Browsing by Author "Saal, Wylene Leandri"

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    The applicability of the theory of planned behaviour in predicting adherence to antiretroviral therapy (ART) among a South African sample
    (Stellenbosch : University of Stellenbosch, 2011-03) Saal, Wylene Leandri; Kagee, S. A.; Swart, Hermann; University of Stellenbosch. Faculty of Arts and Social Sciences. Dept. of Psychology.
    ENGLISH ABSTRACT: The primary aim of the study was to determine the applicability of the theory of planned behaviour (TPB) in predicting adherence to ART among South African patients attending public health clinics. The second aim was to determine the relationship between self-reported adherence and viral load. The results from the hierarchical multiple regression analyses revealed that the linear combination of the variables of the TPB significantly explained 12% of the variance in intentions to adhere to ART. Perceived behavioural control was the only variable that significantly predicted intentions to adhere to ART. The inclusion of perceived stigma was not a useful addition to the model. The results also reflect the relationship between intentions to adhere to treatment and self-reported adherence, which was not significant. The TPB was unable to significantly account for variance in self-reported treatment adherence. When perceived stigma was added to the TPB, the model was still unable to significantly explain variance in self-reported adherence. Nonetheless, attitudes towards treatment were the only variable that significantly accounted for variance in self-reported treatment. It was concluded that interventions aimed at improving adherence among South African patients attending public health clinics, should aim to encourage positive attitudes towards treatment, should aim to increase perceived subjective norms, should increase the patients’ perceptibility that they are able to be adherent and should aim to decrease perceived stigma. Improving adherence to ART can result in increasing the quality of life of patients living with HIV/AIDS.
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    Common mental and substance use disorders among people seeking HIV testing
    (Stellenbosch : Stellenbosch University, 2017-03) Saal, Wylene Leandri; Kagee, Ashraf; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.
    ENGLISH SUMMARY: The baseline prevalence of common mental disorders (CMDs) and symptoms of distress, depression, anxiety and hazardous alcohol use prior to the receipt of a HIV diagnosis is unknown. The primary aim of this research was to determine the prevalence of CMDs, such as major depression, persistent depressive disorder, generalized anxiety, and alcohol use disorders among a sample of people seeking HIV testing. The second aim was to determine the extent of general distress among the sample of HIV test seekers. The third aim of the study was to determine the ability of the Hopkins Symptom Checklist (HSCL), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and the Alcohol Use Disorder Identification Test (AUDIT) to discriminate between CMD caseness and non-caseness. Utilizing a cross-sectional design, 500 participants were recruited while seeking HIV testing at five non-medical testing sites in the Western Cape, South Africa. The research version of the Structured Clinical Interview for the DSM-5 (SCID-RV) was administered to assess the CMDs. Furthermore, the extent of distress, depression, anxiety and hazardous alcohol use was assessed using the HSCL-25, BDI, BAI, and AUDIT, respectively. Descriptive statistics were used to evaluate the prevalence of CMDs and receiver operating characteristic (ROC) curve analysis was used to determine the effectiveness of the screening instruments in predicting CMD caseness against the SCID as gold standard. The results demonstrated that 28.4% (95% CI [24.45, 32.35]) of the sample had at least one common mental disorder. Elevated prevalence rates for major depression (14.4%; 95% CI [11.32, 17.48]), persistent depressive disorder (7.2%; 95% CI [4.93, 9.47]), generalized anxiety disorder (3.4%; 95% CI [1.81%, 4.99%]) and alcohol use disorder (19.6%; 95% CI [16.12, 23.08]) were reported. The results further showed that the HSCL-25, BDI, BAI, and the AUDIT were effective in identifying CMD caseness. Even the subscales of the HSCL-25 were successful in detecting most of the cases of depression (MDD, and PDD) and generalized anxiety. Of the sample, 41.2% were psychologically distressed, while 21% had moderate depression, 13.6% had moderate anxiety and 34.6% reported hazardous alcohol use. The findings of the research indicated that it is important to screen people for CMDs and distress prior to communicating an HIV diagnosis as these disorders may have a negative impact on quality of life and adherence to ART. A further contribution of the study is that the screening instruments may be used as proxies in identifying people seeking HIV testing with a CMD. Given that HIV testing and mental health services are available independently, fragmented services are provided in public health facilities in South Africa. Future research may need to focus on the integration of referral trajectories with routine screening and HIV testing.