Browsing by Author "Rabie, Stephan"

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    Open Access
    Exploring pain science education in the context of a healthcare dyad: what supports or hinders pain reconceptualisation?
    (2025) Le Roux, Stian; Rabie, Stephan; Madden, Victoria; Joska, John
    Background. Pain Science Education (PSE) has emerged as a useful treatment strategy for a wide range of painful conditions, including persistent musculoskeletal pain (PMP). The interaction between the two members of a healthcare dyad is subject to various contextual elements. It remains unclear which contextual elements within the PSE dyadic interaction help or hinder the recipient's reconceptualisation of pain. Purpose of the Study. The purpose of the study was to explore and understand participants' experiences of a PSE intervention and elicit perspectives of a PSE dyad relating to elements of their interaction that supported or hindered the reconceptualisation of pain. Methodology. This study employed a phenomenological research design. Semi-structured interviews were conducted with eight PSE dyads – healthcare providers and people under their care (n = 17). An interpretive phenomenological analysis framework was used to analyse and interpret the data. Summary of Qualitative Findings. Dyad members had mostly congruent perspectives on elements that supported reconceptualisation, especially a strong therapeutic alliance. Some intra-dyadic incongruencies included recipient pain beliefs, which some PSE recipients believed supported reconceptualisation, while their providers perceived them as a barrier. A common thread that influenced multiple contextual elements, was pain intensity. Pain relief was often identified as a helpful element as it increased trust in the provider and the PSE. Increased pain was an unhelpful element for some PSE recipients, but their PSE providers found that it helped reconceptualisation, considering it a learning opportunity. This was another area where intra-dyadic perspectives were incongruent. A novel insight included the value of experiential PSE, where providers facilitated reflection and discussion of painful sensations and experiences, with the explicit goal of deepening the learning by exploring pain as a sensory-affective experience. Observing other painful conditions was another learning avenue that dyads valued, where observation of other pain presentations could be compared with their own experience to gain a deeper understanding of pain. Conclusion. Exploring the perspectives of both members of a PSE dyad triangulated the meaning that each member made of the contextual elements that influenced reconceptualisation, drawing out the similarities and differences in their perspectives. PSE dyads valued a range of contextual elements, and dyadic perspectives mostly converged on the theme that PSE is built on a strong therapeutic alliance and a skilled PSE provider. A limitation of this study was that the selection bias was oriented toward participants with positive PSE experiences. This new perspective of elements that influence reconceptualisation may inform PSE implementation and increase its effectiveness.
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    Open Access
    Interoceptive awareness and emotion regulation through a theatre-based relational health intervention: a heart rate variability study
    (2025) Levin, Ruth; Marais, Adèle; Rauch, Laurie; Rabie, Stephan
    Relational health is considered a key indicator of mental health and requires interoceptive awareness and emotion regulation. The ability to attune to and regulate one's thoughts and emotions for well-being is the precursor to healthy relationships that are empathic, compassionate, and authentic. Within the field of contemplative science, mindfulness-based interventions enhance relational health by targeting self-awareness of entrenched reactivity and behaviour and the regulation thereof to improve relational health. Similarly, theatre pedagogy, an embodied and relational training, targets mindfulness of the relationship between one's internal milieu and external behaviour. The aim of this study was to test whether a new intervention, the Theatre-Based Relational Health intervention, over six weeks, effects changes pre to post intervention in interoceptive awareness and emotion regulation in stressful relationships to improve relational health. This study hypothesised that entraining interoceptive awareness with an emotion regulation exercise, the Golden Nugget Listening Breathing Exercise, in the context of stressful relationships, will improve relational health. Two studies were conducted. A pilot study assessed the feasibility and acceptability of the intervention and measured the preliminary effectiveness using behavioural questionnaires and qualitative interviews. A main study followed using an additional neurobiological measure, heart rate variability, in a waitlist-control design. A third group engaged as a retest group, received the breathing-only intervention. Heart rate variability measures with questionnaires were used to determine associations that index interoceptive awareness in the brain-heart nexus. Heart rate variability measures were used to index cardiac autonomic outflow during emotion regulation. The Multidimensional Assessment of