BRIDGING COURSE – FINAL YEAR

APPLIED SOCIAL SCIENCES II

DESCRIBE THE TERM “SHAM FAMILY” [5]

 It is a type of disorganized family that pretends to preserve the form of

an organized family, but internally the members do not function in the
approved and recognized manner
 The emotional support between parents is entirely absent, or only
present to a minimum degree, often the parent-child relationship is also
inadequate
 Communication between members is also limited to matters necessary
for the material functioning of the home
 Usually the family does not act as a unit and there is a high degree of
individualism, each member going his/her own way and regarding the
home as a boarding house
 The members do not share common values but only consider their own
interests without regard to the other members of the family
 Sexual relations between couples are either entirely absent or are
participated in only intermittently on a purely physical level

DESCRIBE SEVEN TYPES OF FAMILIES [7]

 Nuclear family (monogamous)

- Consist of married couple and their children
 Polygamous family
- Consist of multiple marriages e.g. one husband with many wives
 Extended family
- Consist of basic nuclear unit including grandparents and
grandchildren
 Patriachal family
- Authority governed by the father
 Matriarchal family
- Authority is vested in the mother or a female head
 Single parent family
- Consist of one parent living with own children
 Homosexual family
- Same sex marriage
 Remarriage family
- Widowed or divorced and now married
 Commune family
- Collection of nuclear family living together sharing place and
facilities
 Unmarried parent family
- Whether a couple lives together, without marriage and produce
children forming a family unit
 Sham / pseudo family

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 - Where the family looks like all is well externally whereas
internally the family does not function well

DESCRIBE THE BASIC CHARACTERISTICS OF A FAMILY [6]

 It is formally developed, although in different forms in all societies

 Almost everyone is born into a family, and assumes a certain role by
he simple fact of kinship, e.g. son, daughter, brother, sister, mother,
father
 Although not backed by formal sanctions which force compliance with
other obligations such as keeping the law of the, family members
usually conform to the demands of the family
 It is the fundamental instrument for the socialization of the child into the
culture of the society into which he was born.
 The family exerts pressure on the member so that he conforms to
expect ways of behaviour with regard to work patterns, use of leisure
time and employment of his money.
 It tends to form his way of functioning in the larger society of which the
family is a unit
 The family contributes specific services to the society i.e. the functions
of the family e.g. biological function.

LIST FIVE FUNCTIONS OF THE FAMILY [5]

 Regulation of sexual behaviour

 Replacement of members

 Socialization

 Care and protection

 Social placement.

DESCRIBE THE INFLUENCE OF URBANIZATION ON THE TRADITIONAL

EXTENDED FAMILY WHO LIVED IN A RURAL AREA [5]

 Lose their home and it is difficult to find housing

 Communication problems are due to possible cultural differences
between them and other families
 Unavailability of work opportunities – may find it difficult to secure an
income
 They have lost the support system they had in the traditional
community
 They are unfamiliar with technical/industrial aspects of city life e.g.
ATM machines
 Fast tempo of living and experiences stress

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DESCRIBE THE EFFECTS OF URBANISATION ON THE TRADITONAL
EXTENDED FAMILY COMING FROM THE RURAL AREA (10)

Family structure
 The family structure of the rural people is extended and very communal
in nature.
Problem:
 accommodation and basic amenities will be inadequate and expensive
to be able to maintain the livelihood of an extended family

Norms / values
 In rural communities, norms of behaviour are more simple, coherent
and known to all members of the group. The elders have vested
authority to maintain order and this include the head of the family
Problem:
 In urban setting norms of behaviour are very complex and are
controlled by external persons e.g. government.
 The extended family will find it difficult to adjust to complex rules of
behaviour that are also controlled by unknown individuals.
 This often results in culture shock (exposure to an alien cultural
environment with fundamental different beliefs from that of the
individual or group)

Employment opportunities
 The rural family nearly everyone is working in an occupation related to
agriculture.
 Each family member contributes in various work assignments to meet
the needs of the family.
Problem:
 In the urban areas the work environment is highly complex, specialized
and is characterized by intense technology.
 The work is also very scanty due to rising urbanisation.
 It becomes difficult therefore to find employment by rural persons.

Social status
 Individual status in the extended rural family is determined by the
kinship relations (ascribed status).
 In the urban setting the individuals status is achieved by high level of
competition and conflict
Problem:
 The rural family status will change in the urban area and become
diffused.
 Because of the change in status the rural family often loose identity,
esteem and feel alienated.

Relationships
 The relationships of the rural families are known to be supportive,
close, intimate, long lasting because members have been socialized in
accordance with a homogenous tradition

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Problem:
 In the urban areas relations are said to be impersonal, temporary and
anonymous.
 Therefore the rural family will experience a sense of loneliness,
boredom, alienation, insecurity and distrust which might later lead to
emotional pathologies

Habits and lifestyles

 The rural family will have to adjust to a culture of new diets, noise
pollution, air pollution, and other habits unfamiliar to them leading to a
stressful life

Means of production
 The family is transformed from being both a unit of production and
consumption to being only consumers with high price to pay for the
consumer goods.
 This could lead to problems of malnutrition and poverty

Decision - making
 The decision - making in the rural setting is communal and is vested in
the kinship structure.
 In the urban setting decision making is very bureaucratic (too formal
and impersonal).
 This can cause a lot of stress, conflict to the rural family

Socialization of offspring
 In the rural communities the extended family and the community share
in the socialization of the child.
 Children grow up accepting every adult as a parent to them and
parents accepts that all children are their children.
Problem:
 In the urban setting, socialization of children is by the biological
parents’ responsibility and is very complex and expensive.
 This might create a conflict situation for the rural family

Urban environment
 The urban environment is very alien to the rural family e.g. lack of
privacy and personal space, high wall fencing, crime rate, fast life style.
 This environment creates feelings of insecurity to the rural person
though are some good from such an environment e.g. transport is
readily available

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DESCRIBE THE MAIN DIFFERENCES BETWEEN URBAN AND RURAL
COMMUNITIES [15]

URBAN COMMUNITIES RURAL COMMUNITIES

Type of community Type of community

 Heterogenous  Homogenous

Relationships Relationships
 Status plays a large part and  People know one another on a
people who come into contact personal basis
do not know one another on a
personal basis
 There are fewer personal
relationships

Social control Social control

 Formal  Informal
 E.g. fines are paid for breaking  Behaviour is controlled by
the law customary norms e.g.
ostracism

Social mobility Social mobility

 Horizontal social mobility of  Tend to be socially stable
people from one area to
another or from one job to
another
 Rapid social mobility  Slower social mobility

Political and religious affiliations Political and religious affiliations

 Viewed with tolerance and  People are more rigid.
changes occur more easily
 People come into contact with  Different political and religious
different points of view, tends affiliations are not easily
to make them more tolerant accepted
and ready to adopt others point
of view

Social change Social change

 More social change of all types  More stability and generally
more conservative

Social issues Social issues

 Greater diversity of  Fewer diversity of occupations
occupations
 Lower birth rate  Higher birth rate
 Higher divorce and suicide rate  Lower divorce and suicide rate

Housing Housing
 The poor live in shacks which  Live in traditional huts which

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 are unsafe are safer than shacks
 Middle and upper income live
in developed suburbs

Demography Demography
 Densely populated  Sparsely populated
 Living space is small  Spread out over a large
geographical area

Overcrowding Overcrowding
 Usually more than one family  Families live individually in
per dwelling dwellings
 One roomed shacks lead to
overcrowding

Employment Employment
 Better chance of employment  Less opportunity for
as close to factories, etc employment as no real
infrastructure available

Education Education
 Children are closer to schools  Schools are widely dispersed
 Adults get opportunity to study  Little or no opportunity for adult
further education

Transport Transport
 Mechanized transport is readily  Mechanized transport is erratic
available  Need to rely on animals

Utilities Utilities
 Safe water supply  Water supply often
 Usually have sanitation contaminated
 Sanitation services are usually
non-existent.

Food supply Food supply

 Depend on shops  Grow own crops
 Slaughter own animals

Crime Crime
 More opportunities for crime  Less crime because people
due to overcrowding and know each other
impersonal way of life

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DESCRIBE THE SOCIAL PRESSURES WHICH MAY CONTRIBUTE TO A
FAMILY STAYING TOGETHER EVEN IN THE ABSENCE OF A GOOD
MARRIAGE RELATIONSHIP [7]

 The fact that divorce is frowned upon or forbidden in some religions

may have this effect e.g. Roman Catholic Church
 The wife may not be able to support herself and her children if she left
her husband
 The desire to provide a home for children despite poor parental
relationship
 Fear of censure by parents of married couples
 Fear of revenge on the part of one spouse
 Social disapproval of divorce
 Fear of losing social status as a member of the family

NAME 5 (FIVE) SOCIAL INSTITUTIONS AND EXPLAIN THE FUNCTIONS

OF EACH [5]

EDUCATION
 This social institution is concerned with the name whereby the
accumulated ideas, standards of knowledge and the techniques of
social interaction in society are transferred to or imposed upon the
children and youth of the society
 To develop knowledge and skills for communities

RELIGION
 This is built around a man’s need to have a belief in something over
and above man himself
 Built around the concept of a supernatural being who is, or are
responsible for man’s destiny
 To inculcate moral values to communities

GOVERNMENT
 It is a social institution which refers to functioning of the state in all its
aspects, concerned with the administration of the state and should
continue without a break, despite any change in the political party in
power
 To ensure stability in the country

FAMILY
 It is a social institution which comprises the laws, norms, customs, and
other social behaviour that define kinship relationship among people
 It is a primary group
 A kinship grouping which provides for the rearing of children and for
certain other human needs
 For procreation and socialization of the young

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ORGANIZATION OF ECONOMIC ACTIVITIES
 A social institution whereby the economy and wealth of the society are
organized so that it can be shared by the members of the society and
involves such traits as the banking system, accounting, etc.

