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1.
J Child Adolesc Ment Health ; 24(1): 45-57, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25865837

RESUMO

BACKGROUND: Increased rates of suicide among adolescents aged 15-24 years have led to suicides becoming the third leading cause of death in the Unites States. South African statistics show an equally worrying trend as suicide constitutes 11.5% of the total deaths for the age group 11-20 years (Stark et al. 2010). A national youth risk behaviour survey done in South Africa has re-emphasised the need for concern, as adolescent suicidal behaviour increased between 2002 and 2008 (Reddy et al. 2010). The objective was to investigate the influence of risk and protective factors (psychosocial and individual factors) on suicidal ideation. The Integrated Stress and Coping Process model was used as guiding theory for the inclusion of personal and contextual stressors and resources including coping strategies as potential risk and protective factors, in their relationship to suicidal ideation. METHOD: A purposive, stratified sampling technique was used to study 381 adolescents in the Northern Cape Province. The instruments used were a suicidal ideation questionnaire; a biographical questionnaire; a self-esteem scale; and a survey examining stressors and resources relevant to adolescents. RESULTS: Suicidal ideation was significantly higher in the South African sample than in an American sample. Avoidant coping strategies (denial, emotional venting and restraint coping), negative life events and stressful romantic relationships contributed to higher levels of suicidal ideation while self-esteem and adaptive coping (acceptance and seeking social support for instrumental reasons) reduced these levels. CONCLUSION: A lack of self-esteem, ineffective coping and particular stressors contributed significantly to the vulnerability of adolescents. Future studies should explore a wider range of dispositional factors that influence effective coping and adjustment in addressing adolescent suicidal ideation.

2.
BMC Health Serv Res ; 11: 110, 2011 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-21599883

RESUMO

BACKGROUND: South Africa endorses the global policy shift from primarily client-initiated voluntary counselling and testing (VCT) to routine/provider-initiated testing and counselling (PITC). The reason for this policy shift has been to facilitate uptake of HIV testing amongst at-risk populations in high-prevalence settings. Despite ostensible implementation of routine/PITC, uptake amongst tuberculosis (TB) patients in this country remains a challenge. This study presents the reasons that non-tested TB patients offered for their refusal of HIV testing and reflects on all TB patients' suggestions as to how this situation may be alleviated. METHODS: In February-March 2008, a cross-sectional survey was conducted amongst 600 TB patients across 61 primary health care facilities in four sub-districts in the Free State. Patient selection was done proportionally to the numbers registered at each facility in 2007. Data were subjected to bivariate tests and content analysis of open-ended questions. RESULTS: Almost one-third (32.5%) of the respondents reported that they had not undertaken HIV testing, with the most often offered explanation being that they were 'undecided' (37.0%). Other self-reported reasons for non-uptake included: fear (e.g. of testing HIV-positive, 19.0%); perception of being at low risk of HIV infection (13.4%); desire first to deal with TB 'on its own' (12.5%); and because HIV testing had not been offered to them (12.0%). Many patients expressed the need for support and motivation not only from health care workers (33.3%), but also from their significant others (56.6%). Patients further expressed a need for (increased) dissemination of TB-HIV information by health care workers (46.1%). CONCLUSIONS: Patients did not undergo HIV testing for various patient-/individual-related reasons. Non-uptake of HIV testing was also due to health system limitations such as the non-offer of HIV testing. Other measures may be necessary to supplement routine/provider-initiation of HIV testing. From the TB patient's perspective, there is a need for (improved) dissemination of information on the TB-HIV link. Patients also require (repeated) motivation and support to undergo HIV testing, the onus for which rests not only on the public health authority and health care workers, but also on other people in the patients' social support networks.


Assuntos
Sorodiagnóstico da AIDS/psicologia , Infecções por HIV/diagnóstico , Educação de Pacientes como Assunto , Satisfação do Paciente , Tuberculose Pulmonar/complicações , Sorodiagnóstico da AIDS/métodos , Adolescente , Adulto , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , África do Sul , Inquéritos e Questionários , Tuberculose Pulmonar/patologia , Adulto Jovem
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