Interoceptive Awareness Scale and the Five Facet Mindfulness Scale were used to index interoceptive awareness, and in conjunction with the Self-Compassion Scale, were used to measure emotion regulation. Qualitative interviews were conducted post intervention to explore how participants experienced the Theatre-Based Relational Health intervention and changes pre to post in their relational health. Novel results were found with associations between increased heart rate variability measures and improvements in subscales ‘Not-Worrying' and ‘Trusting' of the Multidimensional Assessment of Interoceptive Awareness Questionnaire and improvements in the subscales ‘Observe' and ‘Acting with Awareness' of the Five Facet Mindfulness Scale. Corroborative results verified associations between increases in heart rate variability and improvement in the subscale ‘Over-Identification' and the ‘Total Score' of the Self-Compassion Scale. Behavioural results showed significant increases in interoceptive awareness through the regulation subscales of the Multidimensional Assessment of Interoceptive Awareness and the Five Facet Mindfulness Scale, and emotion regulation through increases in the combination of all three scales. In the qualitative interviews, participants shared their experiences of substantial improvements in their relational health post-intervention. They described developing self-awareness amidst triggers, self-acceptance, self-care, and managing conflict using the Golden Nugget Listening Breathing Exercise and cited the group as a support system. The results in this study suggest that adapted character development exercises from theatre pedagogy might serve as a socio-cognitive and somatosensory tool for the development of interoceptive awareness. Overall, the intervention showed promise in improving relational health, and the Golden Nugget Listening Breathing Exercise may develop emotion regulation in the context of stressful relationships.
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    Open Access
    Investigating predictors of willingness to receive an HIV vaccine in a South African sample of young adults
    (2025) Watson, Morgan Matshediso Roebert; Joska, John; Rabie, Stephan
    HIV continues to be a major global health challenge, leading to substantial morbidity, mortality, and economic burden. Low and middle-income countries have long borne the brunt of the global epidemic. Specifically, South Africa has the largest population of people living with HIV. Promisingly, new infections have generally decreased largely due to immense treatment-as-prevention efforts. However, HIV incidence remains an issue, especially among youth, and young woman in South Africa. Many experts believe that the addition of a protective HIV vaccine is critical in completely controlling the epidemic. However, as we have witnessed in recent years, vaccine availability does not necessarily result in public acceptance and uptake. Therefore, considering how instrumental an HIV vaccine would be in curbing HIV incidence, it is important to explore key populations- namely young adult's willingness to receive one. This quantitative study employed a cross-sectional design to investigate willingness and associated factors within a sample of young adults. Specifically, the role of socio-demographic factors, key psychological antecedents, HIV stigma, HIV knowledge, perceived risk and perceived severity of HIV were examined as potential predictors of HIV vaccine willingness. In this study 173 HIV-negative young adults between the ages of 18 and 25 were recruited through a convenience sample at two youth clinics in Khayelitsha, Cape Town. This population is characterised by high levels of HIV incidence and are likely to be targeted by initial vaccination efforts. Data were collected through facilitated face-to-face surveys in either English or isiXhosa and stored on REDCap. The statistical analyses in this study were preformed using IBM SPSS Statistics (Version 28.01, 2021). Descriptive statistics were generated for key variables, followed by inferential analyses, including Fisher's Exact Test and one-way ANOVA, to compare group means. For non-normally distributed data, non-parametric alternatives were applied. Regression analyses were conducted to assess predictors of vaccine willingness, ensuring all assumptions, such as homoscedasticity and multicollinearity, were met. The results of the study indicate that there is high willingness to receive an HIV vaccine (82.04%) amongst young adults in this sample. Furthermore, the results showed that HIV stigma, and the key psychological antecedents of collective responsibility and constraints, were significant predictors of willingness within this sample. Sociodemographic variables, HIV knowledge and perceived HIV risk and severity showed no significant association. These results suggest that public health interventions aimed at enhancing vaccine uptake should consider focusing on fostering a sense of collective responsibility while addressing HIV stigma and constraints linked to health seeking. Understanding the factors that influence willingness to receive an HIV vaccine is crucial for public health planning. The findings of this study hope to address the existing gap in the literature on young adults' attitudes towards a future HIV vaccine in South Africa