Dissertations / Theses: 'Counselling and testing'

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Mabota, Princess Martinah. "Psychological well-being of volunteer counselling and testing counsellors." Diss., University of Pretoria, 2013. http://hdl.handle.net/2263/33375.

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In the South African public health care system, HIV Counselling and Testing (HCT) has become a function that is routinely entrusted to lay counsellors. These counsellors are expected to educate clients about HIV and AIDS, encourage them to be tested and convince them to change risky behavioural practices. They have to convey the clients’ test results and assist those who test HIV-positive and their families to cope with the psychological challenges associated with the diagnosis. The counsellors occupy the front line of HIV and AIDS service delivery, even though they are not formally employed in the health care system. They only have basic training and are not adequately remunerated. The counsellors are confronted with psychological and structural stressors in their work. Psychological stressors include the impact of emotionally challenging work, the lack of appropriate training, debriefing and supervision. Because they are not formally employed in the health care system, there is a lack of formal supervision or channels to discuss their frustrations. This research focuses on the stressors which HIV counsellors experience, how they cope, and the impact it has on their psychological well-being. As part of the mixed methods approach 50 HCT counsellors working at the City of Tshwane clinics completed the Bar-On Emotional Quotient Inventory, the Maslach Burnout Inventory for Human Services Survey (MBI- HSS), the Centre for Epidemiologic Studies Depression scale (CES-D), and the Brief COPE scale to assess their psychological well-being. In addition, they participated in focus group discussions. EQ-i scores indicated that counsellors reported below average emotional skills, with the overall group score of (88.76). Scores that indicated average emotional skills were Self-Regard (101), Interpersonal Relationships (100.12), and Impulse Control (102.66). Scores that indicated low emotional skills were Independence (86.66), Self-Actualization (88.28), and Reality Testing (83.94). Although they reported high levels of Emotional Exhaustion (27.66), they also have a sense of high Personal Accomplishment (38.64) (MBI-HSS). Counsellors reported an overall CES-D score which was indicative of mild depression (26.08). Counsellors used mostly positive coping skills that included religion, planning, and direct action in coping with stressors in their lives. In a regression analysis with depression as the dependent variable, there was a positive relationship between depression and depersonalization and a negative relationship with positive or active coping and assertiveness. It was concluded that counsellors experienced some depression, emotional exhaustion, and lower than average levels of emotional well-being. Despite that, they reported positive ways of coping and high levels of personal accomplishment. Counsellors were motivated by their sense of altruism, compassion towards their clients, the positive changes they see in client’s lives as well as the reciprocal relationships they have formed with their clients. Counsellors thus have strengths to cope with the high level of stressors and challenges related to their work. It can be concluded that their state of mental health is in line with Keyes’ proposal that mental health forms a continuum. They fluctuate between mental well-being and mental ill-being. However, it is necessary to assist HCT counsellors to develop their emotional capacities to enable them to enhance their ability to counsel their clients effectively.
Dissertation (MA)--University of Pretoria, 2013.
gm2014
Psychology
unrestricted

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Lawrence, Estelle. "School-based HIV counselling and testing: providing a youth friendly service." University of the Western Cape, 2012. http://hdl.handle.net/11394/2159.

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Philosophiae Doctor - PhD
HIV counselling and testing (HCT) is an essential element in the response to the HIV epidemic. Thereare still major gaps in research about the best ways to provide HCT, especially to young people. School-based HCT is a model which has been suggested for providing HCT to young people in a youth friendly manner. This study was aimed at producing recommendations for providing a youth friendly school-based HCT service using the World Health Organisation (WHO) framework for youth friendly health services. It was conducted in six secondary schools in Cape Town, where a mobile HCT service is provided by a nongovernmental organisation (NGO). It was an exploratory descriptive study, using a mixed-methods approach. Twelve focus group discussions (FGDs) were held with learners to explore their needs with regards to school-based HCT. An evaluation (which consisted of observation of the HCT site, service provider interviews and direct observation of the HCT counselling process) was done to determine whether the mobile school-based HCT service was youth friendly. A learner survey was conducted with 529 learners to investigate the factors that influence the uptake of HCT and to explore learners’ behaviours and experiences under test conditions. In the FGDs, learners said that they wanted HCT to be provided in schools on condition that their fears and expressed needs were taken into account. They wanted their concerns regarding privacy and confidentiality addressed; they wanted to be provided with information regarding the benefits and procedure of HCT before testing took place; they wanted service providers to be competent to work with young people, and they wanted to be assured that those who tested positive were followed up and supported. On evaluation of the mobile school-based HCT service, it was evident that the service did not meet all the needs of the learners nor did it have all the characteristics of a youth friendly health service. The model of ‘mass testing’ used by the NGO did not fulfil learners’ expressed need for privacy with regards to HCT. Service providers were friendly and on-judgemental but had not been trained to work with young people (especially marginalised groups e.g. young men who have sex with men). The information needs of learners were not addressed, and learners were not involved in the provision of the HCT service. Learners who tested positive were not assisted in accessing care and support. The learner survey revealed a high uptake of HCT (71% of learners) at schools with learners who do not identify themselves as Black, with female learners and older learners being more likely to have had an HIV test. Factors that influenced uptake of HCT were complex, with learners reporting many different motivators and barriers to testing. Of concern was the low risk perception of learners with regards to HIV infection and the fact that learners who tested HIV positive were not being linked up with treatment and care. Based on the findings of the study, recommendations were made for proving youth friendly school based HCT. A multisectoral approach, with learner and community involvement, was suggested in order to provide a service which is equitable, accessible, acceptable, appropriate and effective.

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Maama, Lineo Bernadette. "Factors affecting AIDS orphans' from accessing voluntary counselling and testing (VCT)." Thesis, Nelson Mandela Metropolitan University, 2009. http://hdl.handle.net/10948/1046.

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The study seeks to explore and identify factors that prevent AIDS orphans in presenting themselves for Voluntary Counselling and Testing (VCT). Socio-cultural factors, notably, stigma and the resultant discrimination by community members, have been presented by many researchers as the main aetiological factors that hinder the use of VCT by AIDS orphans. It is on the basis of this that this study was conducted to identify factors that hinder AIDS orphans from accessing VCT. The study used a qualitative approach following an explorative and descriptive, contextual research design and was conducted at Ubuntu Education Fund, Port Elizabeth. Purposive sampling was used to determine a sample of AIDS orphans. Participants of the study had to be orphaned as a result of AIDS, isiXhosa-speaking, between 12-17 years, living in the care of a primary care-giver and had not presented themselves for VCT. Data was collected by means of semi-structured interviews. Semi-structured interviews are suitable in cases where the researcher is interested in an issue that is complex or personal (De Vos, Strydom, Fouche and Deloport, 2005). Data was analyzed according to the framework provided by Tesch (1990) as described in Creswell (2003). The major findings of this study were that people are locked in a ‘poverty-of-the mind cycle’, in respect of HIV and AIDS, and this is exacerbated by educational impoverishment and general poverty. The recommendations that emanated from this study are made from policy and service delivery perspectives. It is recommended that in order for AIDS orphans to access VCT they should be developed and empowered through sustainable programmes that enhance their capacities to the outmost realization of their potential. It is also recommended that health and other professionals should encourage AIDS orphans and community members to present themselves for VCT and thus curb the spread of HIV and AIDS.

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Woodman, Catherine. "Psychosocial factors influencing the desire for knowledge and predictive testing in inherited disability." Thesis, Queen's University Belfast, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.335623.

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Minnie, Catharina Susanna. "Best practice guidelines for counselling for HIV testing during pregnancy / C.S. Minnie." Thesis, North-West University, 2007. http://hdl.handle.net/10394/146.

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The 2005 National survey indicates that 30,2 % of South African pregnant women are HIV positive. The risk of transmission to their infants is about 30% unless prevention interventions are applied. The Nevirapine regime, safe intraparturn practices and safe infant feeding methods could limit the risk of mother-tochild transmission to 7%. Antiretroviral treatment is available to women who can afford it and women who qualify for subsidised medication. However, HlV positive women and their infants can only benefit from these strategies when their HIV status is known. Yet only about 50% of pregnant women consent to HIV testing after counselling. Contextual factors, organisational circumstances and pregnant women's personal circumstances determine whether they are tested. This research aimed to develop best practice guidelines for pretest counselling during pregnancy. This was achieved through four objectives: exploring and describing the factors that influence pregnant women's decision to be tested in selected antenatal clinics in the North West Province, identifying the factors that influence HIV counselling during pregnancy according to counsellors who practice in these clinics, exploring the current practices regarding counsellir&! for HIV testing during pregnancy in the selected clinics, investigating research evidence regarding counselling for HlV testing during pregnancy by means of systematic review and finally developing best practice guidelines for counselling for HIV testing during pregnancy. The research followed specific steps that consisted of two phases. Phase 1 was subdivided into four steps that related to the first four objectives and compiled evidence towards formulating best practice guidelines in phase 2. Data-collection methods included semi-structured interviews, semi-structured observation and a systematic review. Phase 1's conclusions were integrated and synthesised as base for developing best practice guidelines in Phase 2. These guidelines were graded and recommendations for implementation were formulated. Finally, the research was evaluated, limitations were identified and recommendations were formulated for nursing practice, education and - research.
Thesis (Ph.D. (Nursing))--North-West University, Potchefstroom Campus, 2007.

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Sefularo, Tebogo Veronica. "A phenomenological study of four students' experiences of voluntary counselling and testing." Diss., Pretoria : [s.n.], 2008. http://upetd.up.ac.za/thesis/available/etd-11192008-190129.

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Foster, Caron. "An exploration of voluntary counselling and testing : a Port Elizabeth-based study." Thesis, Nelson Mandela Metropolitan University, 2010. http://hdl.handle.net/10948/1204.

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The purpose of this study was to explore and identify factors that either facilitate or inhibit individuals volunteering for HIV-testing. The target group was comprised of Xhosa first-language construction workers in a company with an HIV/AIDS workplace policy and programme. This programme provides basic education and awareness about HIV/AIDS. This education includes information about where to access voluntary counselling and testing (VCT) services. Interpretive qualitative research was undertaken in order to explore the beliefs, perceptions and intentions of the target group in regard to the utilisation VCT services. Data was collected using an unstructured interview guide. The data was analysed using Tesch’s approach to content analysis. Concerns about validity and reliability were engaged throughout the research process and supported further by using researcher reflexivity and an independent researcher. The independent researcher analysed data separately and only after discussion and consensus being found between the two researchers were final categories and codes agreed upon and data analysis considered complete. Findings revealed that an HIV/AIDS workplace programme has a positive impact on the health-seeking behaviour of workers in the construction company used in this research. Respondents knew how HIV/AIDS is transmitted, how to prevent transmission and where to find HIV-testing treatment and support. In this case HIV-testing services can easily be accessed further facilitating respondents volunteering for HIV-testing. It was also found that family, friends and churches support HIV-testing behaviour by providing education, guidance and support to respondents encouraging behaviour change. On the other hand, respondents held that community members who had not benefited from an HIV/AIDS workplace programme such as theirs are exposed daily to the devastating effects of HIV leading to AIDS deaths and live in fear of the disease. Debilitating illness and eventual death is equated with an HIV-positive diagnosis which causes community members to believe it is better not to volunteer for HIV-testing than to ascertain one’s HIV-status. The HIV/AIDS workplace policy and xv programme on the other hand is seen to have provided respondents with HIV/AIDS knowledge enabling them to overcome their fear of an HIV-positive diagnosis and to volunteer for regular HIV-testing.