NAME EIGHT FUNCTIONS OF THE HOSPITAL [8]

 Curative
 Rehabilitative
 Integration
 Training/teaching
 Hospital centered community health care
 Specialist
 Research
 Employment

DESCRIBE SEVEN FUNCTIONS OF THE HOSPITAL [7]

 Curative function
- A hospital has become a place where people go for treatment of
a deviation in their state of health, in the hope and belief that
their health problems will be cured

 Rehabilitative function
- The initial stages of rehabilitation are commenced in the hospital
so as to ensure that the pt returns to complete social functioning
on his discharge from hospital

 Specialist function
- The establishment of the hospital whose activities encompass
the care of pts within a medical speciality e.g. paediatric
hospital, psychiatric hospital, maternity hospital, etc.

 Integration function
- The work of a hospital requires the integration of several health
professionals into a team e.g. Dr, nurse, social worker, etc.

 Training/teaching function
- Involves the education and training of personnel e.g. in-service
training, training of interns, training of student nurses

 Research function
- The hospital provides the area for both clinical and non clinical
research which is essential for the expansion of knowledge in
the field of medicine and nursing

 Hospital centered community health care

- The concept of promotive and preventive health service is
centered around a hospital, which acts as a focal point from

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 which radiates out a network of smaller hospitals such as day
hospitals, clinics, and which all have links and communications
within the central point

SOUTH AFRICA IS RECOGNIZED AS ONE OF THE MOST VIOLENT

COUNTRIES IN THE WORLD.
DESCRIBE THE EFFECTS OF VIOLENCE ON THE COMMUNITY [20]

OR

DESCRIBE THE EMOTIONAL TRAUMA WHICH MAY BE EXPERIENCED

BY INDIVIDUALS WHO ARE VICTIMS OF VIOLENCE CAUSED BY
GANGSTERS IN THEIR COMMUNITY

 The community interest and sense of values held in common in the

community life of the old settled areas are lacking in these new,
artificially created townships, and are replaced by an indifferent,
impersonal approach
 Previously everybody knew everybody and they were aware of each
other’s needs
 As a result of the development of new social structures and
relationships, each person now has to fend for himself
 Community involvement slowly died out and the vicious circle of social
isolation and pathology is now present
 Gang life may fill a certain void and act as a substitute for parental and
societal neglect
 Gang members develop a range of activities that are contrary and in
conflict with the mores of the community
 They look upon life as a battle for existence in which the individual, has
little value
 The reign of terror has made residents stay home at night and over
weekends behind security gates

 Emotional blunting
- Due to fear of going outdoors, people become socially isolated,
resulting in emotional blunting

 Fear
- The most damaging effect of violence is fear
- The victim develops a permanent feeling of insecurity and
suspicion towards other people
- The aged live in fear of being attacked in their homes e.g.
murders, etc.
- Violence on senior citizens is on the increase because they are
more vulnerable
- Train commuters live with perpetual fear for attacks – the
possibility of being harassed or thrown off the train is very real
- Distant communities realize that they are possible targets and
are always in fear

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 - Social activities during the evening are limited due to fear of
travelling on roads after dark

 Anger
- Losing a loved one makes people feel angry
- Many people vow to take revenge and develop feelings of
hatred
- Due to loss of property

 Hatred
- Strong feelings of dislike, building up over a period of time drives
people eventually to act in an irrational manner sometimes even
to the extent of committing murder
- Communities may influence each other and mass action results

 Community disruption
- Families are driven apart
- It is not safe for children to play in their own environment
- Houses are set alight, leaving families homeless and destitute

 Poverty
- Families whose homes are burnt down are frequently left with
the clothes they are wearing
- They therefore have to start from scratch
- Frequently these people are from the lower socio-economic
class
- Stealing and even assault may result in order to obtain the basic
needs

 Increased cost
- People need to protect themselves and their property by the
installation of burglar alarms, security gates, burglar bars, etc
- Increase in the number of policeman, security men deployed
- Additional insurance coverage
- Crime costs South Africa millions per year
- The operational upkeep of police departments, courts and
prisons is an additional cost to the country and the taxpayer

 Physical and emotional damage

- Permanent trauma occurs from the act of violence e.g. a victim
of rape – rape hurts, humiliates and degrades the victim

 Family isolation
- The gang member may find himself/herself rejected by his/her
family and friends or the family of the gang member(s) may be
rejected by the community

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FAMILY VIOLENCE MOST COMMONLY OCCURS AGAINST WOMEN AND
CHILDREN.
DISCUSS THE PROBLEM OF FAMILY VIOLENCE WITH REGARD TO:

1. CAUSES [7]

 Violence against children e.g. high divorce rate with women taking in
live-in-lover who is not the child’s father

 High unemployment rate

 General level of violence in country

 Related to income e.g. physical (not sexual) abuse of women and

children more likely to occur in very poor families

 Substance abuse

 Isolation of nuclear family

 Abused as children

2. CONSEQUENCES [3]

 Often battered wife believes she provoked the violence

 And that she is worthless and unlovable

 Leading to feelings of shame and inadequacy

 Abused children often perpetuate pattern of violence as adults e.g.

higher incidence of criminal behaviour

 More likely to abuse own children

 Children spend more time away from home – negative influences etc

 Runaway children - cause of increasing number street children.

DESCRIBE THE CONSEQUENCES OF CRIME FOR THE:

a) INDIVIDUAL [3]
 The criminal loses his freedom when he is in prison
 He will be unemployed and lose his income
 The criminal’s victim suffers loss of money, possessions and
prestige

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 b) FAMILY [4]
 The family must adjust to a lower living standard because of
lack of income
 The children grow up without the influence of a father
 The mother must find employment if she was not employed
previously
 A stigma clings to the family and that leads to further emotional
problems

c) COMMUNITY [3]
 The community bears the losses of crime and must replace
possessions
 The community is indirectly responsible for the maintaining of
prisons and police forces
 Increase in taxes
 Additional expenses must be incurred to protect property e.g.
burglar bars, security gates and burglar alarm systems
 Community loses the productive manpower which affects the
economy when the criminal is imprisoned

DESCRIBE THE PREVENTION OF CRIME IN THE COMMUNITY [10]

 Education of the community on the following:
- Parenting skills
- Crime
- Physical, mental and economic effects of crime
- Criminal justice process
- Whistle blowing encouraged
 Raising the socio-economic standard of the community
- Encourage compulsory education
- Poverty alleviation projects
 Community action and involvement
- Community involvement crime forum
- Voluntary work in probation departments or correctional
institutions
 Encourage a crime free community
- Do not buy stolen goods
 Making the community aware of available economic opportunities for
the youth

SOUTH AFRICA HAS BECOME A COUNTRY WHERE RAPE IS A

REALITY TO CHILDREN AND WOMAN.
DESCRIBE THE MEASURES THAT CAN BE TAKEN TO PREVENT RAPE
[10]
 Avoid walking alone in isolated and deserted areas
 Choose periods when a lot of people are around
 Try to recognise a scar you can identify a culprit with in cases of rape
 Do not be too friendly with males in isolated areas

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  Young girls to avoid taking gifts and lifts from people they do not know
i.e. strange males
 Young girls to report to their parents gifts given to them by male
neighbours and relatives in the absence of their parents
 Teach the community, youth in particular about the value of family life,
how to promote it and avoid family breakdown through divorce
 Advise them about available resource agencies where assistance can
be sought in case of need
 Children to go with adults when sight seeing and picnicking to avoid
rapists taking advantage
 Communities to be involved in self help or development projects to
prevent causes such as unemployment and substance abuse leading
to rape
 Form support groups in communities to help each other during crisis
periods
 Women to report any incidence of rape so as to get the guilty person
arrested and counselling for the victim

MYTHS ARE MISCONCEPTIONS ABOUT RAPE, WHICH LACK VALIDITY

OR HAVE BEEN DISPROVED BY RESEARCH.
JUSTIFY THIS STATEMENT. [10]

 Men rape because they cannot control their sexual desires:

All types of women are raped, whether or not they are married and
whether or not the male has an active sex life.

 Men rape for sexual gratification:

Research shows that some men rape to fulfil their non-sexual needs,
such as the need for power.

 Rapists are always strangers:

Research indicates that rapists are often known to their victims.

 Rapists are insane:

Studies indicate that there are no major psychological differences
between rapists and ordinary people.

 Most rapes in South Africa are committed by Black males against

White females:
Most rapes occur between people of the same race.

 Women encourage or enjoy rape:

Research on the effects of rape indicates the opposite.

 Women accuse men of rape to get them into trouble:

This has occurred in isolated cases and should not be considered the
norm.

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IDENTIFY THE REASONS WOMAN ARE RAPED [5]

 Perpetrator is mentally and psychologically unstable.

 Men may commit rape to release sexual frustrations and tension.
 Lack of inhibition due to substance intoxication.
 The perpetrator may use rape as a means of control or power over the victim.
 It is a means of exerting power or influence over a female who is regarded as
the weaker sex.
 Impulsive rape secondary to robbery or theft.
 Belief in myths about rape.
 Enforcing marital rights whether spouse is willing or not.
 Culture of violence- gangs may use rape as a means of instilling fear in a
specific territory.
 In areas of political unrest, rape is used as a means of humiliating and
terrifying communities.
 Rape as a weapon of war- creates terror, humiliation in the communities.
 Males who have experienced sexual abuse when young may see rape as a
natural activity or retaliatory measure for an injustice done to them.

STREET (TWILIGHT) CHILDREN ARE ON THE INCREASE.

