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dc.contributor.advisorVan der Watt, R.
dc.contributor.advisorBrown, S. C.
dc.contributor.authorPheiffer, Catharina Gerdina
dc.date.accessioned2017-08-29T06:20:11Z
dc.date.available2017-08-29T06:20:11Z
dc.date.issued2016-09
dc.identifier.urihttp://hdl.handle.net/11660/6694
dc.description.abstractEnglish: Children living with a congenital heart defect (CHD) carry the burden of a condition affecting their biological, psychological, and social functioning. The extent of influence depends on the unique and complex relationship between a wide range of developmental domains, outcomes, and life course trajectories. Children with CHDs are more vulnerable to experience psychological difficulties. Although there is a sound body of international research pertaining to the psychosocial themes of children with a CHD, South African research on this topic is non-existent. The aim of this study was to explore and describe the psychosocial themes of children with a CHD in the South African context. Semi-structured interviews were conducted with nine children (six males and three females) in the middle childhood developmental stage between the ages of eight and fourteen years. All had a confirmed congenital cardiac lesion and received treatment for their condition. They resided in three geographical locations, namely the Free State, the Northern Cape, and Lesotho. Data were analysed by means of thematic analyses. To gain a comprehensive understanding of children with a CHD, psychosocial themes were contextualised in terms of the developmental psychopathology model. Five main themes and thirteen subthemes emerged from the participants’ narratives. The five main themes related to (a) understanding of cardiac status (i.e., “I have a heart”); (b) perceptions regarding post-operative cardiac status (i.e., “Talking about my heart”); (c) awareness of psychological experiences related to cardiac status (i.e., “Talking from my heart”); (d) social functioning and cardiac status (i.e., “Heart to heart”); and (e) understanding of cardiac status as a chronic condition with long-term psychological effects (i.e., “Attached to my heart”). Findings of this sample of children with a cardiac condition were that they have (a) an age-appropriate understanding of their cardiac conditions; (b) well-developed episodic memory, which holds inherent advantages for future intrapersonal management of the condition; (c) well-developed cognitive regulation; (d) a combination of misperceptions regarding post-operative cardiac status and more realistic outlooks on their post-cardiac status; (e) awareness of psychological experiences related to their cardiac statuses, including anxiety, fear, loneliness, sadness, anger, and resilience; (f) negative (e.g., peer rejection) and positive (e.g., support from caregivers, siblings, and teachers) experiences in the functional social domain; and (g) an understanding of the unique attachment to their hearts; i.e., a chronic cardiac condition. The clinical implications of the findings highlight that health care professionals and researchers need input from children with CHDs to enhance their professional understanding of the intra- and interpersonal experiences of these children and contribute to the provision of comprehensive high-quality health care. Recommendations regarding future research on CHD include considering sample size, type of cardiac conditions, and the question of quantitative versus qualitative research. This study emphasises the importance of holistic management of paediatric cardiac conditions on a biopsychosocial level and serves as an aide-mémoire that a child with a CHD becomes an adult with a CHD.en_ZA
