextual differences between SA and the United Kingdom (UK) and their vastly different healthcare settings, we conducted a replication study in the UK and improved on the methodology by adding an established measure of sexual dysfunction to the model and obtaining a larger sample. The study comprised of a secondary analysis of cross-sectional data collected among patients with endometriosis. Study particulars were advertised by a national endometriosis association and data were collected online using Qualtrics. The sample consisted of 598 adults with self-reported endometriosis who completed measures assessing symptoms of depression, physical functioning, menstrual characteristics, sexual functioning, feelings about the medical profession, feelings about infertility, and sexual relationships. Seventy-one percent of participants reported moderate to severe levels of symptoms of depression. In addition, physical functioning, concerns about menstrual characteristics, sexual dysfunction, feelings about infertility and feelings about the medical profession were identified as significant predictors of symptoms of depression. It is important that healthcare professionals recognize that patients with endometriosis may be at risk of depression and that psychological referral should be considered.

Understanding the subjective experiences of South African women with recurrent breast cancer: A qualitative study.

This study explored the subjective experiences of 12 South African women diagnosed with recurrent breast cancer. Women were invited to take part in unstructured narrative interviews, and to complete a diary in which they could reflect on their breast cancer experiences. Most responded to their recurrence with an optimistic stance. Religious beliefs and support structures were important coping strategies. Women's perceptions of their changed bodies varied from being of least concern, to becoming the most distressing aspect. The findings highlight the complexity of illness experience and the different ways in which women make sense of a second episode of cancer.

Measuring online health-seeking behaviour: Construction and initial validation of a new scale.

OBJECTIVES: Online health-seeking behaviour (OHSB) such as information- and support-seeking encompasses a range of motivations and outcomes, but few studies consider the nuances of OHSB. The current study aimed to (1) develop and provide an initial validation of an OHSB measure, and (2) explore the role of demographic variables in OHSB among adult Internet users. DESIGN: The study was a quantitative, cross-sectional online survey. METHODS: The study consistent of two data collection waves, including 451 general Internet users (aged 18-73) and 204 online health groups users (aged 19-78) who completed online questionnaires. RESULT: Exploratory Factor Analysis and Item Analysis in the two samples resulted in a final 37-item measure. The scale comprises three distinct factors: Support seeking (α = .97); information seeking (α = .89); and the Internet as a supplement or alternative to offline medical care (α = .88). Multiple regression analyses indicated that younger age, a higher number of people living in the household, and presence of a chronic condition significantly predicted all three aspects of OHSB. Poorer perceived health also predicted support-seeking online, while being male, employed and a general Internet user (vs. online health group member) also predicted using the Internet as a supplement or alternative to offline medical care. CONCLUSION: The study presents a useful scale for future research to explore more complex psychosocial, contextual and health-related variables as potential contributors to health-seeking in the online domain.

Scoping review of the psychosocial aspects of infertility in developing countries: protocol.

INTRODUCTION: Infertility is a widespread social phenomenon. For both women and men, there are several psychosocial issues associated with infertility. Numerous systematic reviews have focused on individuals' psychosocial issues pertaining to infertility, however, these have been conducted in developed countries. Thus, there is a gap in the current literature to analyse individuals' psychosocial issues associated with infertility in developing countries. Given that there are various contextual factors to consider for appropriate interventions to be implemented, it is vital to explore this topic in a developing context. METHODS AND ANALYSIS: A scoping review will be conducted. A total of 12 databases were identified and a search string including terms related to infertility, psychosocial aspects and developing countries was developed. The inclusion and exclusion of each article will be determined through the guidelines provided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow chart. Quantitative and qualitative data will be collated. The findings will summarise existing research on psychosocial aspects of infertility in developing countries and identify gaps in the research corpus. ETHICS AND DISSEMINATION: Data will not be collected from participants. Instead, data will be extracted from published studies and therefore no ethical approval is required. The findings will be published in a peer-reviewed journal.

Moving Beyond Text-and-Talk in Qualitative Health Research: Methodological Considerations of Using Multiple Media for Data Collection.

