The daily functioning and quality of life of adults with obsessive compulsive disorder: a qualitative inquiry

Kohler, Kirsten Celeste (2017-03)

Thesis (MA)--Stellenbosch University, 2017.

Thesis

ENGLISH SUMMARY: Obsessive compulsive disorder (OCD) is a highly debilitating psychiatric condition characterized by recurrent intrusive thoughts and images (obsessions) and/or repetitive behaviours aimed at reducing the distress associated with the obsessions. In the absence of treatment, OCD substantially influences the individuals daily functioning (sleep, productivity, leisure, socialising), and quality of life (QOL) (family, friendships and relationships, academics and work, self-esteem). Current literature reports mainly on quantitative findings regarding the influence of OCD on an individual‘s daily functioning and QOL. Consequently, the lack of in-depth knowledge on the influence of OCD on day-to-day functioning and QOL from the perspectives of patients themselves limits our understanding of this disorder. The present study aimed to qualitatively explore the experiences of adults (18 years and older) diagnosed with OCD within South Africa with a focus on the impact of OCD on their daily functioning and QOL. Twenty individuals with a primary diagnosis of OCD were selected to take part in face-to-face and telephonic semi-structured interviews. All participants gave written informed consent, and were assured of confidentially and anonymity. Interviews were audio-recorded with the permission of the participants, and transcribed verbatim. Thereafter, the transcripts were entered into a qualitative software programme and thematically analysed. Overall, six main themes and 14 sub-themes were identified, and interpreted through the lens of the Ecological Systems Theory (EST). Thematic analysis unearthed participants‘ experiences of OCD. More specifically, at the level of the microsystem, awareness of the disorder and its impact on cognitive processes, sleep, daily routine, leisure and socializing was described. At the level of the mesosystem, social support (and absence of support) received from family, friends and colleagues were considered important. Here participants also described the extent to which OCD influences family functioning. At the level of the exosystem, the impact of OCD on work and academic attendance and performance was salient. At the level of the macrosystem, the use of healthcare services was described. Finally, at the level of the chronosystem participants elaborated on the experience of OCD over time and the use of several strategies that allowed them to cope with, manage and accept their condition. The findings of this study demonstrated that participants experienced poor QOL and functioning in several domains of their lives. These findings are amongst the first to explore OCD qualitatively in a South African sample. Findings may inform practice by providing clinicians with the information necessary to adjust their treatment strategies and to tailor to the needs of the individual. Furthermore, these findings provide clinicians, patients and their families and researchers with a better understanding and greater insight into OCD. Future research should include the perspectives of family members, friends and healthcare professionals in order to capture the impact of the disorder on all those involved.

AFRIKAANS OPSOMMING: Obsessief-kompulsiewe steuring (OKS) is ‘n uitmergelende psigiatriese toestand wat gekenmerk word deur wederkerige en indringende denke en beelde (obsessies) en/of herhalende gedrag wat gemik is daarop om die angs wat saam met die obsessies gaan verminder. Sonder behandeling, affekteer OKS die individu se daaglikse funksionering (slaap, produktiwiteit, ontspanning, sosialisering), en lewenskwaliteit (LK) (gesin, vriendskap en verhoudinge, akademie en werk, self-waarde). Die huidige literatuur weerspieël grotendeels kwantitatiewe bevindinge oor die invloed van OKS op ‘n individu se daaglikse funksionering en LK. Daar is gevolglik min in-diepte inligting oor die invloed van OKS op die dag-tot-dag funksionering van LK. Die gebrek aan inligting vanuit die perspektief van die pasiënte self beperk ons begrip van die steuring. Hierdie studie het ten doel gehad om die ervaring van volwassenes (18 jaar en ouer) wat gediagnoseer is met OKS in Suid-Afrika kwalitatief te ondersoek met ‘n fokus op die invloed van OKS op hulle daaglikse funksionering en LK. Twintig individue met ‘n primêre diagnose van OKS is geselekteer om deel te neem aan een-tot-een en telefoniese semigestruktureerde onderhoude. Alle deelnemers het geskrewe ingeligte toestemming gegee en is verseker van konfidensialiteit en anonimiteit. Onderhoude is met klank opgeneem met die toestemming van die deelnemers en is verbatim getranskribeer. Daarna is die transkripte in ‘n kwalitatiewe sagtewareprogram ingelees en tematies geanaliseer. Ses oorhoofse en 14 subtemas is geïdentifiseer. Hierdie temas is deur die lens van die Ekologiese Sisteemteorie (EST) geïnterpreteer. Tematiese analise het die deelnemers se ervaringe van OKS ontgin. Op die vlak van die mikrosisteem het deelnemers bewustheid van die steuring, invloed op kognitiewe prosesse, slaap, daaglikse roetine, ontspanning en sosialisering beskryf. Op die vlak van die mesosisteem het die deelnemers sosiale ondersteuning (en gebrek aan ondersteuning) van die gesin en familie, vriende en kollegas belangrik geag. Deelnemers het as deel van hierdie tema ook die mate waartoe OKS gesinsfunksionering affekteer, beskryf. Op die vlak van die eksosisteem was die invloed van OKS op werk en akademiese bywoning en prestasie merkbaar. Op die vlak van die makrosisteem het deelnemers die gebruik van gesondheidsdienste beskryf. Laastens het deelnemers op die vlak van die chronosisteem beskryf hoe die ervaring van OKS met die verloop van tyd en met die gebruik van verskeie strategieë verander het sodat hulle dit kan hanteer, bestuur en aanvaar. Die bevindinge van die studie toon dat deelnemers swak LK en funksionering in verskeie lewensdomeine ervaar. Hierdie bevindinge is een van die eerste kwalitatiewe ondersoeke van OKS binne ‘n Suid-Afrikaanse steekproef. Die bevindinge kan die praktyk verryk deurdat dit aan klinici die nodige inligting bied om hulle behandelingstrategieë aan te pas by die unieke behoeftes van die individu. Verder bied die bevindinge aan klinici, pasiënte en hulle gesinne ‘n beter begrip van en meer insig in OKS. Toekomstige navorsing behoort die perspektiewe van gesinslede, vriende en gesondheidsorgwerkers te ondersoek om die impak van die steuring op almal wat betrokke is te beskryf.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/100888
This item appears in the following collections: