The occupations and socio-cultural context of Sesotho speaking adults with mental health problems

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Date
2012-02
Authors
Vermaak, Mia Elsabie
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University of the Free State
Abstract
English: The aim of this study was to explore the occupations and socio-cultural context of the Sesotho speaking adult with mental health problems, attending either of the group therapy programs at The Clinic or The Second Clinic (both psychiatric hospitals in the Free State, South Africa). This exploration was undertaken due to a lack of literature and formal guidance on providing culturally relevant and meaningful therapy to the Sesotho speaking adult with mental health problems. Most sources of literature on occupational therapy in the field of mental health, originates in Western societies, specifically the United States of America and the United Kingdom; and are therefore not directly applicable to practice settings in South Africa. Since the researcher wanted to ‘understand’ more about the daily experiences of the Sesotho speaking adult with mental health problems, a qualitative study of interpretive nature was conducted, with a collective case study as the strategy of inquiry. The first set of data was captured by conducting individual interviews with volunteering Sesotho adults as the sample. These interviews were based on the Kawa Model, a conceptual model of occupational therapy which uses the metaphor of ‘life as river’. The sample of patients that participated in the individual interviews, consisted of Sesotho speaking adults with mental health problems, admitted to The Clinic by psychiatrists. All participants were permanently employed, in jobs ranging from teaching and policing, to traffic officers and performance managers. Data collected during the interviews based on the Kawa Model, needed to be supplemented specifically regarded the socio-cultural context of the Sesotho-speaking patient at The Clinic. A focus group interview was then conducted at The Second Clinic, to further explore the themes identified in the interviews. The sample of patients for the focus group at The Second Clinic, was included according to the same selection criteria than with the individual interviews, and the sample was very similar to that of the individual interviews at The Clinic. Data was analyzed by the researcher and two co-coders. The interpretive thematic analysis approach was used to first analyze the transcriptions of individual interviews, and thereafter the focus group interview. Findings elaborated on the occupations and socio-cultural context of participants, as per the aim of the study. Participants were found to experience much stress at work, relating to strained interpersonal relationships. At the same time, their personal finances, family responsibilities and lack of sleep were found to be stressors. Participation in leisure, as well as experiencing work and family as sources of support (in spite of also regarding those as stressors), were regarded as positives in their daily occupational participation. Values that may influence occupational participation, were described as involvement in community and family; having a positive mindset and an active spiritual life. The participants’ socio-cultural context was described as a context containing habits and ‘ways of doing’ with a strong influence on their occupations and relationships. In conclusion, recommendations towards culturally relevant therapy, were made. These recommendations included suggestions for the content of an occupational therapy program, as well as suggestions for presenting such a program appropriately for the Sesotho speaking person with mental health problems. The limitations of the study were acknowledged and discussed, and recommendations for future research were set out.
Afrikaans: Die doel van hierdie studie was om die aktiwiteitsverrigting en sosio-kulturele konteks van die Sesothosprekende volwassene met geestegesondheidsprobleme, te ondersoek. Die ondersoek is gedoen tydens persone se opname tot Die Kliniek of Die Tweede Kliniek (beide is psigiatriese hospitale in die Vrystaat, Suid-Afrika). Hierdie ondersoek is onderneem as gevolg van die beperkte literatuur en formele leiding relevant tot sinvolle terapie vir die Sesothosprekende persoon met geestesgesondheidsprobleme. Die meerderheid van bronne vir arbeidsterapie in geestesgesondheid, kom vanuit die Weste, spesifiek die Verenigde State van Amerika en die Verenigde Koninkryk, en is daarom nie direk van toepassing op praktyke in Suid-Afrika nie. Met die doel om meer van die daaglikse ervarings van die Sesotho sprekende persoon met geestegesondheidsprobleme te verstaan, is ‘n kwalitatiewe studie vanuit ‘n interpreterende benadering uitgevoer. Die kollektiewe gevallestudie is as navorsingstrategie gebruik. Die eerste stel data is d.m.v. individuele onderhoude met vrywillige Sesotho persone as die steekproef, ingesamel. Hierdie onderhoude is op die Kawa Model, ‘n konseptuele model van arbeidsterapie, gebaseer. Die Kawa Model maak gebruik van die metafoor van ‘my lewe as ‘n rivier’. Die steekproef van pasiënte wat aan die individuele onderhoude deelgeneem het, het bestaan uit Sesotho sprekende volwassenes wat by Die Kliniek opgeneem is met geestegesondheidsprobleme, deur psigiaters. Al die deelnemers was permanent werksaam in ‘n verskeidenheid van poste wat wissel van onderwys en die polisie, tot verkeerspolisie en prestasie beamptes. Data ingesamel tydens die onderhoude geskoei op die Kawa Model, het aanvulling nodig gehad om spesifiek die sosio-kulturele konteks van die Sesotho sprekende persoon te kon beskryf. ‘n Fokusgroep is aangebied by Die Tweede Kliniek, om die tema’s wat tydens die onderhoude geïdentifiseer is, verder te ondersoek. Die steekproef van pasiënte wat hieraan deelgeneem het, is geneem uit Die Tweede Kliniek, volgens dieselfde kriteria as met die individuele onderhoude. Die steekproef was soortgelyk aan die van die individuele onderhoude by Die Kliniek. Data is deur die navorser en twee ko-kodeerders geanaliseer. Die benadering van interpreterende tematiese analise is gevolg om eers die transkripsies van die individuele onderhoude, en daarna die fokus groep onderhoud, te analiseer. Bevindings het die aktiwiteitsverrigting en sosio-kulturele konteks van deelnemers beskryf, soos deur die doelwit van die studie gerig. Dit is bevind dat deelnemers hoë vlakke van werkstres ervaar, wat verband hou met problematiese interpersoonlike verhoudings. Terselfdertyd is bevind dat persoonlike finansies, verantwoordelikhede rondom familie en ‘n gebrek aan slaap, ook stres veroorsaak. Vryetydsbesteding, asook die ondersteuning verkry vanuit verhoudings met familie en vriende, is aangedui as positiewes in daaglikse aktiwiteitsverrigting; hoewel verhoudings met familie en vriende ook aangedui is as bronne van stres. Waardes wat aktiwiteitsverrigting beïnvloed, is beskryf as betrokkenheid in die gemeenskap en by familie; die behoud van ‘n positiewe ingesteldheid asook spirituele belewenis. Die deelnemers se sosio-kulturele konteks is hierna beskryf as ‘n konteks vol gewoontes en ‘maniere van doen’ – wat deelnemers se aktiwiteitsverrigting en verhoudings daadwerklik beïnvloed. Ter opsomming, is aanbevelings t.o.v. kultureel relevante terapie gemaak. Hierdie aanbevelings sluit in voorstelle vir die inhoud van ‘n arbeidsterapie program vir Sesotho persone met geestegesondheidsprobleme, asook voorstelle vir die toepaslike aanbieding van so ‘n program vir die populasie. Ter afsluiting is die beperkings van die studie bespreek, en daarna is voorstelle vir toekomstige navorsing uiteengesit.
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Adulthood -- Mental health, Sotho (African people) -- Mental health, Mental illness -- Social aspects. Occupational therapy, Cultural psychiatry, Dissertation (M. Occupational Therapy (Occupational Therapy))--University of the Free State, 2012
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