DESCRIBE THE EFFECT OF THIS ON THE SOCIALISATION OF SUCH A
CHILD [10]

 Emotional development
- Is impaired because a child first experience love and affection
within the family structure
- The child develops trust when his basic needs and affection are
being provided
- In the absence of affectionate care the child develops mistrust
and other emotional problems

 Role model
- A growing child needs positive role models that will instil
acceptable behaviours of the group/family
- It is a function of a family to promote and nurture these
behaviours
- In the absence of a coherent family system the child will be
vulnerable to role conflict in later life

 Identity formation
- From the role models, family norms and values – the child is
able to develop his own identity
- Street children are disadvantaged in this regard and they
develop problems of identity in later life

 Discipline
- Within a coherent family structure children are able to acquire
attitudes, behavioural expectations of the family/society
- Street children’s behaviour is according to behaviour of the other
children, which in many instances is not approved by society

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  Norms and values
- Of society are taught to a child within the family structure
- Behaviour of the street children is not sanctioned and therefore
these children are exposed to delinquent behaviours

 They grow up without a feeling of security

 Grow up within a culture of:
- No respect for own or other people’s property
- Poor or no school attendance
- Poor or no idea of nutritional food values
- Learns to survive with limited expectations of the future
- Learns to beg, steal or depend on charity
 Exposed to crime and abuse
 Need to survive with limited resources
 Poor self-image due to limited expectations which can lead to
depression/suicide

You are a community health nurse at a clinic situated in a large informal

settlement and are attending to a married women with three (3) young
children.
On assessment you discover they are refugees from a neighbouring
country, staying with distant relatives, that the children appear
neglected and undernourished and that the mother appears withdrawn.
Explain the social reasons why you fear this may be a family at risk for
family disorganisation and have scheduled a home visit.
[10]

Intensity of interaction – this family isolated from other family/friends,

Communicating and interacting mainly with each other – this can affect
relationships

Lack of privacy - they sharing home with another family

May not be sufficient space for their needs to be met
Lack of inner privacy (place to withdraw) can aggravate tension and friction in
the home

Financial problems - as they are refugees, may have to adjust to new socio-
economic conditions e. g. less material goods, as well as adjusting to new
social environment

Foreign nationals may find it difficult to find employment

Psychosocial effects of unemployment
Affects role performance, may cause conflict between couple
as well as adversely affecting rest of family

Social change - move to another country

- may cause maladjustment and stress if great change in
norms and values

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Social control - as this is immigrant family, may be weak integration into the
community and therefore weak control of behaviour and disorganisation more
likely to occur.

Reference : Bezuidenhout 3rd ed Pg 5-8

DESCRIBE THE POSITIVE EFFECT OF MASS MEDIA ON THE

SOCIALISATION OF THE CHILD [5]

 It has a considerable influence on the socialisation process particularly

by providing role models
 It is responsible for teaching the child the correct attitude and
behaviour
 It widens the horizon of the growing child
 Television is the biggest source and it plays a major part in the
socialisation process of the child because more than one sense is used
(hearing, sight) which provides better learning opportunities
 It can broaden the child’s outlook by introducing him to roles that are
not available in the immediate environment

DESCRIBE THE INFLUENCE OF THE FAMILY IN THE SOCIALISATION

OF A CHILD [8]

 Socialization begins in the family

 Children learn who they are
 What they can and should expect in life
 How to behave towards others in society
 The family is a small group where members have constant face-to-face
contact with each other
 Children’s progress can be closely monitored and adjusted as
necessary
 A major function of the family is to provide love and affection to its
members
 “Mothering” enhances the total growth and social development of the
child
 The family is not necessarily an effective agency of socialisation

CHILDREN WHO ARE EXPOSED TO AN UNSATISFACTORY FAMILY

LIFE MAY BECOME JUVENILE DELINQUENTS.

DESCRIBE THE CONDITIONS WITHIN A FAMILY WHICH CONTRIBUTE

TO CHILDREN BECOMING JUVENILE DELINQUENTS [10]

 Structurally disrupted nuclear family e.g. death of a partner, desertion

or divorce
 Families disrupted by external factors e.g. unemployment,
disease/illness or detention

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  Sham families or pseudo family – where the family looks like all is well
externally whereas internally the family does not function well
 Families disrupted by internal factors such as mental, physical or
emotional deviations
 Both parents being incapable of fulfilling their roles e.g. child neglect
 Lack of discipline and control if role model not present in family
 Lack of interest/concern for the child often due to working parents and
child is left alone
 Poverty that results in overcrowding
 Lack of facilities may lead to crime in order to improve income
 Poor self-esteem e.g. repeated failure at school
 The child has delinquent friends who expose the child to crime etc.
 Child has a difficult temperament that may result in children rejecting
family values.
 Discipline may be:
- Erratic
- Unsympathetic
- Harsh e.g. families who take care of children who ’s parents are
not present
 Supervision of children may be:
- Indifferent
- Unconcerned
 Lack of love/affection
- Cold
- Hostile e.g. children left in care of others
 Lack of family cohesion i.e. no sharing of family values/cultural
traditions
 Lack of healthy role models
- An abusive parent
- An alcoholic parent

EXPLORE THE CONSEQUENCES OF JUVENILE DELINQUENCY FOR

THE FAMILY
[10]

 May cause members of the family, especially the parents to experience

psychological stress.
 Disorganisation of their lives due to not knowing where their child is or
what activities they are involved in.
 Constant conflict in the family may put a strain on the parent ’s
marriage.
 May cause parent/s to become depressed having to cope with so
many stressors- delinquent child, breakdown of marriage, other
children, etc.
 May also affect the relationship between the parents and other children
in the home – over protective, neglected
 Places a financial burden on the family due to legal costs as well as
providing for the needs of other members of the family.

SMC 2006 17
  Ostracised from society due to the actions of the delinquent child –
crime such as murder, rape etc
 This ostracism may have negative impact on the socialisation of the
other children in the family.
 If the delinquent is rehabilitated, there may be constant fear that he
may resume these illegal activities.
 If the delinquent has been released from prison after a long period of
time, the family may find adjustment strenuous.

CHILDREN AGED 9 AND 13 ARE LONELY AND NEED TO MAKE

FRIENDS.
DESCRIBE THE ROLE THAT JUVENILE GANGS PLAY IN CHILDREN OF
THE ABOVE NAMED AGE GROUP [5]

 Because these children are lonely the juvenile gang will provide them
with some form of status
 It may serve as a socializing agent in the absence of other peer groups
 The juvenile gang may introduce the child to drugs which may serve as
an escape
 The juvenile gang will serve as a relaxation function and keep the
children busy after school – be part of their activities
 With the juvenile gang the children may find a structure for reaching
their aims
 It can serve as a protector for these children especially in a tough
neighbourhood

INDICATE WHETHER THE FOLLOWING STATEMENTS ARE TRUE OR

FALSE.
WRITE ONLY THE NUMBER OF THE QUESTION AND THE ANSWER IN
YOUR ANSWER BOOK E.G. m - TRUE [8]

a) An extended family is a family group that consists of three or more

generations.
b) A nuclear family usually consists of a mother, father and their children.
c) Statutory rape refers to actual/attempted sexual intercourse through
the use of force.
d) An example of a narcotic drug is barbiturates.
e) The use of addictive substances over a long period of time may impair
the memory and problem-solving abilities of the individual.
f) There is no conclusive evidence that juvenile delinquency will always
lead to adult criminal activities
g) Organised crime relates to activities such as smuggling and drug
trafficking.
h) Crime can be defined as behaviour that is forbidden by an empowered
authority

SMC 2006 18
ANSWER
a) True
b) True
c) False
d) False
e) True
f) True
g) True
h) True

DESCRIBE THE SOCIAL CAUSES OF ILLNESS AND DISEASE [10]

 Poverty
- Due to a low wage, if the earner is too young, is female or
uneducated, poverty prevails
- Because of lack of money to buy food etc. this leads to ill health
due to poor nutrition
- Poor housing and lack of adequate facilities to maintain a sound
quality of life
- Malnutrition e.g. kwashiorkor
- Child and women abuse
- Alcoholism
- Infections and high morbidity rate

 Unemployment
- When one fails to get employment, he has no money to buy food
and this leads to malnutrition
- At the same time, the quality of life i.e. physical, psychological,
social and mental aspects are affected

 Ignorance
- Due to ignorance, sound health practices are affected e.g.
sanitation, housing, water supplies, etc.
- Because parents are uneducated, they may in turn fail to
motivate their children to learn, leading to a vicious cycle of
poverty because these children will not earn good wages
- The children will adopt unhealthy habits
- Defects such as mental retardation can occur as a result of
substances ingested which have teratogenic effects
- Poor or lack of ante natal care, lack of genetic counselling or
medical advice could result in babies being mentally retarded,
deformed, premature, etc.
- The mentally retarded child needs special care and protection
and this can place an economic burden on the family leading to
poverty and ill health

 Life style
- Drinking leads to gastritis, peptic ulcers
- Smoking – respiratory diseases

SMC 2006 19
 - Sexual behaviours e.g. promiscuity and prostitution – AIDS and
Sexually transmitted diseases

 Youth
- Drug and alcohol abuse – related conditions of addiction
- Teenage pregnancy
- Suicide

 Middle age
- Stress related diseases e.g. hypertension, peptic ulcers

 Old age
- Malnutrition due to poor dietary habits and neglect
- Respiratory diseases due to prolonged smoking or exposure to
occupational health hazards

 Low socio-economic status

- Overcrowding – encourages spread of diseases e.g.
tuberculosis
- Poor sanitation and lack of clean water supply leading to water-
borne diseases e.g. cholera and typhoid

 High socio-economic status

- Over eating – obesity, coronary diseases

 Sex/gender
- Females suffer from stress related conditions e.g. depression,
hysteria more than males
- Males suffer from respiratory conditions due to smoking /
occupation more than females

 Environment
- Refuse disposal
- Air pollutants
- Sanitation and water supply
- Life style
- Hygiene

EXPLAIN THE PSYCHOSOCIAL CAUSES OF MENTAL ILLNESS [5]

 Subjective feelings about oneself e.g. low self-esteem, insecurity can

push the individual to mental disturbances
 When life’s demands increases, the individual can be overwhelmed
and use unhealthy coping strategies e.g. aggression, depression, etc.
 Age related factors
- Some periods in life, when the individual is more vulnerable
emotionally than others

SMC 2006 20
 - During adolescence, the individual is struggling to form own
identity, the middle age person due to various factors and as in
old age
 Interpersonal factors
- Refer to the relationship that individuals develops with significant
others
- Negative relationship has a direct influence on the persons
attitude towards himself and others and with the environment
 Cultural factors
- The culture where the individual is born determines the
expected behaviour of the individual
- Some cultural standards of behaviour may cause the individual
to feel unsure, inadequate and unwanted
 Cultural change
- When culture change is acute and rapid, the adaptive
mechanisms of the individual are overwhelmed causing
depression, isolation, etc.