Qualitative researchers are increasingly making use of multiple media to collect data within a single study. Such approaches may have the potential to generate rich insights; however, there are also potential methodological challenges in simultaneously analyzing data from multiple media. Using three case studies from our work with women who had recurrent breast cancer in South Africa, we explore four challenges of using multiple media to collect data: (a) how to understand the repetition of themes (or lack thereof) across multiple media; (b) whether or not data collected from multiple media over a protracted period should be read as longitudinal data reflecting a dynamic process; (c) what impact using multiple media has on the participant-researcher relationship; and (d) how the medium may shape the data obtained. We propose that the value of using multiple methods lies in the opportunity they provide to understand how participants engage with the different media.

Biopsychosocial predictors of symptoms of depression in a sample of South African women diagnosed with endometriosis.

We examined biopsychosocial predictors of symptoms of depression in women with endometriosis. The sample consisted of 202 women with endometriosis who completed a battery of measures including a demographic questionnaire, Beck Depression Inventory, Stellenbosch Endometriosis Quality of life Menstrual characteristics subscale, Short form health survey Physical functioning subscale, and three modular components of the Endometriosis Health Profile 30, namely the Sexual Relationships, Feelings about the Medical Profession, and Feelings about Infertility modules. About 43.1% of the sample reported moderate to severe symptoms of depression. Physical functioning, feelings about the medical profession and sexual relationships were significant predictors of symptoms of depression. The identification of these predictors may enable researchers and practitioners to identify patients to be screened for depression, e.g., patients who report sub-optimal physical functioning, negative feelings about the medical profession and difficult sexual relationships.

The hegemonic role of biomedical discourses in the construction of pregnancy loss.

BACKGROUND AND PROBLEM: Pregnancy is constructed as a joy-filled and natural experience with a taken-for-granted expectation that the outcome will be a healthy baby. However, in South Africa approximately 1 in 4 pregnancies end in miscarriage and the stillbirth rate is 24 per 100 live births. Despite the overwhelming statistics, reproductive loss is considered a cultural taboo and continues to be silenced in various ways by the medical fraternity and society in general. AIM: Our study aimed to demonstrate the role that biomedical discourses play in shaping both women's experiences of reproductive loss as well as how those close to them respond to these losses. The study was located within a social constructionist framework. METHODS: Seven South African women were recruited via snowball sampling to participate in in-depth interviews. A discourse analysis was conducted to deconstruct hegemonic discourses implicit in the participants' dialogues. FINDINGS: The adoption of medical framing of miscarriage and the social awkwardness of loss framed the participants talk about their miscarriages. Our study highlights the centrality of biomedical discourses in influencing both the experiences of our participants as well shaping social discourses. The adoption of the medical framing of miscarriage were identified in the following themes: no answers to first trimester miscarriage and the normalization of miscarriage. The social awkwardness of loss were identified as lack of cultural scripts, lack of acknowledgement and unhelpful words and actions. CONCLUSION: The paper highlights the power inherent in medicine and demonstrates how this hegemony pervades societal understandings of reproductive loss. Caught in this crossfire are grieving mothers with few alternatives in terms of their grief processes.

Women's stories of living with breast cancer: A systematic review and meta-synthesis of qualitative evidence.

RATIONALE: Globally, breast cancer is by far the most frequently occurring cancer amongst women. Whilst the physical consequences of the disease and associated treatments are well documented, a comprehensive picture of how breast cancer is experienced at all stages of disease progression is lacking. OBJECTIVE: This systematic review aimed to synthesize qualitative studies documenting women's breast cancer narratives into an empirically based explanatory framework. METHODS: Two investigators independently searched Academic Search Premiere, CINAHL, Health Source: Nursing/Academic Edition, MEDLINE, PsycARTICLES, PubMed, Science Direct, SCOPUS, Web of Science and three international dissertation repositories using a pre-specified search strategy to identify qualitative studies on women's breast cancer narratives across all geographic and income-level settings. Of the 7840 studies that were screened for eligibility, included in the review were 180 studies, which were assessed using the Critical Appraisal Skills Programme. Using a 'meta-study' approach, an explanatory model of the breast cancer experience was formulated. Finally, we assessed the confidence in the review findings using the 'Confidence in the Evidence from Reviews of Qualitative Research' (CERQual) guidelines. RESULTS: Eight core themes were identified: the burden of breast cancer, existential ordeal, illness appraisal, sources of support, being in the healthcare system, the self in relation to others, changes in self-image, and survivor identity. Together, these form the proposed Trajectory of Breast Cancer (TBC) framework. CONCLUSION: The Trajectory of Breast Cancer explanatory framework offers a theoretically defensible synthesis of women's experiences of breast cancer. This framework provides an empirical basis for future reviewers conducting qualitative and narrative breast cancer research.