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Araujo, Monica Rodrigues. "Perspectives and Experiences of Individuals Undergoing Predictive Testing for Hereditary Breast and Ovarian Cancer (HBOC) Syndrome in the Western Cape, South Africa." Master's thesis, Faculty of Health Sciences, 2018. http://hdl.handle.net/11427/30057.

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Breast cancer is the most common malignancy affecting females globally. Hereditary breast and ovarian cancer (HBOC) syndrome is caused by pathogenic variants in BRCA1 and BRCA2 and is seen in approximately 50% of families with a strong history of breast and ovarian cancers. Predictive testing (PT) is offered to unaffected individuals with a positive family history of HBOC, with an already identified BRCA1 or BRCA2 mutation in an affected family member. There is an overwhelming amount of research that has focused on the after-effects of diagnostic genetic testing for HBOC but there has been little investigation into how individuals experience the actual PT process. The present study therefore aimed to investigate individuals’ decisions for undergoing and their experiences of PT for HBOC in a local context, by focusing on at-risk South African individuals residing in the Western Cape Province. Sixteen participants were recruited retrospectively from the breast cancer and/or clinical genetics clinics at Groote Schuur Hospital, Tygerberg Hospital and private genetic counselling practices in Cape Town. Semi structured interviews were conducted, and the interview transcripts were analysed using the framework approach for qualitative data analysis. Using this approach, five themes were identified relating to the perspectives and experiences of individuals undergoing PT for HBOC, in selected settings in the Western Cape. While some participants felt that their decision to pursue PT was influenced by their family history of cancer and the associated cancer-related distress, others felt that their decision was made out of a sense of duty to their families or in solidarity with those that were affected or received a positive test result. Overall, the participants felt that the pre-test counselling was beneficial in allowing for an improved understanding of HBOC, however not all participants felt that the pre-test counselling prepared them for receiving their results. Receiving a negative test result was often accompanied by feelings of guilt and did not exempt participants from the fear of developing cancer. Some of the concerns raised by participants that received a positive test result were centred around prophylactic intervention and its effect on body image. Overall, participants felt empowered by their mutation status and felt that they were better able to manage their risk. The need for additional support, both practical and emotional support, was particularly evident amongst mutation-carriers. The findings of this study provide valuable insight into the perspectives and experiences of this population, which could potentially impact the services that are provided to individuals undergoing PT for HBOC in similar settings.

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Price, Sue. "Development and testing of a measure of relational depth in counselling and psychotherapy." Thesis, University of Strathclyde, 2012. http://oleg.lib.strath.ac.uk:80/R/?func=dbin-jump-full&object_id=18013.

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Mearns and Cooper (2005), describe relational depth as 'a state of profound contact and engagement between two people ... ' (p. xii). Regarding the relational aspects of therapy, the wealth of research literature suggests that there is a common set of factors to do with the therapeutic relationship across all approaches of therapy which leads to therapeutic improvement. At the time of writing, there is only one measure designed to assess relational depth; the Relational Depth Inventory (RDI). However, the RDI has not been as thoroughly tested for validity and reliability as have other relational measures. No quantitative studies have yet been conducted that explore the association between relational depth and therapeutic outcome that use a relational depth inventory and traditional outcome measures in a practice base. Therefore, the main objective of this research project was to explore, improve and evidence the reliability and validity of the RDI. Using traditional statistics, the first study found evidence that the RDI is essentially unidimensional but composed of a number of elements especially those associated with deep relational experiences such as love, connectedness and respect. Gender was seen to have a limited roll as a determinant of relational depth events. In the second study, Rasch analyses evidenced that the revised RDI, the RDI-R, had excellent reliability. The RDI-R was found to be largely undimensional but that a significant minority of persons experiencing high strength of relational depth were not targeted. In the third study, presence of relational depth, as assessed by the RDIR, during helpful moments in therapy, was found to be significantly associated with therapeutic improvement.

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More, Pontsho Elizabeth. "The importance of voluntary counselling and confidential testing for HIV in the workplace /." Link to the online version, 2007. http://hdl.handle.net/10019/746.

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Baloyi, Gift Rirhandzu. "Loss to initiation on antiretroviral therapy (ART) after voluntary counselling and testing (VCT)." Thesis, University of Limpopo (Medunsa Campus), 2011. http://hdl.handle.net/10386/506.

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Thesis ((MSc(Med)(Pharmacy))--University of Limpopo (Medunsa Campus), 2011.
Background: Anecdotal evidence from fixed Voluntary Counselling and Testing (VCT) centres within the public sector indicates, that many patients are lost in the transition from VCT to Human Immunodeficiency Virus (HIV) care and treatment. The actual number of patients who are eligible for antiretroviral ttreatment (ART) after a positive HIV test, but who do not visit the antiretroviral (ARV) clinic to initiate ART, is currently not known. The need to identify the extent of this problem was therefore evident. Objectives: To investigate and describe the procedures and records used at the VCT centres under study. To identify the proportions of patients who fail to proceed through the different steps of the process from VCT to initiation on ART within a period of six months. To make recommendations for interventions aimed at improving the tracking of patients from the VCT entry point to ART initiation. Methods: The study was conducted as an operational research project at Odi and Stanza Bopape VCT centres. The design of the study was descriptive. Data were collected retrospectively and prospectively over a period of four months. Operational procedures and documentation systems at both VCT centres were observed. The records of all patients who tested HIV positive from 1 April 2009 to 30 June 2009 at Odi and Stanza Bopape VCT centres were identified from the VCT registers and selected for the study. Patients who were eligible for ART were identified based on their CD4 count. Eligible patient names were crossreferenced against the SOZO system (electronic patient database) to determine whether they had attended their pre-treatment visits at the ART clinic and whether ARV medicines had been dispensed to them for the first time. Where there was no proof that the patient attended the pre-treatment visits or finally accessed ART at an ARV clinic within six months, the patient was regarded as lost to initiation on ART. Results: The results obtained from the observational phase of the study showed differences in the procedures followed at the two VCT centres. At Odi VCT centre, patients referred for VCT by medical doctors only had an ELISA test and had to return on a different date for the ELISA test results, while patients visiting the VCT centre voluntarily first had a Rapid test and if positive they had an ELISA test on the same day. At Stanza Bopape VCT centre, patients referred by doctors and patients visiting the VCT centre voluntarily had a Rapid test and an ELISA test after a positive Rapid test. The patients at Odi had their CD4 test results interpreted by the nurse at the VCT centre while at Stanza Bopape the results were interpreted by the doctor at the ARV clinic. x iv The study included a cohort of 743 patients who tested HIV positive from April 2009 to June 2009 at Odi and Stanza Bopape VCT centres. Of these patients 344 tested at Odi VCT centre and 399 were tested at Stanza Bopape. The majority of patients at the two VCT centres were female (55% at Odi VCT centre and 59% at Stanza Bopape VCT centre), unemployed and single. At both VCT centres, patients were expected to return for collection of CD4 results within two weeks of the HIV test. At Odi VCT centre, 159 (49.4%; n=322) patients did not return to collect their CD4 results. Of those who returned, only 41.1% (67; n=163) returned within one month. At Stanza Bopape VCT centre 52.8% (210; n=399) patients did not collect their CD4 results. Of the patients who collected their CD4 count results, 51.3% (97; n=189) collected within one month. The Fisher’s exact test revealed no statistically significant difference (P=0.410) between the two VCT centres in terms of patients who returned for their CD4 results collection and those who did not return. More than half of the patients with accessible CD4 counts at Odi presented late for VCT. This was shown by 65.4% (n=275) of patients with CD4 count 200 cells/mm3 during HIV diagnosis. At Stanza Bopape VCT centre 46.6% (n=386) also had CD4 count 200 cells/mm3. The difference in terms of late presentation between the patients from the two clinics was statistically significant (P<0.001; Fisher’s exact test). The ART initiation rate at both VCT centres was found to be low. More than half of the patients eligible for treatment (CD4 200 cells/mm3) at both VCT centres did not initiate ART. This was shown by 59.4% (n=180) of patients at Odi VCT centre and 67.8% (n=180) of patients at Stanza Bopape VCT centre who did not initiate ART. There was no significant difference (P=0.317; Fisher’s exact test) between the two VCT centres in terms of the patients who did not initiate ART. Conclusion: A high percentage of patients who presented for VCT and were eligible for treatment were lost to initiation on ART. The majority of these patients did not return to collect their CD4 results and thus were lost immediately after VCT. These results suggest a need for an urgent intervention that will improve ART uptake. Recommendations: Patients referred by doctors for VCT at Odi VCT centre should have a Rapid test, and if positive they should have an ELISA and CD4 test on the same day to prevent the loss of patients before they even identify their HIV status. The option of a ‘one stop’ VCT and immediate CD4 results, should be further explored due to the unacceptable patient default rates at both VCT centres. A CD4 count machine which x v will provide results immediately on the same day of the test should be utilised. There must be sufficient personnel and equipment to follow-up on patients who do not return for their CD4 results, pre-treatment counselling and ART. The SOZO system should be integrated between the VCT centres and the ARV clinics to improve the flow of patient information between the VCT centre and the ARV clinic. A qualitative study should be conducted to explore reasons for patients not returning to collect their CD4 results. Key words: VCT; loss to initiation; non-uptake; lost in transition; HIV and AIDS

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Ruzagira, Eugene. "Effect of follow-up counselling after HIV diagnosis through homebased HIV counselling and testing on linkage to HIV care in southwestern Uganda." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2017. http://researchonline.lshtm.ac.uk/4433695/.

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Background: Home-based HIV counselling and testing (HBHCT) is highly acceptable and may be an effective strategy for HIV prevention and population-based test-and-treat programmes in sub-Saharan Africa (SSA). However, few data are available on linkage to care or on the effectiveness of strategies to increase linkage to care among HIVpositive persons identified through HBHCT in SSA. The aims of this PhD were to (i) systematically review the literature on linkage to care among HIV-positive adults diagnosed through HBHCT in SSA; and (ii) to conduct a cluster-randomised controlled trial to measure the effectiveness of a counselling intervention after HIV diagnosis through HBHCT in increasing linkage to care in rural Masaka district, Uganda. Methods: (i) Five databases (Medline, Embase, Global Health, Web of Science, and Africa-Wide information) were systematically searched for studies published between 1st January 2000 and 19th August 2016. Authors of studies for which some required information was missing were requested to provide additional data. (ii) For the trial, 28 rural communities were randomly allocated (1:1) to the intervention (HBHCT, referral, and brief home-based counselling sessions one and two months after HBHCT) or control group (HBHCT and referral only). HIV-positive adults (≥18 years) not yet in care were enrolled. Primary outcomes were linkage (registration with an HIV clinic) at 6 months after HBHCT, and time to linkage. Analyses were by intention-to-treat using random effects logistic regression and Cox regression with shared frailty. Results: (i) 19 eligible studies were identified; one had all the required data. Additional data were obtained for 13 studies; thus, 14 studies were included in the review. Linkage to care was generally lower ( < 33%) if HBHCT was followed by referral only, and higher ( > 80%) if some strategy was used to facilitate uptake of referral. Only one study was a randomised trial and most were susceptible to outcome ascertainment bias. (ii) In the trial, 551 individuals tested HIV-positive; 205 (37.2%) were already in care and thus ineligible. 302 (87.3% of those eligible) were enrolled (intervention, n=149). Retention was similar across trial arms (92% overall). Overall linkage to care was 42.1%. Counselling was associated with a 2.18-fold [95% confidence interval (CI)=1.26-3.78] increase in the odds of linkage. There was no evidence of a difference between arms in the rate of linkage in the first two months, but subsequently the rate of linkage was higher in the intervention arm (hazard ratio=4.87, 95% CI=1.79-13.27). Conclusion: Counselling substantially increases linkage to care among HIV-positive adults identified through HBHCT and can increase antiretroviral therapy coverage in SSA.