INVOLVEMENT OF THE FAMILY IN THE CARE OF SICK INDIVIDUALS IS

VITAL.
DESCRIBE THE MEASURES TO BE TAKEN TO ENSURE THAT THE
FAMILY ACCEPTS THEIR ROLE [10]

 Establish a trusting relationship

 Provide them with the relevant information
 Listen to their concerns
 Be non judgmental
 Never probe
 Encourage them to verbalise their feelings
 Provide professional help e.g. where counselling is needed
 Do not hurry them to take a decision
 Respect their decision even if you do not agree with it
 Acknowledge positive behaviour
 Provide family support from community groups
 Always be available to encourage them

DESCRIBE THE IMPLICATIONS (EFFECTS) OF SOCIAL ILLNESS ON

THE SOCIETY [5]

 Sufferers need help from society in the form of institutional care,

treatment and rehabilitation
 Disruption of families occurs
 Crimes may be committed by sufferers
 Sufferers may indulge in taboo sexual relationships, which can cause
stress and psychological trauma to other members of society
 Sufferers may fail to support themselves and thus become an
economic burden on members of society especially their families or the
government

SMC 2006 21
  Sufferers disregard the norms of society and cause stress to their
families or others’
 Sufferers are unable to adjust to standards of the group or fit in with
group activities

DESCRIBE THE OBLIGATIONS OF THE PT WITH REGARD TO THE SICK

ROLE [5]
 The pt should be concerned about his / her health
 Should demonstrate the wish to recover from the illness
 Should seek professional advice as soon as possible
 Should comply with the prescribed treatment
 Should co-operate with all health providers involved in his care

DESCRIBE THE EMOTIONAL SUPPORT THAT YOU WILL GIVE TO A

PATIENT WHO HAS BEEN BATTERED BY HER HUSBAND [7]

 Reflect genuine concern and allow for verbal and non verbal
communication (listening and eye contact is very important)
 Do not be judgmental
 Create an understanding and trusting relationship to enable pt to
verbalize her emotional stress
 Do not confront pt with direct questions regarding the cause of the
assault but listen in case the pt wants to reveal the facts
 Incorporate “significant others” e.g. parents, friends, for support but
avoid confrontation between pt and family/friends
 Keep occupied with meaningful activities
 Refer to expert help e.g. psychologist, psychiatrist, social worker
 Acquire information regarding community resources e.g. lifeline,
P.O.W.A. – People’s Organisation of Woman Abuse
 Encourage pt to contact these organisations

A 29 YEAR OLD WOMAN WAS ADMITTED TO THE EMERGENCY ROOM

WITH SEVERAL BRUISES AND UNEXPLAINED ABRASIONS TO HER
FACE.
SHE ADMITS TO BEING EXPOSED TO PHYSICAL ABUSE.

DESCRIBE THE SUPPORT THIS PT SHOULD RECEIVE FROM THE

NURSING / MEDICAL STAFF [9]

 The Dr normally tries to advise the pt to be admitted so that the pt

can receive the necessary assistance, in terms of protection
 The nurse should not ask any personal questions regarding the
abrasions, but allow the pt to talk and share information if she
wants to
 The nurse needs to be professional, friendly, kind and caring in
her approach
 Allow the pt to verbalize her fears and anxieties

SMC 2006 22
  The wounds needing medical attention should be cared for and all
procedures needs to be explained
 A careful record of all the bruises and extent of her injuries needs
to be documented by the Dr, in case the pt decides to open a
case against the alleged perpetrator
 Referral to a social worker in the hospital for counselling or to
FAMSA – who assist couples with domestic problems
 Assist with arrangements regarding transport, etc.
 If the pt refuses to be admitted, provide information regarding
support services/organizations which offers safe accommodation
until she has made up her mind what the best option is
 Maintain the strictest confidentiality at all times, of all information
and records

YOU ADMIT A 2 YEAR OLD CHILD IN YOUR NURSING UNIT.

DESCRIBE THE SIGNS AND SYMPTOMS OF CHILD ABUSE YOU WOULD
LOOK OUT FOR [11]

OR

DESCRIBE THE WARNING SIGNS EVIDENT THAT WOULD MAKE YOU

SUSPECT THAT A CHILD IS THE VICTIM OF CHILD ABUSE

 Unexplained physical evidence of injuries e.g. human bites, bruises,

abrasions, lacerations and cigarette burns
 Unexplained, subdural haematoma, dislocations, sprains or fractures
on skull, face, nose, arms or legs
 A delay in seeking medical assistance for the above injuries
 Evidence of sexual abuse e.g. trauma to the genitalia
 Seems dehydrated or malnourished without obvious cause
 Is not dressed appropriately for season or weather conditions e.g. on a
hot day the child is wearing long sleeves and a jacket
 General health of child indicates neglect e.g. poor hygiene, diaper rash,
malnutrition
 Conflicting stories from about the “accident” or injury from the parents
or others
 An injury inconsistent with the history e.g. a concussion and broken
arm from falling off a bed
 History inconsistent with child’s developmental level e.g. a 6 month old
baby turning on the hot water
 A complaint other than the one associated with signs of abuse e.g. a
chief complaint of a cold when there is evidence of first or second
degree burns
 Regressive behaviour e.g. bed wetting, self destructive behaviours,
running away from home
 Inappropriate response of parents e.g. refusal to sign for additional
tests or agree to necessary treatment
 Absence of parents for questioning
 Inappropriate response of the child

SMC 2006 23
 - Little or no response to pain
- Fear of being touched
- Excessive or lack of separation anxiety
- Indiscriminate friendliness to strangers
- Difficulty in sleeping, relaxing, poor appetite
- Isolation, fearfulness or excessive anxiety
- Insecurity, low self esteem, withdrawn, impassivity
 Previous reports of abuse in the family
 Repeated visits to emergency facilities with injuries
 Evidence that injuries occurred at different times e.g. healed and new
fractures
 No new lesions occurring during the child’s stay in hospital

DIFFERENTIATE BETWEEN CHILD ABUSE AND NEGLECT [4]

 Child abuse
- Child abuse is any maltreatment of children or adolescents by
their parents, guardians, caretakers
- Wilful and unjustifiable infliction of pain and suffering on a child
- It includes physical or emotional abuse, injury, trauma, neglect
or sexual abuse of a child that is intentional and non accidental
- Abuse includes battering, drug abuse, sexual abuse, sexual
assault / molestation, incest and chronic behaviour of humiliating
and belittling a child

 Neglect
- Neglect is the omission of certain appropriate behaviours
- The omission has a detrimental physical or psychological effect
on the development of the child
- Neglect includes child abandonment, lack of provision of the
basic needs of survival namely shelter, clothing, food, love,
safety, attention, education, emotional nurturing and medical
care

DESCRIBE THE EFFECTS OF DIVORCE ON A WOMAN WHO HAS MINOR

CHILDREN [10]

 Emotional problems in adapting to unmarried life

 Sexual adjustment – risk of unwanted pregnancy
 Economic adjustment – has to work
 Difficult to rear children if working
 Social adjustment – loss of friends
 Cannot go out alone – must look after the children
 May become a victim of suicide due to emotional problems
 Target of improper advances of men – seen as an easy target
 Children may blame her for the divorce – missing their father
 Guilt feelings – marriage has failed
 Difficulty in socialising children
 Financial difficulty – only one salary

SMC 2006 24
  Move to a smaller house or a different area
 Stigma attached – divorced woman
 Ostracised by her family, in laws

THE NUCLEAR FAMILY IS THE PRIMARY SOCIALIZING AGENT FOR

CHILDREN.

DESCRIBE THE EFFECTS A DIVORCE MAY HAVE ON THE CHILDREN

[10]
 Biological
- Both parents are known to the children but extended partners
can influence parents opinions of their own children causing
conflict and emotional upsets in families

 Maintenance
- Both biological parents provide for the children, however due to
economic constraints related to the family break-up less money
is available to provide for needs

 Status
- Loss of status - due to divorce, the children’s status may drop in
society causing emotional conflict

 Social control
- Enforcing discipline on the children could be problematic
- One parent who cares for the children do most of the disciplining
and act out both parent roles of mother/father
- Different parental values may cause conflict for the children

 Educational function
- The children may need to change schools due to divorce, and
may resent the change of schooling environment, which can
affect their grade adversely
 Recreational function
- Due to parents divorcing the child may be asked to spend
alternative weekend with the other parent
- The families recreational functions are disrupted which can
result in emotional upsets

 Religious role
- The religious role may change after the divorce if both parents
did not identify with the same religion resulting in conflict or
resentment e.g. Catholic mother, Protestant father

 Socialization
- The child may leave friends behind if they leave from the family
home and may need to move into another neighbourhood or
environment e.g. house to a flat, causing loneliness and
emotional turmoil

SMC 2006 25
 - They may blame parents for their loss of friends

 Role identification
- One parent adjusts to being both mother and father to the
children causing conflict between this parent and the children as
they see both roles played by the one parent
- Psycho emotional – the children may experience a variety of
feelings e.g. loss, self blame, guilt and rejection

DISCUSS GROUNDS FOR DIVORCE [6]