Students' self-reported fears and the perceived origins thereof.

The objective of this study was to explore the five most frequently reported fears in a sample of university students, and investigate the origins of these fears. The study employed a cross-sectional design with convenience sampling. Data were collected using a self-report questionnaire and analysed using a combination of descriptive statistics and content analysis. Participants consisted of 544 first-year psychology students. This study identified academic failure, animals, general failure, losing loved ones to death, and violence/crime as the top five fears among a sample of university students. 'Conditioning experiences' was one of the most prominent pathways in the acquisition of all these fears. 'Negative information transmission' was also a dominant pathway relating to the origin of fear such as academic failure and violence/crime. However, 'modelling experiences' was not identified as a prominent pathway in the present study. These findings contribute to identifying the origins of first-year students' self-reported fears by using the three pathways theory. These findings may contribute meaningfully to the development and implementation of prevention and intervention programmes at higher education institutions.

Salient aspects of quality of life among women diagnosed with endometriosis: A qualitative study.

This study examined health-related quality of life among a sample of South African women diagnosed with endometriosis. Semistructured interviews were conducted with 25 participants in South Africa. Participants discussed the ways in which endometriosis affected their health-related quality of life. A total of 10 categories emerged from the data, namely, (1) medical factors, (2) physical functioning, (3) psychological functioning, (4) sexual functioning, (5) reproductive functioning, (6) interpersonal functioning, (7) occupational functioning, (8) information and knowledge, (9) healthcare and medical treatment and (10) financial impact and considerations. Each category was described and compared with findings from other health-related quality of life research in women with endometriosis.

Psychosocial predictors of distress and depression among South African breast cancer patients.

OBJECTIVE: The present study focused on psychological distress and symptoms of depression among a sample of patients attending an outpatient breast cancer clinic in South Africa. The authors also sought to identify the predictors of distress and depression by using demographic, medical, and psychosocial variables, including perceived and received social support. METHODS: A convenience sample of breast cancer patients was recruited from the Breast Clinic at a hospital in the Western Cape, South Africa. Participants (N = 201) were asked to complete a questionnaire battery consisting of, inter alia, the Center for Epidemiological Studies-Depression Scale, the Hopkins Symptom Checklist, and the Berlin Social Support Scales. RESULTS: More than one-third of participants scored in the elevated ranges on the Center for Epidemiological Studies-Depression Scale and Hopkins Symptom Checklist, indicating that distress and symptoms of depression were a concern for a sizable minority of participants. Regression analysis showed that body change stress and perceived social support were significant predictors of both psychological distress and symptoms of depression. CONCLUSIONS: Distress and depressive symptoms are prevalent among South African breast cancer patients, especially those with higher body change stress and lower perceived support. For breast cancer patients who are distressed or have symptoms of depression, social support, information, psychosocial counseling, and in some cases, referral for medication management and cognitive psychotherapy is indicated. This article calls attention to the need for psychosocial services directed at supporting patients receiving care at breast clinics in South Africa.

Predictors of burnout among HIV nurses in the Western Cape.

BACKGROUND: Burnout has been implicated as one of the reasons for key healthcare personnel, such as nurses, leaving their profession, resulting in insufficient staff to attend to patients. OBJECTIVE: We investigated the predictors of three dimensions of burnout, namely emotional exhaustion, depersonalisation and personal accomplishment, among nurses in South Africa attending to patients living with HIV. METHOD: Participants were recruited at a large tertiary hospital in the Western Cape region, with the help of the assistant director of nursing at the hospital. They completed the Maslach Burnout Inventory, the Quantitative Workload Inventory, the Interpersonal Conflict at Work Scale, the Organisational Constraints Scale, the Death and Dying subscale of the Nursing Stress Scale, and the HIV and AIDS Stigma Instrument - Nurse. RESULTS: We found elevated levels of burnout among the sample. Workload, job status and interpersonal conflict at work significantly explained more than one-third of the variance in emotional exhaustion (R² = 0.39, F(7, 102) = 9.28, p = 0.001). Interpersonal conflict, workload, organisational constraints and HIV stigma significantly explained depersonalisation (R² = 0.33, F(7, 102) = 7.22, p = 0.001). Job status and organisational constraints significantly predicted personal accomplishment (R² = 0.18, F(7, 102) = 3.12, p = 0.001). CONCLUSION: Factors such as workload, job status and interpersonal conflict in the work context, organisational constraints and stigma associated with HIV were found to be predictors of burnout in the sample of nurses. Our recommendations include developing and testing interventions aimed at reducing burnout among nurses, including reducing workload and creating conditions for less interpersonal conflict at work.