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Verkijk, Nakita. "An investigation into the reasons for non-uptake of carrier testing in a family affected by alpha thalassaemia X-linked mental retardation (ATR-X) syndrome." Master's thesis, University of Cape Town, 2011. http://hdl.handle.net/11427/11481.

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Includes abstract.
Includes bibliographical references (leaves 127-134).
Alpha thalassaemia X-linked mental retardation (ATR-X) syndrome is a rare, X-linked intellectual disability syndrome with an estimated prevalence in the range of 1-9/1 000 000. The prevalence in South Africa (SA) is unknown; however in Cape Town there is one extended family with seven males who were clinically, and later molecularly, diagnosed with this condition. Due to the identification of the mutation in this family, carrier and prenatal testing is available. However, since the announcement in 2007 that testing is available, no individuals have presented themselves for their carrier status to be determined. The aim of this study was to investigate the reasons why females in this family have not presented for carrier testing.

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Mackinnon, Christopher. "The development and pilot testing of the meaning-based group counselling intervention for bereavement." Thesis, McGill University, 2014. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=121133.

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While bereavement interventions have proved effective in reducing complicated/prolonged grief reactions, the scholarship over the past 10 years suggests that the effectiveness of bereavement interventions for uncomplicated grief is negligible. However, these past studies have been critiqued for numerous design flaws, making any definitive conclusions about effectiveness premature. What has emerged is a need for theoretically-based uncomplicated bereavement interventions for individuals actively seeking support, which are supported by sound design and methodology. Correspondingly, the meaning-making paradigm offers a potentially potent conceptual lens to understand grief reactions and is garnering increased empirical support. However, no studies to date have examined the application of a meaning-based approach to inform interventions for support groups targeting uncomplicated bereavement. This study seeks to address these gaps in knowledge. The first objective of this dissertation was to review existent theories of meaning and their empirical applications, with the goal of deriving clinical implications for counselling psychologists engaged in cancer-related bereavement psychotherapy (reported in manuscript 1). Second, the lack of use of meaning-based theories in bereavement support groups resulted in the creation of an original meaning-based group counselling (MBGC) intervention for uncomplicated grief (reported in manuscript 2). The third objective was to conduct a pilot test of MBGC using a formative evaluation to assess feasibility and effect refinements to MBGC as needed (reported in manuscript 3). Findings of this feasibility trial (n = 9) resulted in several modifications to MBGC based on participant feedback. The majority of group members reported the meaning-based intervention as beneficial. Descriptive statistical examination of outcome measures assessing depression and grief suggested small improvements from baseline. Following successful completion of the pilot study, it was decided to proceed with a pilot randomized controlled trial (RCT), which constituted the final objective of this dissertation (reported in manuscript 4). The pilot RCT was registered with ClinicalTrials.gov (identifier NCT01384942). Recruitment resulted in 26 individuals randomly assigned to either MBGC or a control (treatment-as-usual) bereavement support group. A total of 20 participants (n = 11 in the experimental arm; n = 9 in the control arm) completed all aspects of the study including pre, post, and 3-month follow-up measures of meaning, anxiety, depression, and grief. Final analyses suggest MBGC continued to be a feasible intervention in the pilot RCT phase. Overall results encourage proceeding with a full RCT to assess the efficacy of MBGC. However, relatively low recruitment rates suggest that a full trial will need to be conducted in multiple sites. A general discussion finalizes the dissertation.
Tandis qu'il a été prouvé que les interventions faites suite à un deuil réussissent à réduire l'incidence de réactions de deuil compliqué/prolongé, les travaux de recherche des dix dernières années semblent suggérer que l'efficacité de ces interventions reste négligeable dans les cas de deuil non compliqué. Toutefois, beaucoup critiquent ces études en raison de nombreux défauts de conception qui rendent prématurée toute conclusion catégorique. Il convient maintenant de trouver des interventions pensées à partir d'une base conceptuelle, théorique et méthodologique solide, et qui pourraient servir dans les cas de deuil non compliqué pour les personnes qui recherchent activement un soutien. Par ailleurs, le paradigme de construction du sens offre une lentille conceptuelle qui pourrait nous aider à comprendre les réactions de souffrance liée au deuil et jouit d'un support empirique accru. Aucune étude ne s'est, toutefois, encore penchée sur ce que pourrait apporter la méthode de construction de sens pour informer les interventions des groupes de soutien qui ciblent le deuil non compliqué. Cette étude se propose d'examiner ces lacunes. Le premier objectif de cette thèse a été de revoir les théories du sens existantes ainsi que leurs applications empiriques dans le but d'en tirer des implications pertinentes pour le travail de counselling des psychologues appelés à intervenir dans une psychothérapie pour deuil lié au cancer (rapporté dans le manuscrit 1). Ensuite, du fait de l'absence de prise en compte des théories de construction de sens dans les interventions des groupes de soutien, le second objectif a été d'élaborer une intervention de counselling de groupe fondée sur la construction de sens (MBGC) pour le deuil non compliqué (rapporté dans le manuscrit 2). Le troisième objectif a été de réaliser une étude pilote de l'approche basée sur la construction de sens (MBGC) à l'aide d'une évaluation formative qui permettrait d'en juger la faisabilité et d'y apporter les raffinements éventuels nécessaires (rapporté dans le manuscrit 3). Les observations faites dans le cadre de cette étude de faisabilité (n = 9) ont entrainé plusieurs modifications au modèle MBGC à partir des commentaires des participants. La majorité des membres du groupe ont jugé bénéfique l‘intervention basée sur la construction de sens. L'examen descriptif statistique des critères mesurés pour la dépression et la souffrance liée au deuil a indiqué de légères améliorations par rapport aux valeurs de départ. L'étude pilote ayant été menée à bien, il a été décidé de procéder à un essai randomisé contrôlé (ERC), ce qui a constitué l'objectif final de cette thèse (rapporté dans le manuscrit 4). L'ERC pilote a été enregistré sur ClinicalTrials.gov (identifiant NCT01384942). Le recrutement a produit 26 personnes réparties de manière aléatoire entre le groupe de soutien au deuil basé sur la construction de sens (MBGC) et le groupe témoin de soutien au deuil (traitement classique). Un total de 20 participants (n = 11 dans le bras expérimental; n = 9 dans le bras témoin) ont participé à toutes les étapes de l'étude, incluant les mesures pré, post et de suivi à 3 mois pour le sens, l'angoisse, la dépression et la souffrance liée au deuil.Les analyses finales semblent montrer que l'approche basée sur la construction de sens (MBGC) est restée une intervention réalisable dans la phase ERC. L'ensemble des résultats plaide en faveur d'une pleine étude randomisée contrôlée pour évaluer l'efficacité des interventions basées sur la construction de sens (MBGC). Cependant, les taux de recrutement relativement bas laissent penser qu'une telle étude devra se faire sur plusieurs sites. La thèse se termine sur une présentation des conclusions générales.

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Maja, Lusanda Nobom. "Experiences and feelings of counsellors involved in HIV and AIDS voluntary counselling and testing." Pretoria : [s.n.], 2008. http://upetd.up.ac.za/thesis/available/etd-11262008-142405.

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Nguyen, Hai Thuong Bhuiyan Shafi Ullah. "Determinants related to the utilization of voluntary counselling and HIV testing services in Vietnam /." Abstract, 2006. http://mulinet3.li.mahidol.ac.th/thesis/2549/cd387/4838006.pdf.

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Mokalake, Ellen N. "Determinants of HIV voluntary counselling and testing among the youth: The case of Botswana." Master's thesis, University of Cape Town, 2010. http://hdl.handle.net/11427/9403.

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Includes bibliographical references.
This study was conducted in Gaborone city, Botswana. Botswana is a small country in south central part of Africa with a population of 1.7 million (Botswana population census, 2001) The overall aim of the study was to examine barriers and facilitating factors influencing the readiness for and acceptability of voluntary HIV testing among the youth aged 18-24 years in Gaborone, Botswana. A quantitative methodology was used in this study. A multistage sampling strategy was also used to recruit one hundred and forty four (144) participants. Information on socio-demographic characteristic, knowledge and utilization of VCT sexual behaviour and perception of risk was gathered by use of a self administered structured questionnaire. STATA version 8 was used to analyse the results of this study. Summary statistics, chi-square test and logistic regression were employed in the analysis. Participants comprised of students from senior secondary schools and tertiary education institutions from the sampled schools of Gaborone. The modal level of education was secondary and the more than half of participants (56%) were females. Their age ranged from 18-24 years. The majority of participants (75%) were sexually active and just over a third 36% of all participants considered themselves not at risk of HIV. VCT knowledge was reported by a significant proportion (59%) who also reported knowledge of VCT sites. HIV testing was reported by a minority of participants 42% and the most commonly reported reason for testing was media campaigns encouraging HIV testing whilst the most commonly reported reason for not testing was never been sexually active. Findings from this study revealed that, HIV test acceptance among the youth is still an area that needs greater attention. The facilitation of HIV testing amongst the young people and removal of barriers to testing can be achieved through a focus on use of strategies that seem vii to work such as the media. Also, there is need to ensure utilization of VCT services by youth through making them understand of the role that VCT plays in preventing HIV and AIDS.

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Ngoma, Sarah Nyirongo. "Factors influencing the uptake of couple's HIV counselling and testing among men in Livingstone District, Zambia." University of the Western Cape, 2015. http://hdl.handle.net/11394/4736.

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Magister Public Health - MPH
Background: HIV counselling and testing is important as a gateway to accessing prevention, treatment, care and support services. Studies have shown that couples who are married or are in a stable heterosexual relationship are at risk of transmitting HIV infection to each other if one partner is infected. The uptake of couples counselling and testing (CHCT) by males in Livingstone is very low despite the fact that they are the decision makers in most homes. Aim: The aim of the study was to assess the factors determining the uptake of CHCT amongst males in a long term heterosexual relationship who came to a health facility for HIV counselling and testing in Livingstone, Zambia and their perceived benefits of CHCT. Methodology: A case control study was conducted with cases being men age 21 years and above, who were married/cohabiting or were in a steady heterosexual relationship for six months and more and had jointly tested for HIV as a couple, and controls were men age 21 years and above, who were married/cohabiting or were in a steady relationship for six months and more and came to be tested for HIV alone without a partner. The structured questionnaires were administered to a total of 294 participants (147 controls, 147 cases) who were recruited from three public health facilities and one private facility in Livingstone between August and September 2013.Results: The only 2 factors independently associated with testing for HIV via CHCT was, talking about HIV as a couple‟ which positively affected CHCT and „had a previous HIV test as a couple‟ which negatively affected CHCT. Findings indicate that „talk about HIV as a couple‟ was a strong independent predictor of CHCT in the multivariate analysis; however it was uncertain whether it was a predictor of CHCT or a consequence of CHCT. It is probable that having already „had a previous HIV test as a couple‟ the participants would not see the need for testing via CHCT again. Other factors that were significantly associated with uptake of CHCT on bivariate analysis but were not significant on multivariate logistic regression analysis included those that are associated with a greater likelihood of CHCT: think CHCT is beneficial /useful, know partners HIV status, know positive things about CHCT and talk about sexual issues as a couple. Other factors negatively associated with uptake of CHCT were: ever tested for HIV before, informed partner about HIV status, think partner is at risk of contracting HIV, think self is at risk of contracting HIV, low self-risk-rating of HIV infection and marital status. Conclusion: The decision for a couple to go for CHCT is probably relatively complex, because most of the factors measured were linked to each other and it was difficult to separate them to identify if a factor on its own was able to influence the uptake of CHCT. However a couple that communicates with each other about HIV issues is likely to be motivated to go for CHCT.