 Irretrievable marriage breakdown

 Divorce can be granted against the following people
- Habitual criminal who has been incarcerated at least for one
year before commencement of divorce proceedings
- Someone who is adulterous and the complainant views that as
irreconcilable
 Mental illness (Mental Health Act 18 of 1973) section 5 (11) allows
divorce to proceed under the following circumstances:
- Someone admitted under reception order
- President’s pt
- Detained as ill, convicted prisoner as a psychopath
 Mental Health Act (18 of 1973) section 5 (2) grants divorce to the
complainant if:
- The defendant has been unconscious for 6 months prior to
divorce action
- This should be confirmed by two surgeons, one being a
neurosurgeon to say that the defendant will never recover

DESCRIBE THE INFORMATION THAT YOU WOULD GIVE TO A GROUP

OF MOTHERS TO ENABLE THEM TO IDENTIFY A DRUG DEPENDENCY
PROBLEM IN THEIR TEENAGE CHILDREN [10]

 Change in behaviour e.g. moody, irritable

 Change in functioning
- Decline in school performance
- Loss of interest in hobbies, sport, etc
 Episodes of intoxication e.g. slurred speech, staggering gait, etc.
 Discovery of suspicious substances
- Liquor hidden in the garage
- Dagga hidden in a drawer
 Disappearance of medicine from storage places
 Unlawful acts e.g. stealing, dealing with drugs
 Spiritual problems
 Change in physical appearance
- Weight loss
- Red eyes
- Puffy face

SMC 2006 26
 - Untidiness
 Attitude changes
- Increased aggression
- Suspiciousness
- Nervousness
- Irritability
 Financial problems
- Money disappearing
- Always looking for more pocket-money
- Items in the house goes missing
 Relationship problems
- Increased conflict situations
- Communication breakdown

EXPLAIN THE FACTORS RESPONSIBLE FOR THE PERPETUATION OF

GENDER INEQUALITY. [6]

 Culture of most societies reflect the assumption of male dominance

whereby more power and prestige given to men than women

 Because male dominance is built into cultures it shapes perceptions

and daily interactions of members

 This ideology supporting gender inequality and justifying male

dominance is called sexism

 Is based on perception that differences between men and women

make them unequal

 To some extent the above is accepted by women as they have been

socialized to accept their traditional role as natural and this helps to
maintain inequality

 Inequality still evident in situations of marriage, work, religion and

politics e.g. fewer female priests, politicians and executives, problems
of working mothers

SMC 2006 27
 MATCH THE CONCEPT IN COLUMN A WITH THE STATEMENT IN
COLUMN B.
WRITE DOWN ONLY THE NUMBER OF THE QUESTION AND THE
LETTER OF THE CORRECT ANSWER IN YOUR ANSWER BOOK E.G.
11 = M [10]

COLUMN A COLUMN B

1 Community (a) Grouping together of cultural traits around a central trait

2 Cultural diffusion (b) Allotted to an individual or group as a result of birth

3 Folklore © The function or kind of behaviour expected or associated

with status
4 Cultural norms (d) Involves the spreading of cultural traits and complexes from
one society to another
5 Legitimized norms (e) Allotted to an individual as a result of what he/she personally
does
6 Cultural inertia (f) The hierarchical division of society into rank, class or status
levels
7 Ascribed status (g) Written codes of behaviour

8 Social role (h) Beliefs, myths, stories and traditions which exist in a people

9 Social stratification (i) Unwritten forms of behaviour which arise spontaneously

10 Acquired status (j) Refers to the organisation of a society into various

subgroups
(k) Is a subgroup of society

(l) Resistant to cultural change

1. k
2. d
3. h
4. i
5. g
6. l
7. b
8. c
9. f
10. e

SMC 2006 28
 MATCH THE CONCEPT IN COLUMN A WITH THE STATEMENT IN
COLUMN B.
WRITE DOWN ONLY THE NUMBER OF THE QUESTION AND THE
LETTER OF THE CORRECT ANSWER IN YOUR ANSWER BOOK E.G.
3.1.11 = P [11]

COLUMN A COLUMN B

1 Norms (a) A combination of related cultural complexes

2 Relative deprivation (b) Afforded to person(s) moving between social

classes
3 Ethnocentrism © Negative discrepancy between one’s own
expectations and existing realities
4 Values (d) The expression of what is desirable

5 Status (e) Social rules of conduct

6. Social mobility (f) Evaluate own culture as superior to other

culture
7 Social institution (g) Hierarchical position of the individual

8 Accommodation (h) A reward conforming to norms

9 Sanction (i) Enforcement of the will and wishes of one

person

10 Acculturation (j) Major sphere of social life organized in such

a way that they fulfil human needs

11 Coercion (k) Different cultures brought into conformity

(l) Friendly interaction and adjustment

1. e
2. c
3. f
4. d
5. g
6. b
7. a
8. l
9. h
10. k
11. i

SMC 2006 29
DIFFERENTIATE BETWEEN PRIMARY AND SECONDARY GROUPS
TABULATE YOUR ANSWER [8]

PRIMARY GROUP SECONDARY GROUP

1. Has few members 1. Has a lot of members

2. Face to face relationships 2. Has little face to face relations

3. Gives members emotional security 3. Not supported emotionally

4. Membership of group is a goal on 4. Serve the interest of the group

its own

5. Share collective goals 5. Goals are a means to an end

6. Frequent contact between 6. Intermittent contact

members

7. Interact informally 7. Interact formally with each other

8. Relate to each other as unique 8. Relationship with structure

whole persons

LARGE NUMBERS OF HIGHLY QUALIFIED NURSES ARE LEAVING THE

COUNTRY (BRAIN DRAIN)

DESCRIBE:
1. THE EFFECT THIS PROBLEM HAS ON MANPOWER / HUMAN
RESOURCES [6]

 Depletion of manpower
 If shortage of personnel exist this will be aggravated
 Training of inexperienced nurses is a process and this will have
negative effects on the provision of a health care service
 Remaining nurses will be stressed and overworked by the
unfavourable working conditions
 Absenteeism and resignations may be increased
 There will be concentration of manpower in urban areas at the expense
of the “underserved areas” e.g. rural areas
 Specialized nurses take their expertise and skills along when they
leave the country leaving the health care service deprived of specialist
nurses

SMC 2006 30
2. THE FACTORS CONTRIBUTING TO THIS PROBLEM [6]

 Poor working conditions e.g. poor salaries and lack of human and
material resources
 Escalating crime rate
 Bribery and corruption
 Affirmative action
 Poor social amenities especially in rural areas
 Declining standards in education
 Political intolerance
 Better prospects in overseas countries e.g. better salaries and better
working conditions

3. THE INFLUENCE ON THE RENDERING OF HEALTH SERVICES [3]

 Loss of experience and skills leading to poor health service delivery

 Drop in the economy of the country
 Drop in the health status of the country
 Expensive curative and tertiary services cannot be afforded by the
majority of the population
 Primary health care approach becomes difficult to implement
 Increase utilization of agency staff who must be taught – increase
pressure on full time staff

DESCRIBE STRESSFUL EXPERIENCES ASSOCIATED WITH

HOSPITALIZATION WITH REGARD TO THE FOLLOWING:

1. THE LOSS OF PRIVACY [6]

 Sharing of a room with other pts
 Sharing of bathroom facilities with other pts
 Restricted visiting hours
 Information about the pt discussed with other people e.g. doctors,
paramedical and nursing staff without prior arrangements
 Curtains do not ensure absolute privacy during procedures
 Loss of identity being one of many pts
 Loss of individuality

2. THE LOSS OF INDEPENDENCE [4]

 Loss of control about health responsibility – this is taken over by
medical and nursing staff
 Dependent on health workers for information needed to make
informed decisions
 Pt must get permission from health workers for own mobility
 If pt’s condition is serious, nursing staff will fulfil basic needs

3. DEPERSONALISATION AND THE LOSS OF IDENTITY [5]

 Improper identification of the pt referring to him/her according to:
- Diagnosis
- The room or bed he/she is confined to

SMC 2006 31
  The pt may be classified as a good or a bad pt according to his/her
demands
 The transfer of pts between hospitals or departments i.e. from known
to the unknown
 Loss of personal belongings e.g. clothes, jewellery
 Removal of prosthesis e.g. teeth pre-operatively
 Procedures done to pt e.g. insertion of an indwelling catheter

DESCRIBE THE EMOTIONAL SUPPORT THAT YOU WOULD GIVE TO

HUSBAND WHOSE WIFE IS AN ALCOHOLIC [10]

 Reflect genuine concern to the husband

 Talk to him in a private place
 Allow the husband to verbalize his feelings
 Identify coping mechanisms used in order to establish strengths and
weaknesses
 Use his strengths to plan interventions
 Enquire about problems that he encountered due to his wife ’s problem
e.g. child minding
 Assist him to accept the reality of the situation
 Refer him to a support group for the family members of alcoholics
 Refer him to a social worker for treatment possibilities for his wife
 Avoid being prescriptive or judgmental

DESCRIBE THE EFFECTS OF ALCOHOLISM IN THE COMMUNITY [6]

 Withdrawal from social groups
 Loses interest in work
 Loses his/her role as a father/mother in the family
 Family disorganization e.g. divorce and child neglect
 Loss of work leading to violent crimes like murder
 Immorality e.g. prostitution and/or promiscuity

INFORMAL SETTLEMENTS (SHACK DWELLINGS) ARE AT HIGH RISK

FOR OUTBREAKS OF FIRES.