Predictors of burnout among HIV nurses in the Western Cape

Background: Burnout has been implicated as one of the reasons for key healthcare personnel, such as nurses, leaving their profession, resulting in insufficient staff to attend to patients.Objective: We investigated the predictors of three dimensions of burnout, namely emotional exhaustion, depersonalisation and personal accomplishment, among nurses in South Africa attending to patients living with HIV.Method: Participants were recruited at a large tertiary hospital in the Western Cape region, with the help of the assistant director of nursing at the hospital. They completed the Maslach Burnout Inventory, the Quantitative Workload Inventory, the Interpersonal Conflict at Work Scale, the Organisational Constraints Scale, the Death and Dying subscale of the Nursing Stress Scale, and the HIV and AIDS Stigma Instrument ­ Nurse.Results: We found elevated levels of burnout among the sample. Workload, job status and interpersonal conflict at work significantly explained more than one-third of the variance in emotional exhaustion (R² = 0.39, F(7, 102) = 9.28, p = 0.001). Interpersonal conflict, workload, organisational constraints and HIV stigma significantly explained depersonalisation (R² = 0.33, F(7, 102) = 7.22, p = 0.001). Job status and organisational constraints significantly predicted personal accomplishment (R² = 0.18, F(7, 102) = 3.12, p = 0.001).Conclusion: Factors such as workload, job status and interpersonal conflict in the work context, organisational constraints and stigma associated with HIV were found to be predictors of burnout in the sample of nurses. Our recommendations include developing and testing interventions aimed at reducing burnout among nurses, including reducing workload and creating conditions for less interpersonal conflict at work

Coping strategies employed by women with endometriosis in a public health-care setting.

This study explored how South African patients attending public health facilities reported coping with endometriosis. A total of 16 women with endometriosis were interviewed, and we explored how participants coped with endometriosis. All interviews were audio-recorded and transcribed. Thematic analysis was used to identify themes. Participants reported employing both problem-focused and emotion-focused strategies to cope with endometriosis. Problem-focused strategies included limiting physical activities, increasing knowledge about endometriosis, scheduling social and work activities around menstrual cycle, engaging in self-management and relying on social support. Emotion-focused coping strategies included accepting the disease, adopting a positive attitude, engaging in self talk and evoking spirituality.

The Psychological Experience of Women who Survived HELLP Syndrome in Cape Town; South Africa

Background: Haemolysis; elevated liver enzymes and low platelet count (HELLP syndrome) is a high-risk pregnancy condition that could be fatal to mother and/or baby. It is characterised; as the acronym indicates; by haemolysis; elevated liver enzymes and low blood platelets.Objective: This study explored women in Cape Town's psychological experience of HELLP syndrome. Method: Six participants who previously experienced HELLP syndrome were interviewed. Using a grounded theory approach; themes emerged and a model illlustrating the psychological experience of HELLP syndrome was constructed. Results: The major themes that emerged were the perceived lack of information; a need to assign blame and a shift in focus. Themes of not knowing and trance and/or surreal experience underpin the cognitive aspects of the HELLP syndrome experience. Themes that expressed feelings of an inability to control; whirlwind and/or rapid pace and support acted together to bind the experience. Finally; emotions such as anger; ambivalence; disbelief; anxiety; guilt; loneliness and fear were present throughout the experience. Conclusion: This study developed an initial exploratory model representing the psychological experience of HELLP syndrome in a sample of South African women. Underlying this entire experience was a perceived lack of information which had a profound effect on numerous aspects of the experience ranging from where to locate blame to the varied emotions experienced