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Woke, Felix Ikechi. "The Role of Socio-demographics factors in Voluntary Counselling and Testing uptake in South-Africa." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/1990.

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Many researchers have alluded to the inequity in distribution of HIV preventive services in South Africa (SA). Other researchers have demonstrated that socio-demographic factors are main determinants of distribution of preventive services like voluntary counseling and testing (VCT) in SA. VCT is a primary HIV prevention tool through which infected persons enter the treatment, care, and support programs; identifying the impact of socio-demographic determinants (SDDs) on VCT uptake in SA could help direct VCT services to areas and individuals that need them most. The research question in this study examined what and how SDDs impact the uptake of VCT in SA using the integrated theory of health behavior change (ITHBC) as its theoretical framework. A quantitative study with a cross-sectional design using secondary data from a population-based survey by the John Hopkins Education and Health SA (2012) was conducted. In a multivariate logistic regression analysis, SDDs like province, settlement, employment, races, and age were statistically significant while marital status, education, and SES (socio-economic status) did not have statistically significant impact on VCT uptake. This study demonstrated that Black, unemployed men of low to medium SES between the ages of 15-49 years living in peri-urban and urban-informal areas of all provinces but especially Eastern Cape, Northern Cape, and North West provinces of SA had the lowest VCT uptake. This study advocates policies and programs to improve VCT distribution and accessibility in places and individuals with lowest uptake. Improved uptake will help reduce new HIV infection, HIV-associated morbidity, and mortality; as well as ensure equity, equality, and social justice in the distribution of HIV preventive services in SA.

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Pastore, Olivia Lena. "Understanding and Testing the Link Between Motivational Interviewing and Self-Compassion Through Physical Activity Counselling." Thesis, Université d'Ottawa / University of Ottawa, 2020. http://hdl.handle.net/10393/40950.

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Background: Motivational Interviewing (MI) is an accepting and compassionate collaborative counselling style that has been linked with various desirable client outcomes. However, its association with self-compassion (SC), an important psychological resource is unknown. One context in which this relationship can be studied is in Physical Activity Counselling (PAC), which is an MI-based intervention that has been found to enhance motivation towards physical activity (PA) and PA behaviour, as well as reduce depressive symptoms. However, no hypothesized link has ever been made between MI and SC and no research has been done on the impact of MI-based PAC onto SC or has investigated SC’s relationship with PA within PAC. Purpose: Article 1: To explore the link between MI and SC. Article 2: To test this proposed association by investigating the impact of a MI-based intervention, specifically through PAC, over time on (1) self-compassion and its subcomponents, and (2) PA and its intensities. A third and fourth purpose were to (3) examine whether any improvements in SC or PA variables were continued at 1-month follow-up and lastly, (4) study the relationships between SC and PA variables over time in university students and employees receiving PAC. Methods: Article 1: This article was a commentary paper that rationalized the hypothesized link between MI and SC. Article 2: This article reports results from a study which used a repeated-measures experimental study design, whereby forty university students and employees filled out online validated self-report questionnaires assessing SC and PA before (baseline), immediately after (endpoint), and 1-month after (follow-up) receiving individualized PAC sessions. Participants reached out to PAC mostly on their own or were referred by other programs on campus. Fidelity checks showed that PAC counsellors were accepting and compassionate. Results: Article 1: A hypothesized link was made between MI and SC, such that the accepting and compassionate spirit of MI, as well as certain content-based techniques used within could help to foster a self-compassionate mindset within the receivers of MI. Article 2: Paired-samples t-tests and multivariate analysis of variance tests revealed that there were significant moderate-to-large increases in total SC, self-kindness, and total, moderate, and strenuous PA from baseline to endpoint. There was also a significant large effect for decreases in self-judgement and isolation from baseline to endpoint. All changes appeared to be continued at 1-month follow-up. Lastly, results revealed that common humanity at baseline positively influenced moderate PA at endpoint. Conclusion: This provides a strong case for the link between MI and SC and provides preliminary evidence to support the positive impact of MI, specifically through PAC, onto SC and PA variables, as well as their relationship over time. Future research is recommended in order to ascertain these findings and practitioners are encouraged to show high acceptance and compassion while assisting individuals with PA behaviour change.

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Anderson, Tarryn Nicole. "An implementation evaluation of the University of Cape Town's HIV voluntary counselling and testing programme." Master's thesis, University of Cape Town, 2009. http://hdl.handle.net/11427/10073.

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Includes bibliographical references (leaves 57-65).
This programme aims to ensure that all students and staff are aware of their HIV status and encourages the reduction of high-risk behaviours. Furthermore, UCT's VCT programme provides access to both medical care and social support at HIV positive individuals. The focus of this implementation evaluation was to determine the extent to which UCT's VCT programme was operating effectively and in keeping with UCT's mission.

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Cawley, C. "Understanding the role of HIV testing and counselling services in HIV prevention in rural Tanzania." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2015. http://researchonline.lshtm.ac.uk/2373946/.

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This thesis aims to describe the uptake and coverage of HIV testing and counselling (HTC) services in a community cohort study in rural Tanzania between 2003 and 2010, and to investigate the impact of HTC on changes in sexual risk behaviour and HIV incidence. Paper A uses data from three HTC services (community outreach HTC (CO-HTC), walk-in HTC (WI-HTC) and antenatal HTC) linked to the community cohort data to compare the characteristics of services users, and found that while WI-HTC was most likely attract HIV-positive individuals, the overall proportion of infected persons diagnosed was greatest at CO-HTC. Rates of repeat testing are important to understand given potential HIV treatment as prevention approaches. Paper B found that small proportions of cohort participants repeat tested between 2003 and 2010, although this improved over time. Paper C presents a quantitative analysis of the impact of CO-HTC on changes in sexual behaviour and HIV incidence, and found moderate associations between HTC use and reductions in some risk behaviours among HIV-negative participants, but no impacts among HIV-positive individuals or reductions in HIV incidence, possibly as a result of small sample sizes and a declining background incidence in the study area. Paper D presents findings from a qualitative study exploring the effectiveness of HIV prevention counselling messages, which showed that relationship dynamics constrained the extent to which HIV-negative women felt able to control their HIVrelated risk, and imbalanced client-counsellor interactions limited communication during counselling sessions. Overall, the findings from the thesis reveal that provision of different HTC models increased the uptake of services, but the proportions of individuals repeat testing were low and there was limited evidence for an impact of HTC on sexual risk reduction. Future research should explore the effectiveness of different HTC modalities in encouraging repeat testing among high risk HIV-negative individuals, influencing sexual behaviour change and linking HIV-positive people to care and treatment.

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Cremin, Ide. "The impact and importance of voluntary counselling and testing for HIV in sub-Saharan Africa." Thesis, Imperial College London, 2010. http://hdl.handle.net/10044/1/6059.

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Voluntary counselling and testing (VCT) for HIV is promoted as a primary prevention strategy to reduce the heterosexual transmission of HIV in sub-Saharan Africa. A theoretical framework for the determinants of uptake of VCT and behavioural outcomes following VCT was developed. Demographic and Health Survey (DHS) data collected from 2003 to 2005 from ten countries were analysed to test the framework by comparing nationally representative trends in uptake of testing. Data from a population-based open cohort study in Manicaland, Zimbabwe was also used to test this framework by analysing trends in sexual behaviour and behaviour change associated with having received VCT. DHS data indicate that knowledge of serostatus varied widely between countries and ranged from 2% among women in Guinea to 27% among women in Rwanda. Despite these varied levels of testing, univariate analysis showed the profile of testers to be remarkably similar across countries with respect to socio-demographic characteristics. Adjusted analyses indicate that a secondary or higher level of education and an awareness that treatment exists are key determinants of uptake of VCT. Uptake of VCT in the Manicaland cohort is low, at 8.6% in the most recent survey. Against a background of behavioural risk reduction in the general population, there was no evidence for additional risk reduction associated with having received VCT in the Manicaland cohort. This work provides a baseline for monitoring trends in testing and exploring changes in the profile of those who get tested as provision of testing and treatment services increase. Within the Manicaland study population, these results do not provide evidence that VCT can promote behavioural risk reduction, in a context of background reductions in risk. Uptake of VCT is expected to increase in this population as treatment becomes available. It is important that VCT services are monitored and evaluated and the importance of risk reduction is emphasised through good quality counselling. To succeed as a prevention measure, VCT must attain a high coverage of the sexually active population and lead to sustained risk reduction among both infected and uninfected individuals.

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Sproul, Grace Yuen-Yee Tse. "Preparing for counselling : developing and testing an affective awareness training program for the mentally disabled." Thesis, University of British Columbia, 1985. http://hdl.handle.net/2429/26610.

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This thesis starts with the observation that if mentally disabled individuals are to establish a place for themselves in the community and successfully cope with the accompanying stress, they must, within their own range of capabilities, (1) learn to recognize their emotions, and (2) learn to express these emotions in socially acceptable ways. The thesis then attempts to explore whether this is a realizable goal. A review of the literature reveals that, in spite of its importance to the mainstreaming process, the emotional development of mentally handicapped individuals has received scant attention toy psychologists, special educators, or counsellors. Some of the reasons for this are explored including an examination of the prevalent "cognitive deterministic" viewpoint which assumes that emotional awareness presupposes higher levels of cognitive development than the mentally handicapped are commonly capable of demonstrating. The thesis notes the recent view of researchers in special education and psychotherapy that appropriate behavioral expression of feelings by the mentally handicapped must develop out of awareness of feelings; it cannot come about through efforts to manipulate manifest behavior alone. Perhaps more importantly, it is argued that affective development takes place in tandem with cognitive abilities, not necessarily as a consequence of them. Based on evidence that affective awareness training for mentally handicapped individuals can and should be pursued along with cognitive and life skills training, the thesis focuses on taking up the challenge of developing and field testing "An Affective Awareness Training Program for the Mentally Disabled." A Gestalt approach to developing awareness of oneself and one's environment was utilized as the theoretical basis for preparing the 46 lessons which make up the content of the "Affective Awareness Training Program." The researcher adapted freely from the work of others to create a unique instructional program designed especially to meet the needs and abilities of Trainable Mentally Retarded (TMR) students. The effectiveness of this program in teaching recognition of, and improving ability to empathize with, expressions of the five primary emotions of joy, sadness, fear, anger, and surprise, was then tested by the researcher using 12 TMR subjects living in an institution (six in the control group, six in the treatment or experimental group). The test instrument for measuring changes in pre-treatment, post-treatment, and retention level performance, was a series of 15 specially prepared video vignettes. Each vignette focused on one emotion and there were three different vignettes portraying each emotion. The thesis concludes that the experimental group, who participated in the affective awareness training program, changed significantly in their ability to recognize and empathize with expressions of the five primary emotions.
Education, Faculty of
Educational and Counselling Psychology, and Special Education (ECPS), Department of
Graduate

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25

Shepherd, Margaret H. "Attitudes of patients and professionals to genetic testing in diabetes with specific reference to maturity onset diabetes of the young (MODY)." Thesis, University of Exeter, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.341151.