DISCUSS HOW THE ABOVE PROBLEM CAN BE PREVENTED BY:

1. THE STATE [5]

 Housing policy to ensure adequate and safe housing for the
population of the country
 Establish a National Housing Trust to ensure funding for sub-
economic housing
 Policy with regard to elimination of informal settlements (Slums
Act)
 Involve the business and other stake holders in assisting the
government to address the backlog on housing

SMC 2006 32
  To encourage communities to participate in housing projects
e.g. building own houses

2. FAMILIES [5]
 To build houses on approved sites and use approved materials
 To refrain from use of open fires extinguish fires correctly
 To refrain from illegal connections of electricity
 Teaching of children on prevention of fires in the home
 Awareness of emergency fire services

DESCRIBE THE EFFECTS THAT A RAPIDLY DEVELOPING INFORMAL

SETTLEMENT HAS ON THE HEALTH SERVICES AND VOLUNTARY
ORGANISATIONS IN THE IMMEDIATE ENVIRONMENT [8]

 Health services
- Hospitals and clinics must provide emergency and care services
to increasing numbers of pts whilst the nursing personnel
numbers stay constant
- Free services to pregnant women and children under 6 years of
age demand often that the budget is totally exceeded
- Immunization campaigns must be held to prevent the incidence
and spread of communicable diseases
- Mobile clinics must go to informal settlements because transport
is not always available
- Health workers must do an assessment of needs and provide
appropriate education sessions to:
* Prevent illness
*Promote health
* Increase life standards

 Hygiene and sanitation

- Health department of the local government must provide basic
services such as:
* Sewerage
* Refuse removal
* Clean water supply
* Control of vectors

 Voluntary organisations
- Basic living substances like food and clothing must often be
provided free of charge
- This leads to budgetary constraints

LIST TEN FACTORS THAT CAN CAUSE SOCIAL CHANGE IN A SOCIETY

[5]
 Natural disasters e.g. floods, drought
 Industrial pollution
 Over population

SMC 2006 33
  Technological development, e.g. information technology
 Cultural values e.g. capitalism, religion
 Cultural diffusion due to contact between different cultures
 War and peace
 Social differentiation due to specialization
 Political change
 Economical change e.g. poverty
 Disease e.g. epidemic
 Industrialisation

DESCRIBE THE EFFECTS OF POVERTY ON THE HEALTH OF THE

PEOPLE [10]

 There is a close relationship between poverty and ill health

 Poor people are more prone to ill health due to lowered resistance
 Malnutrition in expectant mothers which is associated with premature
and still births
 Malnutrition in children and adults lead to numerous diseases e.g.
infectious diseases due to lower resistance
 Overcrowding and poor hygiene
 Chronic diseases are more prevalent due to poor diet and lack of
health care
 Mental illness occurs more often among the poor
 Specialized medical care is less accessible to poor people due to cost
and scarcity in poverty-stricken areas
 Unskilled workers are more prone to occupational hazards e.g.
industrial accidents in mines
 Home hazards e.g. paraffin poisoning occur more often in lower-class
homes
 More deaths due to unnatural causes occur e.g. resulting from violence
and accidents
 Stress may also lead to different forms of abuse e.g. child, woman
abuse and substance abuse

DESCRIBE THE CAUSES OF POVERTY IN THE COMMUNITY [10]

 Poor health
- The worker may be absent from work due to ill health, which
may reduce his level of income especially if he is hourly paid

 Work related factors

- Workers may find themselves confronted by strikes, dismissals
and retrenchments – these situations may affect their financial
positions especially those in low-income market as well as those
who are higher earners – they may lose their financial security

 Environmental factors

SMC 2006 34
 - Droughts, fires, excessive rain and flooding, pests and other
harmful environmental factors may ruin or reduce the income
potential of farming community.
- This in turn affects the income of the industrial worker who is
reliant on the products of the farming community

 Industrial and non-industrial related accidents

- Accidents in the workplace may affect the employability of the
worker, and it reduces the level of income of the individual and
his / her family
- The above also applies to those involved in road accidents

 Absence of the breadwinner

- Families may become impoverished when the sole breadwinner
dies or disappears without a trace

 Substance abuse
- Families may find themselves becoming impoverished when the
substance user uses the family income to maintain his / her
habit
- The abuser may lose his / her employment resulting in loss of
income

 Education and training

- Many workers are unable to compete for a higher paid job, due
to low standard of education and training
- Unequal opportunities and privileges
- Physical disability and low intellectual ability
- Unemployment due to lack of skills, job opportunities, rapid
urbanization and economic recession

 Size of the family

- Impoverished, large families may find it difficult to meet
sustaining healthy lifestyles

 War and other forms of violence

- War and long-standing ethnic and political conflict may cause
poverty
- War leads to the destruction of the natural environment in which
people have to live and earn their living

 Illegal immigrants
- The presence of illegal immigrants in a society aggravates the
problem of unemployment and poverty

 Cultural, food and / or emotional deprivation in childhood

 Improper utilization of income
 Lack of natural resources and expertise to manage industries and
farms

SMC 2006 35
THE MAJORITY OF SOUTH AFRICANS LIVE IN POVERTY.

DESCRIBE THE THREE (3) MAIN EFFECTS THAT POVERTY HAS ON

SOCIETY IN GENERAL [3]

Wasted workforce
 Persons are physically able to work but due to poor economy no jobs
are available

Taxation
 Poor do not pay direct taxes therefore the burden falls on the officially
employed person

Criminal consequences
 Many resort to crime in order to support families which results on an
extra burden for the tax payer.

DISCUSS THE RELATIONSHIP BETWEEN POVERTY AND HEALTH [10]

 Poverty leads to physical and mental illness more than in people who
are not poor
 Poor people make less use of health care facilities because of
inaccessibility and cost
 Poverty contradicts the value of good health
 The relationship between poverty and health is a vicious circle that
characterizes social problems
 Health problems puts additional strain on the family ’s meagre financial
resources
 Poverty generates stress and leads to illness that intensifies stress and
the circle continues
 Children in the lower socio – economic strata suffers from malnutrition,
stunted growth and infant death
 Inability to meet the basic needs due to poverty leading to:
- Inadequate housing – overcrowding leading to spread of
disease and lack of privacy
- Nutritional diseases – malnutrition, pellagra and mental
retardation
 Poor education – drop out is increased
- Due to inability to afford education
- Reason to go and work and have a source of income for the
family

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WHEN CONSIDERING PROBLEMS SUCH AS POVERTY OR
UNEMPLOYMENT, THE QUESTION IF IT IS A SOCIAL OR PERSONAL
PROBLEM IS OFTEN ASKED

1. DIFFERENTIATE BETWEEN PERSONAL AND SOCIAL PROBLEMS

[4]
Personal problem
 causes
 and solutions
 lie within the individual
 and individual’s immediate environment

Social problem
 causes
 and solutions lie outside the individual
 lie outside the individual
 and individual’s immediate environment

2. DESCRIBE THE DIFFERENCE DEFINING A PARTICULAR PROBLEM

AS A SOCIAL OR PERSONAL MAKES [3]

 Distinction determines the causes identified

 The consequences of the problem

 And how to cope / deal with the problem

 If problem defined as personal, individual may view self as inadequate

 But if social – different perspective, seen as problem of society

 And view self as victim rather than culprit.

DESCRIBE THE BEHAVIOURAL CHARACTERISTICS OF POOR PEOPLE,

THEMSELVES RAISED IN POVERTY, WHICH MAY EXPLAIN THE
CONTINUATION OF POVERTY FROM GENERATION TO GENERATION.
[10]

 Children of poor people are raised in a culture of poverty

 Which they find difficult to move out of
 Develop particular attitudes, convictions, values and behaviour
- fatalism
- helplessness
- dependence
- may develop inferiority complex
- do not develop long term objectives

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 - live from day to day
- do not motivate their children
- do not become involved in society`s decision making processes

DESCRIBE THE FACTORS THAT ENHANCE UPWARD MOBILITY [3]

 High industrialized society

- People get employed and move upwards as compared to
unemployed people
 Education
- Better occupation, higher status and class
 Family size
- The smaller the family the better the education and better
opportunities

DESCRIBE THE FACTORS THAT CONTRIBUTE TO SOCIAL MOBILITY

[5]
 Family size
- Fertility rates noted to be high in rural areas than in urban areas
thus difficult for rural children to get opportunities vertical
mobility

 Race and ethnicity

- Discriminatory practices against certain members of a group
make it difficult for members of the group to achieve vertical
mobility

 Education
- Provides the individual with relevant skills to enter a job market
and compete with others and the higher the skills the higher the
salary with accompanied vertical mobility

 Sex and ordinal position

- In many societies, it was and is still a belief that males are
superior to females, and first children are given more priority
than last children
- This approach prevented females and other children to achieve
upward mobility
- There is now a change/shift in many societies to promote equity
to all

 Marriage
- Vertical mobility may be obtained by marrying into a social class
higher than one’s own

 Deferred gratification
- Individuals who defer gratification are more likely to be upwardly
mobile than those who seek immediate gratification

SMC 2006 38
DESCRIBE THE CONSEQUENCES OF SOCIAL MOBILITY [8]

 Can be positive and negative

 Anxious and uncertain because of adjustments into new status
 Old friends, beliefs and attitudes are exchanged for a new social status
 Upward mobility with all its advantages e.g. more money, prestige, etc.
 May cause serious family problems
 Parent / child relationship
 Husband / wife relationship
 Sometimes create false expectations
 Lead to disappointment
 Downward mobility may cause stress which may lead to suicide

DEFINE THE FOLLOWING TERMS: [5]

REGRESSION
 Denotes a reverting to immature stage due to overwhelming anxiety

FIXATION
 Denote the arrest of personality growth in response to insecurity

INTROJECTION
 Taking of the goodness of others into the self in order to boost one ’s
poor self esteem

REPRESSION
 Keeping out of one’s awareness any thought, memory or feeling that
would cause anxiety

REACTIVE FORMATION
 Threatening impulse is replaced by opposite behaviour

MATCH THE STATEMENT IN COLUMN A WITH THE CONCEPT IN

COLUMN B.
WRITE DOWN ONLY THE NUMBER OF THE QUESTION AND THE
LETTER OF THE CORRECT ANSWER IN YOUR ANSWER BOOK
E.G. 6 = H
[5]
COLUMN A COLUMN B