dc.description.abstractAfrikaans: Kinders wat met ʼn kongenitale hartgebrek (KHG) saamleef dra die las van ʼn toestand wat hulle biologiese, sielkundige en sosiale funksionering beïnvloed. Die mate van invloed hang af van die unieke en ingewikkelde verhouding tussen ʼn wye reeks ontwikkelingsdomeine, uitkomste, en lewensloopbane. Kinders met KHG’e is meer kwesbaar om sielkundige probleme te ondervind. Hoewel ʼn sterk hoeveelheid internasionale navorsing ten opsigte van psigososiale temas van kinders met ʼn KHG bestaan, bestaan daar geen Suid-Afrikaanse navorsing oor hierdie onderwerp nie. Die doel van hierdie studie was om die psigososiale temas van kinders met ʼn KHG in die Suid-Afrikaanse konteks te verken en te beskryf. Semi-gestruktureerde onderhoude is met nege kinders (ses seuns en drie meisies) tussen die ouderdomme van agt en veertien jaar in die middelkinderjare-ontwikkelingsfase gevoer. Almal het ʼn bevestigde kongenitale hartletsel gehad en behandeling vir hulle toestand ontvang. Hulle het in drie geografiese gebiede gewoon, naamlik die Vrystaat, Noord-Kaap en Lesotho. Data is deur middel van tematiese analise ontleed. Om ʼn omvattende begrip van kinders met ʼn KHG te ontwikkel, is psigososiale temas in terme van die psigopatologiese ontwikkelingsmodel gekontekstualiseer. Vyf hooftemas en dertien subtemas het uit die deelnemers se verhale na vore gekom. Die vyf hooftemas het verband gehou met (a) begrip van hartstatus (m.a.w. “Ek het ʼn hart”); (b) persepsies ten opsigte van postoperatiewe hartstatus (m.a.w. “Praat oor my hart”); (c) bewustheid van sielkundige ervarings verwant aan hartstatus (m.a.w. “Praat uit my hart”); (d) sosiale funksionering en hartstatus (m.a.w. “Hart tot hart”); en (e) hartstatus is ʼn chroniese toestand met langtermyn sielkundige uitwerkings (m.a.w. “Geheg aan my hart”). Bevindings uit hierdie groep kinders het ingesluit dat kinders met ʼn harttoestand (a) vir hulle ouderdom ʼn toepaslike begrip van hulle harttoestande het; (b) goed ontwikkelde episodiese geheue het wat inherente voordele vir toekomstige intrapersoonlike bestuur van die toestand inhou; (c) oor goed ontwikkelde kognitiewe regulering beskik; (d) ʼn kombinasie van wanpersepsies oor postoperatiewe hartstatus en meer realistiese beskouings van hulle hartstatus toon; (e) bewus is van sielkundige ervarings verwant aan hulle hartstatusse, insluitende angs, vrees, eensaamheid, hartseer, woede en veerkragtigheid; (f) negatiewe (bv. verwerping deur portuur) en positiewe (bv. ondersteuning deur versorgers, broers en susters, en onderwysers) ervarings in die funksionele sosiale domein het; en (g) ʼn begrip van ʼn unieke verbintenis met hulle harte, m.a.w. ʼn chroniese harttoestand, het. Die kliniese implikasies van die bevindings beklemtoon dat professionele gesondheidsorgwerkers en -navorsers insette van kinders met KHG’e benodig om hulle professionele begrip van die intra- en interpersoonlike ervarings van hierdie kinders te versterk en tot die voorsiening van omvattende hoëkwaliteit gesondheidsorg by te dra. Aanbevelings ten opsigte van toekomstige navorsing oor KHG sluit oorweging van steekproefgrootte, tipes harttoestande, en die vraag oor kwantitatiewe versus kwalitatiewe navorsing in. Hierdie studie beklemtoon die belangrikheid van holistiese bestuur van pediatriese harttoestande op ʼn biopsigososiale vlak en dien as ʼn aide-mémoire dat ʼn kind met ʼn KHG ʼn volwassene met ʼn KHG word.af
dc.description.sponsorshipNational Research Foundation (NRF)en_ZA
dc.language.isoenen_ZA
dc.publisherUniversity of the Free Stateen_ZA
dc.subjectPsychosocial themesen_ZA
dc.subjectCongenital heart defecten_ZA
dc.subjectMiddle childhooden_ZA
dc.subjectDevelopmental psychopathology modelen_ZA
dc.subjectQualitative studyen_ZA
dc.subjectPediatric cardiologyen_ZA
dc.subjectDissertation (M.A. (Psychology))--University of the Free State, 2016en_ZA
dc.titleThe psychosocial themes of children with a congenital heart defecten_ZA
dc.typeDissertationen_ZA
dc.rights.holderUniversity of the Free Stateen_ZA


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