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Campbell, Tomas. "Reasons for HIV testing in a heterosexual sample : the role played by affective factors and constructs from the health belief model." Thesis, University of Surrey, 1997. http://epubs.surrey.ac.uk/618/.

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Nkhoeli, Zengiwe Maria Dilahloane. "Atteridgeville prisoners' experiences of HIV/AIDS pre- and posttest counselling." Diss., Pretoria : [s.n.], 2005. http://upetd.up.ac.za/thesis/available/etd-12082005-144431.

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Jusayo, Nomonde. "Factors affecting the utilisation of a workplace voluntary counselling and testing programme in the Eastern Cape." Thesis, Nelson Mandela Metropolitan University, 2013. http://hdl.handle.net/10948/d1010273.

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The world has entered the third decade of the HIV and AIDS epidemic under different times in which the epidemic is treatable. The International Labour Organisation (ILO) (2005) declares HIV and AIDS a developmental crisis destroying developmental gains over generations. Since HIV and AIDS affect the most productive segment of the labour force, it is therefore not only a threat to development but also to the world of work without which development will be sacrificed (ILO, 2001). Collaborative response efforts that seek to mitigate the HIV pandemic by government, business and higher education institutions have been fraught with challenges. The main challenge that beset these efforts is that, in the absence of an HIV vaccine, voluntary counselling and testing remains the gateway to access treatment and care. Regrettably, participation in VCT has been confronted by challenges of low utilisation. This precedes the objectives of this study, which were to explore and describe factors that serve as barriers and facilitators of workplace VCT programmes with the objective to improve participation in these programmes. The current study was a product of a qualitative and exploratory-descriptive research design. A nonprobability convenience sampling method was used to sample participants for this study. The targeted population in this study were the non-academic employees of an academic institution in the Eastern Cape. Data was collected by means of focus group discussions and by using semi-structured interviews. The focus group samples comprised of an equal number of men and women with an overall participation of fifty-six participants. Data obtained was transcribed, thematically analysed and coded using Henning, Van Rensburg, and Smit's (2004) qualitative analysis and interpretation method. Findings of this research revealed that factors that facilitate and inhibit voluntary counselling and testing are psychosocial and cultural by nature. At psychosocial level, participants reported factors that facilitate voluntary counselling and testing to include psychological readiness to go for HIV testing, reassurances of confidentiality of HIV test results and normalising HIV testing (making the process more like that for screening and diagnostic testing). Cultural factors included cultural practices and beliefs such as "intonjane" and traditional circumcision - positive cultural nurturers that could facilitate VCT participation. Results of this study showed a lack of basic knowledge about VCT and fear of knowing one's status, fear of breach of confidentiality, fear of being stigmatised and a lack of trust towards health professional as the major psychosocial factors that serve as barriers to VCT participation. The cultural barriers to VCT pointed to hegemonic masculinity as a socially constructed gender identity that encourages gender inequalities and undermines efforts to improve HIV testing. The study suggested that strategies to increase VCT participation should consider leadership support of VCT programmes, incentivisation of VCT programmes, institutionalisation of HIV and AIDS education and the establishment of integrated wellness services for employees.

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Toivo, Aini-Kaarin. "Perceptions and experiences of pregnant women towards HIV voluntary antenatal counselling and testing in Oshakati Hospital, Namibia." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&amp.

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This study focused on perceptions and experiences of pregnant women who opted in against those who opted out of voluntary antenatal HIV counseling and testing. The pregnant women's perceptions and experiences were assessed in order to gain insight into their views towards voluntary antenatal counseling and testing.

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Weimers-Maasdorp, Delia Angelique. "Evaluating the outcome of voluntary counselling and testing for HIV at the workplace : a Namibian case study." Thesis, Stellenbosch : University of Stellenbosch, 2011. http://hdl.handle.net/10019.1/6723.

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Thesis (MPhil)--University of Stellenbosch, 2011.
ENGLISH ABSTRACT: In Namibia the HIV prevalence rate in adults (15 to 45 years of age) is estimated at 18.1%. The first HIV infection in Namibia was reported in 1986 and the epidemic constitutes the biggest developmental challenge for Namibia. Approximately 39 new infections occur every day and approximately 28% of deaths in the country are AIDS-related. The majority of Namibia’s workforce is in the age group of 15 years to 45 years and it can be anticipated that HIV and AIDS will have a major disruptive effect on the country’s workforce as well as its economy over the next two decades. According to the Namibian government, voluntary counselling and testing (VCT) for HIV is one of the most effective methods to prevent the spread of the epidemic. With this in mind, this study aims to evaluate the outcome of voluntary counselling and testing at one workplace in Windhoek, Namibia, to see whether VCT provides education as well as whether VCT is a vehicle to promote awareness, good attitudes, intentions and behaviour change. The main purpose of this outcome evaluation is to determine to what extent voluntary counselling and testing at the workplace has led to HIV-related changes in knowledge, attitudes, behaviour and practises. Although the majority of respondents indicated that their knowledge of HIV had increased after their participation in the VCT programme, upon closer analysis it was evident that participants who had a secondary or higher level of education had more knowledge, or had had more of a knowledge increase, than participants with a primary or lower level of education. From the research findings, it appeared that the voluntary counselling and testing had helped participants to identify their individual risks, as their self-reported risk perceptions with regard to becoming infected with HIV and/or a sexually transmitted disease increased after their participation in the VCT. There was also evidence that participants implemented risk reduction plans after the voluntary counselling and testing, as the percentage of participants who had casual sex partners decreased while the percentage of participants who had not had casual sex partners in the previous six months increased. It can be concluded that the general attitude amongst employees towards HIV-positive people is relatively non-discriminatory. However, it seems that the VCT was not as successful in transferring information and education on HIV amongst employees with lower education levels than amongst their peers with higher levels of education, and employees with primary or lower education levels appear not to have benefited much from the intervention in terms of an increase in knowledge. It is recommended that voluntary counselling and testing be provided to the employees at the company on a regular basis, not only because employees have requested it, but also to monitor whether the voluntary counselling and testing for HIV at the company has had the desired effects on the employees, especially with regard to effecting an increase in knowledge, a reduction of stigma and discriminatory attitudes, and the desired behaviour change amongst participants.
AFRIKAANSE OPSOMMING: In Namibië word die MIV voorkomssyfer onder volwassenes (ouderdom 15 tot 45 jaar) op 18,1% geskat. Die eerste MIV-geval in Namibië is in 1986 aangemeld en vertoonwoordig die land se grootste ontwikkelingsuitdaging met ongeveer 39 nuwe infeksies daagliks en ongeveer 28% van sterftes in die land wat VIGS-verwant is. Die meerderheid van Namibië se werksmag val in die ouderdomsgroep 15 tot 45 jaar en daar kan verwag word dat MIV en VIGS oor die volgende twee dekades grootskaalse ontwrigting op die land se werksmag sowel as sy ekonomie gaan veroorsaak. Volgens die Namibiese regering is vrywillige berading en toetsing (VBT) een van die mees doeltreffende metodes om die verspreiding van die epidemie te verhoed. Gedagtig hieraan het hierdie navorsingsprojek dit ten doel om die uitkomste van vrywillige berading en toetsing by een werksplek in Windhoek, Namibië, te evalueer ten einde te bepaal of VBT opvoedkundig is en of dit bewuswording, gesonde houdings, voornemens en gedragsverandering bevorder. Die hoofdoelwit van hierdie uitkomsevaluering is om die mate waartoe vrywillige berading en toetsing tot verandering in kennis, houding, gedrag en praktyke gelei het, te bepaal. Alhoewel die meerderheid respondente aangedui het dat hulle kennis na VBT verbeter het, het dit by nadere ondersoek geblyk dat deelnemers wat sekondêre of hoëronderwys gehad het, oor meer kennis beskik het of hul kennis meer uitgebrei het as respondente wat slegs 'n primêre of laer vlak van onderwys gehad het. Uit die navorsingsbevindings blyk dit dat daar onder deelnemers aan vrywillige berading en toetsing 'n toename in die self-aangemelde risiko-persepsie van besmetting met HIV en/of geslagsoordraagbare siektes na hul deelname aan VBT was. Daar was ook bewyse dat deelnemers na die vrywillige berading en toetsing risikoverminderingsplanne geïmplementeer het, omdat daar 'n afname was in die persentasie deelnemers wat informele seksmaats gehad het, sowel as 'n toename in deelnemers wat geen informele seksmaats in die vorige ses maande gehad het nie. Daar kan tot die slotsom gekom word dat werknemers se houding teenoor MIV-positiewe mense oor die algemeen betreklik nie-diskriminerend is. Dit blyk egter asof VBT ten opsigte van die oordrag van inligting en opvoeding oor MIV aan werknemers met laer vlakke van onderwys nie so geslaagd was nie omdat werknemers met primêre of 'n laer vlak van opleiding nie veel by die ingrypaksie gebaat het in terme van ‘n toename in kennis nie. Daar word aanbeveel dat vrywillige berading en toetsing op 'n gereelde grondslag aan werknemers by die maatskappy aangebied moet word, nie bloot omdat werknemers daarvoor gevra het nie, maar ook om te bepaal of vrywillige berading en toetsing vir MIV by die maatskappy die gewenste uitwerking op die werknemers gehad het, veral met betrekking tot die uitbou van kennis, 'n afname in stigmatisering en diskriminerende houdings, en 'n toename in die gewenste gedragsverandering onder deelnemers.
jfl2011
Imported from http://etd.sun.ac.za

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Taegtmeyer, Miriam. "Approaches to the successful scale up of HIV voluntary counselling and testing services in Kenya 2001-2005." Thesis, University of Liverpool, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.479051.

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Nakao, Jolene H. "Acceptance and access : home-based HIV counselling and testing and barriers to care in rural Western Kenya." Master's thesis, University of Cape Town, 2009. http://hdl.handle.net/11427/12137.

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Includes abstract.
Includes bibliographical references (leaves 83-94).
Home-based HIV counselling and testing (HBCT) is a wayt to provide confidential HIV testing in a person's home. As home-based testing has not yet been evaluated on a wide scale in Kenya among adult individuals [over age 15], this project is designed to assess in rural Kenya 1) overall acceptance rates and variables that predict differential acceptance rates of home-based HIV testing, 2) reasons for refusal of home-based testing, and 3) barriers to seeking treatment for people who are HIV positive.

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Godino, Lea. "Presymptomatic testing for familial cancer syndromes in young adults : considerations, decision making and impact." Thesis, University of Plymouth, 2017. http://hdl.handle.net/10026.1/8643.