1. John grins and smiles as he relates the (a) Symbolization

details about his automobile accident

2. A 4 year old begins to suck her thumb and (b) Dissociation

wet the bed shortly after the birth of a sibling

3. Larry sends his girlfriend a dozen roses © Substitution

SMC 2006 39
4. Tom cannot remember attempting suicide (d) Regression

5. A young woman chooses to become a (e) Compensation

teacher just like her mother

(f) Identification

(g) Repression

ANSWER
1. b
2. d
3. a
4. g
5. f

DESCRIBE THE CAUSES OF UNEMPLOYMENT IN SOUTH AFRICA WITH

REGARD TO:

1. THE GOVERNMENT [3]

- Basic conditions of employment Act and the Labour relations Act
regulating employer – employee relationships
- Lack of foreign investment
- Industrialisation / atomisation necessitates less manpower
- War fare causing external investment to decline due to unstable
political situation
- Lack of national plan for skills development leading to high rates
of unskilled labour force
- Inappropriate educational system e.g. one that does not address
life skills and technological/technical skills required by the
employer bodies

2. THE INDIVIDUAL [5]

- Lack of basic education required for entrance into the
employment market
- Inappropriate skills for the market e.g. technological / technical
skills are basic requirements by employers
- Lack of entrepreneur skills because the bigger markets are
employing fewer and fewer employees who are highly
specialized
- Culture of dependency on the government by individuals
- Social mobility of many families from rural to urban areas
causing influx of people to the already populated urban areas
- Fear of the unknown
- Health related problems
- Voluntary retrenchments
- Unwillingness to be deployed
- Relocation
- Involvement in crime related activities

SMC 2006 40
DESCRIBE THE FOLLOWING WITH SPECIAL REFERENCE TO THE HIGH
UNEMPLOYMENT RATE IN SOUTH AFRICA:

1. CAUSES [4]
 Age – an old person or a child cannot be hired
 Education – a less educated person is likely not to be employed
 Incapacitation / illness – a physical citation, accidents
 Alcoholism – an alcoholic may be expelled and remain
unemployed

2. TYPES [3]
 Those who cannot find a job
 Those who do not want to work (work shy)
 Those who cannot work because of illness

3. EFFECTS ON THE FAMILY [2]

 Loss of income
 Loss of status
 Loss of family stability
 Lack of respect
 Arguments, divorce

4. EFFECTS ON THE INDIVIDUAL [5]

 Loss of income
 Loss of status
 Loss of social contacts
 Loss of self respect
 Loss of family stability
 Loss of health
 Loss of integrity

DISCUSS THE SPECIFIC IMPLICATIONS OF UNEMPLOYMENT ON THE

FAMILY. [8]

Loss of income
 Family savings may be eroded.
 May lead to changes in standard of living.
 May be drain on government if breadwinner does not find work –
social assistance required.
 May have demoralising effect on family.

Loss of status
 Loss of occupation
 Loss of social status
 Any status is higher than that of being unemployed.
 May need to relocate to poorer residential area with a further loss of
status.

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Loss of Social Contacts
 Due to loss of income and status and perhaps change in residential
area there may be loss of contact with previous social groups,
individuals.

Loss of employment
 The longer a worker is unemployed, the less suited he becomes for
employment. (Credit relevant detail).

Loss of Self Respect

 Unemployed person may be father/husband role model who may now
not be able to support dependants –
 Feeling of inadequacy, loss of self-respect and self-confidence.
 Family may take on his/her roles – extra burden for family members.

Loss of family stability

 Mother may go out to work in place of father.
 Husband / wife / mother roles are reversed.
 May lead to friction at home
 Children may leave school sooner to supplement family income.
 Discipline may be affected in family.
 May be guilt feelings – detrimental human interaction between family
members.
 Family disorganisation may result.

Loss of health
 Income reduced – may lead to lowered nutritional status of family and
decline in health status.
 May not be able to support health costs / adequate housing / reaction.

Loss of integrity
 Unemployed person may lose integrity and commit crime to prevent
implications of unemployment for the family.
 Crimes – varied – petty theft to crimes of violence.
 May turn to substance abuse to relieve resultant tension with
implication for family members.

NATURAL DISASTERS CAN BE A CAUSE OF SOCIAL

DISORGANISATION.
DESCRIBE THE EFFECTS A DEVASTATING FIRE WILL HAVE ON A
FAMILY [6]

 Loss of personal property accumulated over the years

 Emotional trauma
 Physical trauma due to injury
 Grief due to loss of loved ones and pets
 Destitution due to loss of physical property
 Dependency on social organisations for survival

SMC 2006 42
DISCUSS THE FACTORS IN THE COMMUNITY THAT PROMOTE FAMILY
DISORGANISATION [7]

 Disorganising influence of the modern age that leads to loss of

solidarity of the family group.
 Transfer of traditional family functions to other social institutions, e.g.
educational function.
 The rapid changes that have followed new inventions such as the
railway, and the invention of labour savings devices, which have made
the home, tasks lighter.
 The members of the family are thus freer to move outside the home
with consequent loss of unity.
 The emancipation of women who no longer stay at home to look after
the family, but goes out to work.
 Economic conditions may contribute to this.
 Public opinion has changed, so that the mother can go out to work, the
young leaving home early and the unmarried members of a family set
themselves up in their own establishments.

DESCRIBE THE VALUE OF INTEGRATING CULTURE IN A

CONTEMPORARY NURSING PRACTICE [8]

 Cultural expectations on body image differ from culture to culture

therefore, during clinical assessment this should be taken into
consideration and be respected
 Teenagers are sensitive to their bodies. This self awareness must be
respected and built into the nursing care plans
 Wards that admit both male and female adult pts may not be
acceptable to other ethnic groups. The pt should be informed about the
situation in order to make an informed decision
 Age differences in most cultures is linked to respect for the adults by
the youths therefore nurses need to respect the age of the pts
 Cultural beliefs and customs influence the diet of pts which may not be
suitable for their conditions. Thus, nurses need to ensure that the diet
is adapted to culture
 Different cultures are characterized by different patterns of response to
pain. Nurses should identify those cultures that allow for expression
and those that allow suppression of pain in order to provide pain relief
appropriately
 The pts identity must be respected. Pts need to be addressed by their
names and not as bed number….
 Different cultures generate different value systems. Nurses need to
ensure that nursing interventions are compatible with cultural pattern
and personal values

SMC 2006 43
DESCRIBE THE EMOTIONAL SUPPORT THAT YOU WOULD GIVE TO A
PATIENT WHO HAS ATTEMPTED SUICIDE [8]

 Reflect genuine concern and allow for verbal and non verbal
communication (listening and eye contact is very important)
 Do not be judgmental
 Create an understanding and trusting relationship to enable pt to
verbalize her emotional stress
 Do not confront pt with direct questions regarding the cause of the
suicide attempt but listen in case the pt wants to reveal the facts
 Incorporate “significant others” e.g. parents, friends, for support but
avoid confrontation between pt and family/friends
 Keep occupied with meaningful activities
 Refer to expert help e.g.
- Psychologist
- Psychiatrist
- Social worker
 Acquire information regarding community resources e.g.
- Lifeline
- Suicide anonymous
 Encourage pt to contact these organisations

DESCRIBE THE PRIMARY PREVENTION OF SUICIDE IN A COMMUNITY

(7)
 Provision of ante-natal and post-natal care to ensure the physical and
emotional support for the parents to be and also to encourage
emotional bonding of the child
 Provision of school health services to monitor and support the
development of the school going children during secondary
socialization
 Health education on parenting skills to promote good emotional climate
for the developing child
 Community development programs (social, physical, economic) to
support families/children to meet their needs e.g. housing, recreation,
early childhood centres, self help projects, rehabilitation centres, ) to
promote the well being of community/society
 Socialization and national education of the child must include the
teaching of life skills, problem solving, stress management,
technological skills to meet the challenges of the environment
 Involvement of the state, non-governmental organs, business and
communities to set up social assistance programs or grants to alleviate
suffering of poor communities
 Establish community centres that can effectively deal with individuals in
a crisis
 Family structures to be strengthened and supported so that they can
function optimally
 Establish and encourage community support systems e.g. support
groups for parenting, scholars, aged etc
 Support services during warfare, mass disasters to enhance coping

SMC 2006 44
DESCRIBE THE SOCIO-ECONOMIC EFFECT OF ACQUIRED IMMUNE
DEFICIENCY SYNDROME (AIDS) ON THE INDIVIDUAL [7]

 May lose his job

 People tend to avoid him/her
 Can become a social outcast
 Disturbed interpersonal relationships with family and significant others
 May lead to divorce
 Affects the sexual life of the person
 High cost of medication and hospitalisation
 Pt may become totally dependent on others

DESCRIBE THE EFFECTS OF ADOPTION ON THE BIOLOGICAL

MOTHER [5]

 T he mother mourns the loss of the child and cannot disclose it

 Stress related problems such as depression and eating disorders may
occur
 Should she marry, keeping it a secret from her husband will haunt her
 The provision of the Act that prohibits her to make contact with the
adoptive parents causes more pain and frustration
 Not knowing the whereabouts of her child
 The desire to know the appearance and progress of the child haunts
the mother
 The mother engages in self destructive behaviour e.g. alcohol

DISCUSS THE EFFECTS OF ILLEGITIMACY FOR:

1. THE MOTHER [5]

 Experience a sense of shame
 The emotional trauma can leave lasting impressions on the woman
 Can affect her status and eligibility in the community
 Rejection by family and friends
 The presence of a child may affect her chances of marriage
 Men may consider her a woman of easy virtue and she may find
herself the target of unwelcome advances
 Find difficulty in supporting the child
 Have a stigma attached to her

2. THE CHILD [5]

 The health of the child affected by attempts of mother to commit
suicide or have a criminal abortion
 The mother may not receive the necessary ante-natal care because
she is ashamed to expose herself and this could have a detrimental
effect on the unborn baby
 The child may be resented by the mother

SMC 2006 45
  The mother’s income may be small so that the child does not receive
adequate food and medical attention
 Illegitimate child may have to face peer group and community pressure
and stigma which may cause stress and result in pathological
behaviour
 Effective socialisation does not take place as the unmarried mother has
to perform both parents roles simultaneously
 The child may be rejected by the stepfather if the woman marries after
years of being single
 Teasing and taunting by other children because the child does not
have a father leading to the child becoming insecure

GROUP NORMS CONTRIBUTE TOWARDS CONFORMITY AND

OBEDIENCE WITHIN A GROUP
DESCRIBE THE ABOVE MENTIONED STATEMENT [10]

 Group norms are rules of conduct specifying what group members

should do and ought to do, expected to do under given circumstances
 Group norms have constraining and controlling effects which leads to
conformity and obedience
 Group norms specify how they should behave towards one another
 Members feel attracted to each other
 This attraction leads to group cohesion
 Group norms are accepted and shared by all members of a group
 Members who do not comply are sanctioned
 A free and accepting group climate makes it possible for members to
easily communicate their personal attitudes and feelings of a co-
operative and supportive nature
 Problem solving becomes possible due to the fact that group members
determine the facts, formulate solutions, test them out and finally find a
solution agreeable to all
 Participation and commitment is possible as group members share a
common goal, utilize expertise of all group members, accepts
limitations and give continuous feedback
 Norms / standards and limits set have been agreed and adhered to by
all group members
 Leadership is shared among all members depending on the needs of a
specific situation and expertise of each member required

DESCRIBE THE INFLUENCE OF THE FOLLOWING ON THE HEALTH OF

THE INDIVIDUAL:

1. SOCIO-ECONOMIC FACTORS [8]

 Lower socio-economic class
- Poverty, overpopulation and slum conditions cause for example
tuberculosis
- No funds for proper control of e.g. malaria mosquito

SMC 2006 46
 - Dense population near dams and rivers – pollution e.g. with
bilharzias and cholera
- Lack of education regarding hygienic principles
- Nutritional diseases e.g. kwashiokor
 High socio-economic class
- Nutritional deficit due to fast / junk food
- Funds available for drugs
- Cardio-vascular conditions due to hurried life style and eating
habits

2. ENVIRONMENTAL FACTORS [7]

 Respiratory conditions
- Air pollution in cities
- Houses near industries
- Working in the mines, factories
 Noise pollution
- Railway stations
- Highways
- Airports
 Vectors in the environment
- Ticks
- Flies
- Mosquito
 Working environment
- Occupational diseases e.g. lead poisoning
- Work related accidents
- Sinusitis due to air conditioning
- Stress due to work pressure

3. PERSONAL FACTORS [3]

 Psychological disturbances
- Family illness / death
- Conflict in marriage
- Personal problems leads to depression, stress, extensive
smoking and drinking habits
 Hereditary
- Porphyria
- Hypertension
- Cystic fibrosis

DESCRIBE HOW YOU AS A NURSE CAN PREVENT

DEPERSONALIZATION OF YOUR PATIENTS [7]

 Resources are controlled

- If admitted pre-operatively, don’t take all their possessions away
and give hospital gowns to wear
- Allow them to wear own clothing until necessary to wear the
gown

SMC 2006 47
  Restricted mobility
- Allow them to walk to the toilet / bathroom if able to
 Pt excluded from decision making
- Don’t exclude them rather give alternatives and consequences
and let them choose what they want themselves
 Pts are stripped of social security
- Know pts names – don’t say the fat one or bed number 7, etc. – know
them and address them correctly as Ms, Mr, Mrs
 Pt is now dependent
- Allow them to be independent
- Don’t do everything for them unless necessary e.g. wash
themselves

DIFFERENTIATE BETWEEN NORMS AND VALUES [5]

NORMS VALUES

 Application of general values  Ideas around whether

to a specific situation experience is important or not
important

 Norms are broad standards of  Values are specific i.e. they

behaviour of a society deal with the moral aspect of
behaviour

 Normative ways include  Values mean prizing of

thoughts, feelings, moral and standard behaviour i.e.
behavioural aspects of society emotive

 Expectations of expected  Concepts regarding good or

behaviour of what to do or bad, right or wrong
what not to do

 Based on past behaviour

 Define standards of behaviour  Direct judgment and behaviour

 Formal written prescriptions or  Abstract, cannot be measured

informal, not written

 Affected by culture of group  Influence normative behaviour

 Trespasser subjected to
sanctions

SMC 2006 48
EXPLAIN THE FOLLOWING CONCEPTS: [5]

LIFE EXPECTATION
 Refers to the number of years which a person can, in normal
circumstances, expect to live e.g. in the developed countries today life
expectancy is 70 yrs for males and 75 yrs for females

POPULATION EXPLOSION
 This is an extraordinary increase in the numbers of a population, so
that overpopulation occurs
 Is when the birth rate and the immigration ratio of the population are
greater than the death rate and the emigration ratio of the population

RATE OF NATURAL INCREASE

 Refers to the number of deaths in a given year subtracted from the
total number of births in the same year per 1000

 Birth per year – deaths per year X 1000

Average (mid-year population) 1

CRUDE BIRTH RATE

 Refers to the number of live births during one year, per 1000 persons
alive in the given population at the middle of the year

 Live births in Xtown X 1000

Average mid-year population of Xtown 1

AGE SPECIFIC DEATH RATE

- Refers to the death rate among individuals in the population of a specific
age(s) e.g. high death rate before the age of 1 year is known to be due to
infectious diseases in the developing countries


 Deaths during year in specific age group X 1000

Average mid-year population in specific group 1

DEFINE AND EXPLAIN THE VALUE OF THE FOLLOWING CONCEPTS OF

EPIDEMIOLOGY:

DEMOGRAPHY [2]
 Demography is the scientific study of the composition of a
population.
 It identifies the age groups, numbers, sex composition and specific
characteristics of the population
 so that health services can be planned to meet the characteristics
of that specific population or a particular geographical area.

SMC 2006 49
  It is quantitative data that is collected by keeping statistics in that
geographical area by health workers.

MORTALITY [2]
 Is the statistics of the number of deaths which occur in a population
 The level of the population is mortality is related to the technological
and medical knowledge and availability of health services that
geographical area has
 Indicates the utilisation of health facilities in that area, to promote
health
 There are various methods to measure mortality, namely crude
death care, age specific death rate, neonatal death rate, infant
death rate

MORBIDITY [2]
 Refers to the number of cases and incident of a particular decease
in a certain age group within a specific geographical area,
 E.g. malaria is more prominent in tropical climatic areas and
therefore measures to control the decease will be implemented in
the tropical geographical areas in the wet season e.g. spray huts
with DDT in spring.

FERTILITY RATE [2]

 Fertility rates are associated with the populations ’ age.
 Developing countries have a higher younger population and
therefore have a higher fertility rate.
 Older populations more prominent in developed countries hence
lower fertility rate.
 Populations that have young couples marrying have a high fertility
rate.
 Extended families living together also tend to have a higher fertility
rate.
 Religious and cultural factors play a rate in fertility rates

EXPLAIN THE USE OF HEALTH STATISTICS IN THE PROVISION OF

HEALTH CARE [5]

 For future planning purposes e.g. human resources and funding needs
 For purposes of comparison e.g. high incidence of tuberculosis in area
A than in area B
 Quality improvement tool i.e. monitoring of standards
 For further research
 Educational tool

SMC 2006 50
 MATCH THE CONCEPT IN COLUMN A WITH THE CORRECT
DESCRIPTION IN COLUMN B.
WRITE DOWN ONLY THE NUMBER OF THE QUESTION AND THE
LETTER OF THE CORRECT ANSWER IN YOUR ANSWER BOOK
E.G. 11 = M [10]

COLUMN A COLUMN B

1 The man demands that his sexual partner wears a (a) Sexual sadism
raincoat during coitus.
2 Cross dressing like a woman by a heterosexual male (b) Exhibitionism

3 Fantasize and act sexual activity with animals © Sexual masochism

4 Fantasize and act sexual activity with pre-pubertal (d) Fetishism

children
5 Exposing the genitals on an unsuspecting person (e) Transvestitism

6 Observes unsuspecting persons who are undressing (f) Paedophilia

or having sex
7 Being humiliated, beaten or bound to obtain sexual (g) Zoophilia
arousal
8 Producing intentionally inflicted psychological or (h) Voyeurism
physical suffering on a non-consenting partner
9 Sexual abuse where the adult is a family member, (i) Pederosis
e.g. father
10 Sexual intercourse in return for economic gain (j) Prostitution

(k) Incest

ANSWER :

6. d
7. e
8. g
9. f
10. b
11. h
12. c
13. a
14. k
15. j

SMC 2006 51
A 52 YEAR OLD MALE PRESENTS HIMSELF AT AN OUT PATIENT
DEPARTMENT WITH A HISTORY OF CHRONIC PAIN ON THE LEFT SIDE
OF THE FACE.
ON INVESTIGATION NO PHYSICAL CAUSE FOR THE PAIN COULD BE
ESTABLISHED.

EXPLAIN 8 (EIGHT) PSYCHO - SOCIAL FACTORS THAT CAN

INFLUENCE THE INDIVIDUAL’S PERCEPTIONS ABOUT PAIN [8]

 Meaning of pain to the person e.g. some may be fearful, anxious,

whereas others are tolerant and optimistic
 Preparation for pain context e.g. pts well prepared for pain experience
are less anxious
 Cultural values I.e. some people are taught from childhood to endure
even severe pain without reacting outwardly whereas others are taught
to be very expressive
 Past experiences e.g. the more experienced the pt is with pain, the
more frightened of painful stimuli he will be
 Age - Assessing pain in the elderly is very difficult due to:
- Response to pain is poor
- Pain may be referred
- Perceptions that pain is normal for the aged
- Fear of serious illness
 Parental attitudes towards pain
- Response to pain is learnt i.e. what stimuli are supposed to be painful
and what behavioural responses are to be made
 Fear / anxiety / stress – cause physiological responses that cause an
increase in pain
 Heath professional’s attitude
- Lack of knowledge / disbeliefs about pain leading to inability to ensure
pain free care

SMC 2006 52