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Background: Presymptomatic genetic testing should always involve a considered choice. Young adults are at a key life stage as they may be developing a career, forming partnerships and potentially becoming parents. Presymptomatic testing may therefore affect the future lives of consultands significantly when testing is undertaken in early adulthood. Aim: To explore presymptomatic testing for hereditary cancer in consultands aged 18-30 years with particular reference to psychosocial impact, the decision-making process and the consequent counselling needs. Methods: A mixed-methods sequential exploratory design was used, comprising a systematic review, a qualitative study and a quantitative study. Results of all phases were used to build a theoretical model regarding the process of presymptomatic testing in young adults. Findings: The systematic review indicated that many participants grew-up with little or no information concerning their genetic risk. The experience of genetic counselling was either reported as an opportunity for discussing problems or associated with feelings of disempowerment. Parents appeared to have exerted pressure on their children during the decision-making process. However, as a result of the qualitative study, the influence of other people and the decision-making process prior to counselling were identified as key factors. Further results from the quantitative phase underlined that parents felt they had control over the decisions their children made, while the majority of the young adults reported the request for the genetic test as their own decision. A new theoretical model of decision making and impact on young adults was built to synthesise the overarching experience of participants in this research project. Conclusion: Counselling approaches to this population may require modification both for young adults and their parents. Young adults may benefit from a multi-step approach to presymptomatic testing. Parents need to be more informed that genetic counselling is a forum where information can be obtained and young adults can talk about the testing decision, regardless of whether they want to be tested or not. The traditional ‘wait until they come to us’ approach by health services may be failing to meet the educational and emotional needs of this population.

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Mucheke, Stephen Kinyua. "Experiences of Heterosexual Couples Who Undergo HIV Counseling and Testing in Nakuru-Kenya." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2673.

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The increase in new human immunodeficiency virus (HIV) infections among heterosexual couples in Africa may reverse the gains made by HIV prevention programs. HIV screening among such couples remains low and understudied.This qualitative study focused on the motivations for HIV screening among heterosexual couples. The primary research goal was to examine the lived experiences of heterosexual couples who were screened for HIV and received their results in Nakuru-Kenya. The health belief model (HBM) served as the theoretical framework and as a basis for the secondary questions which sought to explore the participants' perceptions on HIV based on the constructs of the HBM. Semi-structured interviews were conducted with a purposively selected sample of 14 heterosexual couples. Data were collected through face-to-face audio-recorded interviews, which were coded and analyzed using Moustakas's phenomenological data analysis method. Six major themes emerged from the clustered responses of the participants. Couples recognized that they may be susceptible to HIV infection because HIV is transmitted primarily through sexual contact. Some couples perceived HIV as a severe, life-threatening condition in their lives; others perceived HIV as chronic disease that could be managed through treatment and good health care. The fear of negative consequences was cited as a barrier to couples' willingness to receive HIV counselling and testing. Couples perceived HIV testing as having multiple benefits, including freedom from worries and as a motivation to plan their lives. Health messages and partner dialogue were major cues that encouraged couples to undergo HIV testing. Testimonials from other couples who had been tested and chose to talk about their experiences contributed to a strong feeling of self-efficacy. These study findings may help to improve HIV prevention interventions for heterosexual couples.

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Budaza, Thokozile. "The relationship between self-esteem and uptake of HIV counselling and testing among young women in South Africa." University of the Western Cape, 2018. http://hdl.handle.net/11394/6890.

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Magister Public Health - MPH
High HIV incidence among young women is a global public health concern with the potential for a huge impact on their lives. Several interventions have been identified to help reduce HIV incidence among young women, including HIV Counselling and Testing (HCT). Lack of knowledge of HIV status is a major barrier to HIV prevention, care and treatment efforts. Therefore, HCT uptake among young women needs to be up-scaled. Early detection and treatment can help cushion the impact of AIDS on the lives of young women. There are various factors that negatively influence young women’s HCT uptake, including psychosocial characteristics. Studies have linked self-esteem to HCT and high levels of HIV risk behaviour practices among young women. The aim of this study was to assess the relationship between self-esteem and HCT uptake among young women (16 to 24 years) in South Africa using data from the 2012, Third National HIV Communication Survey (NCS). This was a quantitative secondary data analysis of cross-sectional data from the 2012 NCS. The participants of this study were young women (n =1922) from all provinces in South Africa. The independent variable was self-esteem and the dependent variable was ever testing for HIV and testing in the last 12 months, with a number of socio-demographic characteristics as covariates. Data was analysed using STATA statistical software (version 13.0, STATA Corp., College Station Texas, USA). Socio-demographic characteristics were described through descriptive statistics. The relationship between independent variables and HIV testing was analysed with Chi-squared tests of association. Logistic regression models were used to examine the relationship between self-esteem and HCT uptake when controlling for confounders.

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Shawa, Remmy Malama. "Exploring experiences of HIV counsellors towards the HIV counselling and testing policy in Zambia’s public urban health centers." Master's thesis, University of Cape Town, 2014. http://hdl.handle.net/11427/6027.

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Lewis, Celine. "The effect of psychosocial information resources on the psychological impact of genetic testing for patients." Thesis, University of Plymouth, 2011. http://hdl.handle.net/10026.1/543.

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The effect of psychosocial information resources on the psychological impact of genetic testing for patients Background: The genetic testing process has been shown to have a profound psychosocial impact on patients and families, yet research suggests that there is a lack of practical and helpful psychosocial information written to support decision-making. Ideally, this should be available for use both before and after genetic testing and should be easily accessed through genetic clinics. The development of pre-written leaflets or on-line resources which draw on the experiences and advice of families who have been through similar experiences, and are readily available through genetic clinics, might be one way of helping families make necessary adjustments. Aim: The aim of this study was to develop information resources for a) people undergoing carrier testing, and b) parents of children with undiagnosed conditions, and to pilot the use of these resources with service users. Methods: A systematic literature review was conducted to identify key themes to inform the content of the resources. To build on these findings, in-depth interviews were conducted with 11 people who had undergone carrier testing and 14 parents of children without a diagnosis. Interview data were analysed using the grounded theory method. A grey literature search of existing patient information was also conducted. These three phases informed the content of information resources. The development process also included input from genetic specialists, patient group representatives and interviewees. Finally, a pilot study was conducted through three genetic centres to assess the feasibility of a study testing the use of the resources. Findings: The participants in this study were striving for empowerment: carriers sought reproductive empowerment; parents developed empowerment strategies in order to advocate for their child. Moreover, a theory named ‘reconstructing the meaning of being a parent’ was constructed to describe the experience of parenting a child for whom no clear care pathway existed. The importance of providing timely information was identified as being a key factor in supporting parents during their search for a diagnosis. A new model was built to summarise the overarching experience of participants in this study. Conclusions: Empowerment was identified as a dynamic and multi-faceted construct. Health professionals and support groups can help facilitate the empowerment process through the provision of timely psychosocial information. This is particularly important in an age when patients are expected to take greater control than ever before over decisions affecting their healthcare.

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Esack, Abdul Aziz. "Knowledge, attitudes, beliefs and practises (KABP) of adolescents / young adults (15-24 year of age) attending a private general practice, regarding HIV Voluntary Counselling & Testing (VCT)." Master's thesis, University of Cape Town, 2008. http://hdl.handle.net/11427/26934.

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Background: By 2005 an estimated 5. 5 million South Africans were living with HIV and the peak prevalence of HIV/AIDS occurs in young people aged 15-24 years. In order to develop prevention strategies aimed at young people, it is important to determine risk behaviours for HIV in this age group. As VCT has been shown to impact on risk behaviours, it is important to determine the accessibility of these services to youth. Aim: This study assessed the knowledge, attitudes, beliefs and practises (KABP) of young adults, 15-24 years of age attending a private general practise, regarding risks for HIV and accessibility of HIV Voluntary Counselling and Testing (VCT) services. Methods: This was a cross-sectional study. A self-administered questionnaire was completed by a sample of 100 patients attending a general practice located in Athlone. Results: Thirty-six of respondents were male and 64 were female. The age range was 15 to 24 years, with a mean age of 20.2 years. The demographic profile of the study population was typical of a formal urban settlement in a traditionally coloured area. Sixty four percent of respondents reported current or previous sexually activity, of which 89% reported that they had one sexual partner over the preceding three months and 58%, reported not using a condom at their last sexual encounter. The mean age of sexual debut was 16 years. Most respondents could identify safer sexual practices. While 97% of respondents had heard of HIV, only 33% knew someone who had died of HIV/AIDS. Most respondents knew how HIV was transmitted and 74% felt that they had never put themselves at risk of contracting HIV. Seventy five percent of respondents had heard of VCT, and 60% had considered having a test. Knowledge regarding the location of VCT testing sites, methods of testing and waiting period for results was generally poor. Most respondents had a favourable impression of staff in the clinic/CHC setting and would return to these facilities for HIV VCT. However, 71 % reported that they were prepared to pay for a HIV test. Respondents reported that having an HIV test would have a positive effect on sexual behaviour; however, only a third would disclose their HIV test result. Discussion: Respondents had high levels of awareness of HIV prevention strategies but these did not always translate into the adoption of appropriate behaviours. This disparity between awareness of HIV prevention strategies and actual risk taking sexual behaviour could reflect inadequacies in current HIV education programmes. Knowledge regarding most aspects of HIV VCT was inadequate, but there was a high willingness to test for HIV. Respondents indicated that they were prepared to pay for VCT. VCT could be used to engage with young adults and impact on behaviour changes. Further studies may be useful to illustrate the potential of VCT as a prevention strategy and to promote the allocation of more resources for this purpose.

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Lawrence, Michelle. "Exploring attitudes of University students towards seeking psychological counselling." Thesis, University of the Western Cape, 2009. http://hdl.handle.net/11394/3327.

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Magister Psychologiae - MPsych
Student counselling services, typically located within a holistic developmental approach, aim to render comprehensive student services to service users in relation to their psychological, social,educational and spiritual well-being. However, a number of cognitive and affective barriers reportedly reduce the likelihood of young people at universities seeking professional psychological help for personal-emotional problems. Accordingly, the aim of this study, which is located within the Theory of Reasoned Action, was to explore students’ attitudes towards utilising student counselling services, as well as their interpretations of the influence of age, gender and education on their attitudes and self-rated knowledge regarding seeking psychological help. The study thereby attempts to provide an understanding of the factors that influence help-seeking behaviours in university students. The research sample consisted of twenty nine students from the Cape Peninsula University of Technology. The data was collected through focus group discussions, which were conducted using an open-ended and participantcentred approach to the discussion. The qualitative approach of the study was informed by the theory of social phenomenology. Data gathered from the focus group discussions was thematically analysed. The results suggest that attitudes have a potentially important influence on intentions to seek out psychological counselling. Findings show that students feel shame and guilt when they are struggling psychologically and as a result avoid seeking psychological intervention for fear of being negatively stigmatised. The study revealed that education around mental health disorders and the management thereof was crucial in order for them to be demystified and de-stigmatised, and to facilitate openness in the sharing of these problems, and society’s understanding and acceptance of people experiencing psychological disorders. Results also indicate that there is a shift taking place in these attitudes, and suggest ways in which this change can be further facilitated, such as the utilisation of peer helpers who could play a key role in facilitating and reinforcing help seeking behaviour. The outcomes of the study may further contribute to informing universities’ goal to provide accessible, quality and effective development and support services to its students.

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Futter, Merle. "Predictive testing and clinical genetic counselling services for Huntington disease in the Western Cape : an evaluation over eleven years." Doctoral thesis, University of Cape Town, 2007. http://hdl.handle.net/11427/3094.

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Komanyane, Lorato. "Factors influencing the utilization of voluntary counselling and testing services amongst employees of the Lobatse Town Council in Botswana." Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/535.

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In this study both qualitative and quantitative methods were used to find out to what extent the Lobatse Town Council employees used Voluntary Counseling and Testing (VCT) HIV and AIDS services, the reasons for using or not using the services, the preferred service providers reasons for choosing a service provider. Lastly recommendations were made on how the uptake HIV and AIDS VCT services could increased amongst the employees. A sample of 200 respondents was selected from the employees of the Lobatse Town Council, and it was established that 65.5 percent of the respondents had used VCT. Females had a higher testing participation rates than males, white collar respondents had a higher testing participation than the blue collar respondents. There was a higher rate amongst the married than the single respondents and the older ages of 30 and above than the young ages of 29 years and under. In the study it was also established that the majority of the respondents considered voluntary counselling and testing for HIV and AIDS as being important. However there were some groups that were more positive than others regarding the importance of testing. More females than males were positive regarding the importance of testing, and also amongst the employment categories the white collar respondents were more positive than the blue collar respondents regarding the importance of HIV and AIDS testing. Furthermore it was established that the most important reason for testing amongst the employees that did test for HIV and AIDS was that they felt that they needed to undergo testing before they tested. The respondents that did not test for HIV and AIDS indicated that the most important reason for not testing was that they were scared the results could not be kept confidential. The research also showed that the most preferred service provider was Tebelopele. Tebelopele was the most used and preferred service provider amongst both gender and age groups, all marital groups and the blue collar group in the employment categories. However, for the white collar group the most preferred service provider was the private practitioners. The most common reason for choosing a service provider was confidentiality and privacy. Lastly, the research makes recommendations on what needs to be done to increase the uptake of VCT HIV and AIDS testing amongst the Lobatse Town Council employees. One of the recommendations is that there was a need to educate the employees of the Lobatse Town Council and that the education should be specific for each group. For example from the group discussion the participants felt that the reason to why males did not want to utilise HIV and AIDS VCT was because they lacked knowledge on the importance of testing. Also the respondents indicated that there was a need to remove stigma and discrimination through removing confidentiality attached to HIV and AIDS. It was also, recommended that the Lobatse Town Council formulate and implements a workplace policy on HIV and AIDS

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Musemwa, Shingisai. "Factors influencing university students' use of HIV voluntary counselling and testing services : an analysis using the health belief model." Thesis, Nelson Mandela Metropolitan University, 2011. http://hdl.handle.net/10948/1448.

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Human Immune Virus (HI)V /Acquired Immune Deficiency Syndrome (AIDS) has emerged as the most devastating epidemic that the world has experienced. Voluntary counselling and testing (VCT) has proven to be an effective way of preventing and controlling HIV. South African universities provide free VCT services on their campuses; however, these facilities are underused. The study’s objectives were to use the components of the health belief model (HBM) to explore and describe the factors that influenced the decision made by university students who have gone for VCT. The sample consisted of five male students. Data was collected through one-on-one in depth interviews, which were recorded. Data was analysed using thematic analysis, and the components of the HBM were used as codes for the data. Themes were generated for each component. The results indicated that perceived severity, perceived benefits and cues to action played a role in influencing the participants’ decision to go for VCT. In addition, results show that perceived susceptibility had little influence on their decision to go for VCT. Even though participants acknowledged barriers to VCT, they reported that the perceived benefits for VCT outweighed the barriers, and the decision to go for VCT was made. Participants suggested that to increase uptake of VCT on their campus, the university could improve current VCT campaigns, introduce rewards for VCT and introduce couples VCT.

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Gonzalez, J. A. Leon. "The role of voluntary counselling and testing in modifying risky sexual behaviour for HIV infection : cross-sectional study from the ‘Wellness Clinic’ of a District Hospital in rural Limpopo, South Africa." Thesis, Stellenbosch : University of Stellenbosch, 2015. http://hdl.handle.net/10019.1/97242.

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Background: Voluntary HIV counselling and testing (VCT) is considered one of the key strategies in the prevention and control of HIV/AIDS in South Africa. However its role in modifying risky sexual behaviour among patients tested as HIV-negative (primary prevention) is controversial. Objective: This study was intended to demonstrate the likelihood of VCT reducing risky sexual practices among patients testing sero-negative for HIV infection. Methods: This is a quantitative cross-sectional survey that took place over a period of 3½ months in a district hospital in rural South Africa. A self-administered questionnaire was completed by 54 patients who had VCT and tested sero-negative for HIV infection during the previous 12 months (Study Group). The same questionnaire was filled in by 61 patients who had never received VCT before (Control Group). Both groups consisted of women and men aged 18 years or older. Socio-demographic information, sexual behaviour, willingness to disclose the HIV sero-status with the sexual partner, and readiness to have VCT were asked in the survey. To compare differences between two independent proportions the Pearson Chi-square test was used. Significant results were regarded as a p-value of less than 0, 05, which was taken as an indication of association between VCT and the variable being measured. Results: The median age of our sample was 29 years (Interquartile Range 24-40), with most of the respondents (38 %) between the ages of 26 and 35 years. More than 90 % of patients in both groups reported being sexually active. Sexual intercourse with more than one partner was significantly lower in the Study group (p=0,003). Those who had never received VCT before had a higher (although not significant) incidence of episodes of unprotected sexual intercourse and symptoms of sexually transmitted infections (STIs) (81, 9 % and 42, 6 % respectively) when compared to the study group (77, 7 % and 35, 1 %). Most of the participants in both groups did not consider the disclosing of their sero-status an issue of concern for their sexual partner(s). Readiness to receive VCT was significantly higher in the study group (p=0, 02). Conclusions: In this study, people who tested sero-negative for HIV through VCT showed a significant decrease in the number of sexual partners as compared to the control group who did not undergo VCT. The VCT group had less unprotected sexual intercourse and less symptoms of STIs than the control group.

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Elliott, Diana. "The impact of genetic counselling for familial breast cancer on women's psychological distress, risk perception and understanding of BRCA testing." University of Western Australia. School of Population Health, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0190.

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[Truncated abstract] Background: A review of the literature indicated there was a need for more long-term randomised controlled studies on the effects of BRCA counselling/testing on high risk women, including improved strategies for risk communication. Reviews have also shown women are confused about the significance of inconclusive or non informative results with a need for more research in this area. Aims: The general aim of this study was to evaluate the impact of breast cancer genetic counselling on psychological distress levels, perception of risk, genetic knowledge and understanding of BRCA testing/test results in a cohort of 207 women from high risk breast cancer families who were referred for genetic counselling in Perth during the period 1997 to 2001. Short- and long-term impact of BRCA genetic counselling/testing was determined in women with and without cancer in a randomised controlled trial as part of which women were randomised to either receive immediate versus delayed genetic counselling. This included family communication patterns before BRCA testing, anticipated outcomes of testing on oneself and family including intentions for result disclosure. Comprehension of index and predictive BRCA testing with possible results was assessed both in the short- and the long-term and understanding of individual or family BRCA test results was evaluated at long-term. The effect of genetic counselling on breast cancer risk perception in unaffected women was evaluated. This study considered a theoretical framework of educational learning theories to provide a basis for risk communication with possible relevance for future research. ... Only 25% of the original study population (52/207) reported BRCA results and women's understanding of results is concerning. Key findings were: 1. The majority of affected women received an inconclusive result. 2. Out of twelve unaffected women who reported results, seven were inconclusive which are not congruent with predictive testing. This implies that these women did not understand their test result. 3. A minority of untested relatives did not know whether a family mutation had or had not been found in their tested family member or what their actual test result was. This implies either a lack of disclosure or that woman did not understand the rationale for and significance of testing for a family mutation. 4. Three relatives did not understand a positive result was a mutation. Conclusion: The implication of this research for breast cancer counselling and testing services is that women who wait for counselling are no worse off in terms of short- or long-term general psychological distress than women who receive the intervention early. There is a suggestion that unaffected women without the disease found counselling more advantageous than affected women. The meaning of BRCA results as reported by women is concerning particularly women's understanding of negative and inconclusive results and further research is needed in this area. Too much information presented at counselling may affect women's comprehension of risk, BRCA testing and future test results and further research is required to evaluate the effects of information overload.

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Ndirangu, Eunice Wambui. "Communication and interaction in the context of routine provider initiated HIV testing and counselling for HIV : the case of Kenya." Thesis, University of Nottingham, 2016. http://eprints.nottingham.ac.uk/38061/.

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Background: The global policy focus of today’s HIV efforts and strategies is to reverse the spread of HIV/AIDS and provide care, treatment and support. A key component of this strategy is to increase individual HIV status awareness through expansion of HIV testing and counselling (HTC). However, the numbers tested still remain low and evidence suggests that there are significant missed opportunities for HIV testing in clinical settings. One key strategy to expand HTC in clinical settings has been to implement a policy of ‘provider initiated counselling and testing’ (PITC) in which all patients accessing health facilities for treatment are routinely offered a HIV test. The introduction of PITC has brought with it a ‘dilution’ of the previously lengthy and stringent testing process by doing away with signed informed consent and extensive pre and post test counselling. The previous process was recognised as a barrier to public health gains of HIV testing expansion, particularly as it differentiated an HIV test from other routine medical tests resulting in a sense of HIV exceptionalism. In its place, the PITC policy recommends an opt-out approach and replaces the extensive pre test counselling with an information giving session placing more emphasis on post test counselling in cases where the result is positive. This change has given rise to debates about the potential for PITC to infringe patients’ rights to informed consent and counselling especially in developing countries. Emerging evidence from the exploration of the PITC process within antenatal settings in the Sub Saharan Africa has revealed some of the complexities of implementing PITC guidelines in different cultural and healthcare contexts. These studies suggest that information giving and consent are difficult to apply in contexts characterized by healthcare worker dominance, lack of sufficient resources and time constraints. This study aimed to specifically investigate how patients and counsellors co-construct informed consent and perform counselling during the PITC consultation. It examined ‘real time’ patient-counsellor interaction within hospital outpatient and inpatient settings in Kenya, explored the patient’s experience of a routine HIV test and evaluated how stigma and patient – provider interaction norms influence the PITC process in this context. Methods: In order to explore the context of the routine testing consultation and the way the interaction played out, a qualitative research approach was adopted, utilizing multiple data collection methods (interviews, observations and audio recording of consultations). The study was carried out in two government run health facilities in Kenya’s capital, Nairobi. The intention was to follow patients through the PITC process, i.e. before testing, during the HIV test and (whenever possible) after the HIV test. To get a broader picture of the events during the routine HIV testing consultation, additional interviews were conducted with five nurse-counsellors whose consultations had been observed. Ethical approval was obtained from the Kenya National Research Council, Kenya Medical Research Institute and the Aga Khan University Ethics Committee. The data were analysed using Charmaz’s constructivist grounded theory approach which allowed for a systematic yet flexible approach to analysis. This method facilitated immersion and engagement with the data, and provided a means of managing the different data sets in the study and undertaking a process of constant comparison within and between data sets. Findings: Results from the study suggest that HIV remains a highly stigmatised illness in Kenyan society and is associated with death and immorality. This is still the case in spite of years of health promotion and high profile media campaigns raising awareness about HIV and the availability and effectiveness of treatment. The context of stigma shaped the consultation so that both patients and counsellors worked together to help patients to maintain a ‘moral face’. Patients tended to withhold information on risky sexual behaviour whilst the counsellors avoided inquiring into this domain. The PITC consultation was characterised by a counsellor dominated approach to communication and health promotion. Counsellor inputs were generic, highly scripted and didactic rather than patient-centred. As a result, the counsellors’ style of communication allowed little space for personalised risk assessment or for patients to ask questions or to express concerns. The findings suggest that informed consent enabling explicit refusal of the test offer was difficult to achieve in an environment where the HIV test was not framed as a choice and patients came to the health facility expecting to be told what to do. Nevertheless, in spite of the obvious lack of explicit informed consent and the counsellor dominated interaction, post test interviews revealed that patients were satisfied with the nature of the interaction. The study concludes that there is a considerable distance between the policy recommendations and their implementation on the ground due to the complexity of real world practice. Lay constructions about HIV (HIV stigma) and the existing norms of patient-provider interaction that are characterised by a passive patient and a dominant health care provider shape the way the consultation unfolds. PITC training programs and manuals need to include skills and strategies that can support counsellors manage an uncomfortable interaction and emphasis the need to ensure an individualized post test counselling is carried out. The thesis makes several contributions to knowledge. The study pays attention to the operationalization of PITC recommendations thus illuminating how the PITC policy is translated into practice within a developing country like Kenya. It informs the existing debates on how informed consent and counselling should be implemented. The study findings suggest that in spite of the global debates on what constitutes ideal informed consent and counselling, in practice, sociocultural norms shape how these issues are translated and implemented. However, the study indicates that diversion from the PITC policy recommendations does not necessarily constitute a disregard for the recommendations but, rather, is an attempt to adapt to the prevailing environment. The study methodology enabled unique insights to be gained on how counselling and consent are constructed and managed in the PITC setting through the use of observations / audio recording to examine ‘real time’ interactions. The research study has been able to illuminate barriers that are posed by sociocultural and organisational structures in the real world implementation of the PITC policy. Therefore, my study suggests that the national PITC policy needs to consider the practical problems faced on the ground in developing contextually appropriate recommendations for the conduct of PITC and implementation of key guidelines.

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Teng, James Wei Jie. "An interpretative phenomenological analysis of the experiences of HIV-positive lay counsellors working in the voluntary counselling and testing settings." Thesis, Rhodes University, 2011. http://hdl.handle.net/10962/d1002579.

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The purpose of this study was to present and understand the experiences of HIV-positive lay counsellors working in Voluntary Counselling and Testing (VCT) settings. Specifically exploring and understanding the utilisation of personal experiences within counselling encounters, the practice of peer counselling within VCT, and the challenges experienced by HIV-positive lay counsellors within VCT settings. This study, employing a qualitative interpretative phenomenological methodology required a small sample of practicing HIV-positive lay counsellors, who were selected and interviewed on their experiences utilising semi-structured interviewing. Data was analysed for meaning units, which were interpreted inductively and hermeneutically, and categorised into super-ordinate themes. Three superordinate themes within the participants’ experiences of providing VCT services were determined, namely: ‘diagnosis and disclosure experiences’, ‘peer counselling’, and ‘challenges’. This research found that the experiences of providing peer counselling depended upon identification with their client’s negative appraisal of their diagnosis experiences. Whether through empathic connections generated through the shared experience of discovering a seropositive status, or through countertransferential reactions induced through their client’s yearning for care and support. This required the counsellor to selfdisclose within counselling encounters in order to provide personal experiences of living with HIV/AIDS. Successful implementation of peer counselling provided recently diagnosed individuals with knowledge surrounding HIV/AIDS, coping skills to manage the daily physiological and psychological challenges, facilitation and adherence to treatment, social assistance, ongoing relationships, inspiring hope, and the creation of positive appraisals. However the informal utilisation of task-shifting within lay healthcare cadres, and the lack of governmental recognition for the emotional labour provided within VCT indicated that HIVpositive lay counsellors require ongoing training, support and remuneration to limit potential occupational stress, resignation, and burnout.

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Nzaumvila, Doudou Kunda. "Reasons given by pregnant women for not returning for their results following voluntary counselling and testing (VCT) for the human immunodeficiency virus at Embhuleni Hospital." Thesis, University of Limpopo (Medunsa Campus), 2010. http://hdl.handle.net/10386/202.

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Thesis (M Med.(Family Medicine))--University of Limpopo, 2010.
OBJECTIVE: In 2007 36% of the pregnant women tested positive for HIV at Embhuleni Hospital and its satellite clinics. However, only one quarter of those returned to the wellness clinic for their CD4 results so as to begin with Anti-Retrovirus Therapy (ART) if they qualified. The rest would not return to the wellness clinic, and would only present late with opportunistic infections or a subsequent pregnancy. The study aimed at exploring the reasons why women who had been tested for HIV by means of VCT failed to return for their CD4 results, to understand those reasons, to determine what information was given to them before they were tested, to assess the availability of personal support systems (family, friends, etc), and finally to assess the women’s understanding of HIV/AIDS, for which they were tested. METHODS: A descriptive qualitative study was conducted using the free attitude interview technique for data collection. The Ante-natal care (ANC) clinic register of the Embhuleni Hospital was used to trace patients who had consented for voluntary counselling and testing (VCT), but who had since not returned for their results after 30 days of testing. Those patients were visited at their places of residence by the research team (interviewing nurse and the researcher) to request them to participate in the study. The exploratory question was: “May you tell us why you did not come back for your HIV test results?” “Sicela usichazele kutsi yinindzaba ungasetanga kutewuhlola imiphumela yakho yengati? (SiSwati Version). The interviews were audio recorded and field notes taken. The interviewer sought clarification for unclear issues raised, and gave reflective summaries at the conclusion of each idea under discussion. The interviews continued until there was information saturation. In this study, was reached at respondent number nine. The audio-tapes were transcribed verbatim, followed by translation into English. The emerging themes formed the basis for the write-up. RESULTS: The following themes emerged:  Communication between health care workers and patients Poor quality of communication (patients not told to come back)  Knowledge on HIV/AIDS and PMTCT Patients had poor knowledge of HIV/AIDS and PMTCT  Fear of stigma for HIV/AIDS The community associated coming back for the results with being HIV positive  Poor patient support Poor family support system for the patient Limited patient financial resources  Experience at the health facilities Lack of patient privacy Attitude of the health care workers not acceptable to patients CONCLUSION: The factors that resulted in non-return of the pregnant women to the facility for their results were that the women were not made aware that they were to return for their results; poor quality of communication by the hospital staff; unpleasant experiences by patients at the facility; patients feared community stigmatisation; there was lack of patient support, and the patients had poor knowledge of HIV/AIDS and PMTCT

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Hara, Rosiana Julia. "Perceptions and attitudes of first year student nurses towards voluntary HIV counselling and testing at the Western Cape College of Nursing." Thesis, University of the Western Cape, 2007. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_6595_1256887789.

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Voluntary HIV counselling and testing (VCT) programmese have been regarded as an important strategy in the management of the HIV/AIDS pandemic. This is in light of having statistics showing only one in five South Africans who know about voluntary counselling and testing also went for testing/ The aim of this study was to get a better understanding of the barriers whoch prevented student nurses from participating in voluntary HIV counselling and testing, explore their knowledge of the VCT process, explore factors which influence their decision to test or not to test and their perception of the VCT programme in their college.

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Hudrog-Shalan, Hana. "Testing the efficacy of a counselling intervention : facilitating the motivation to learn among Arab high school students and teachers in Israel." Thesis, University of Derby, 2017. http://hdl.handle.net/10545/621957.

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The motivation of students to learn is one of the most investigated topics in education. Abu Asba (2007) and Assor (2005) have tried to understand the basic factors that enhance motivation and how both teachers and students can benefit from enhancing the motivation to learn. There has been no research that has contributed to the study of motivation in Israeli Arab high schools. The main purpose of the current study was to examine the processes elicited by a counselling intervention designed to enhance motivation, to improve self-image, school climate and student-teacher achievements of high-school students. Thirty students from five 10th grade classes and thirty-five teachers participated in the study. One of the research aims was to formulate a strategy teachers can use when attempting to motivate their students. The study found that it is difficult for teachers to arouse students' intrinsic motivation to learn in a cultural and educational system where motivation to learn is extrinsically controlled. The study also found that motivation to learn increased after students and teachers participated in a counselling intervention program. When students' motivation to learn was elicited, student engagement with the learning processes was enhanced. The findings showed that student and teacher motivation grew and developed when student and teacher self-images improved. Strategies to improve teacher and student self-images included the implementation of teacher training on the subject of learning styles and on the use of relevant instructional styles and the training of educational teams to address teacher and student motivation.

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Sikasote, Janet Precious Banda. "Effect of voluntary counselling and testing and a negative HIV result on risk behaviour : a qualitative longitudinal study in a Zambian mining community." Thesis, University of Edinburgh, 2010. http://hdl.handle.net/1842/4441.

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Background: Countries in sub-Saharan Africa are scaling up access to Voluntary Counselling and Testing (VCT) services as a strategy for HIV prevention, treatment, care and support. The international and national push to achieve targets for anti-retroviral therapy scale up has emphasised VCT as an entry point to treatment, with follow-up mostly directed at those who test positive. Yet over 60% of those testing are HIV negative. Limited understanding of how HIV voluntary counselling and testing, and receipt of a negative result impact on sexual behaviour has resulted in underdeveloped support for those testing HIV negative. Aims: To gain the perspective of those who have tested HIV-negative on the following: (1) the decision making process that precedes attendance for voluntary counselling and testing; (2) how voluntary counselling and a negative test result influence sexual behavioural intentions and reported subsequent behaviour; and (3) support systems and networks that would enhance the respondent’s ability to remain HIV negative. Method: Qualitative longitudinal study utilising semi-structured interviews, six months apart, with people who have tested negative and three one-off focus group discussions with counsellors. Participants were purposively sampled from VCT centres in two mining towns in Zambia. Interviews were digitally recorded, transcribed verbatim and analysed thematically with the aid of the qualitative data analysis software, Nvivo7. Cross-sectional analysis of all data sets was conducted and paired transcripts were analysed longitudinally to assess change over time. Results: Forty-two HIV-negative people were interviewed, with thirty-one returning for the follow-up interview (74% return rate). VCT was perceived as ‚testing for HIV‛. Before attending VCT most participants had gone through a protracted period of angst, resulting in a resolution to reduce number of partners, use condoms or abstain from sex. Counselling affirmed life choices, rather than initiating them. Although perception of the risk of HIV increased, misconceptions about HIV transmission persisted post-counselling. The negative test result provided impetus and resolve to implement or maintain life change. Themes identified were: (1) recognising personal susceptibility to HIV infection; (2) emotional and cognitive engagement with the problem of testing; (3) a driving need to know status (regardless of test result); and (4) empowerment and being in control providing the ability to plan for the future. Analysis of post-test support needs revealed two further themes: (1) reinforcement of behaviour change through additional knowledge, supportive networks, and life-skills training; and (2) access to recreational activities. There was no reported post-test increase in unsafe sexual behaviour among those that returned for the follow-up interview. Focus group findings reinforced those from interviews. Conclusions: This study has shown that in this population of people who tested HIV-negative: 1. the majority made life changes before attending VCT and used VCT to know their status 2. counselling consolidated pre-test decisions about risk behaviour and testing provided motivation to adopt safer behaviour and to maintain previous low- or no-risk behaviour and 3. there is a felt need for post-testing recreational activities, further HIV/AIDS education and participation in HIV prevention activities. Recommendations include: (1) the promotion of community-based interactive one-to-one and group information, education and communication (IEC) (to aid understanding and progression to the point where testing appears to be of optimum benefit) ; (2) referral to post-test support options such as support groups and inclusion on a text messaging list should be made available; and (3) post-test intervention strategies, for example, provision of result-specific IEC materials and active involvement in prevention activities should be developed and evaluated.

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Dissertations / Theses on the topic 'Counselling and testing'

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