An exploration of aspects of mental health in school-going adolescents in Ghana

Wilson, Angelina (2015-12)

Thesis (PhD)--Stellenbosch University, 2015

Thesis

ENGLISH ABSTRACT : In Ghana, research that focusses on the importance of psychological strengths for adolescent mental health is virtually non-existent. As a result, the pathways to mental health among Ghanaian adolescents have remained unknown. The present study aimed to test a structural model demonstrating the possible pathways to psychological well-being and psychological distress among a sample of school-going adolescents from the Northern region of Ghana. In addition, gender differences in the hypothesised model were also investigated. A secondary aim of the study was to qualitatively explore the adolescents’ experiences of hope, perceptions of support and life satisfaction as well as the resistant resources for coping. A mixed-method, cross-sectional design, was used to gather quantitative and qualitative data on aspects of mental health. Pertaining to the quantitative data, questionnaires were used to gather information on adolescents’ experience of hope, perceived social support, life satisfaction and mental health. For the qualitative data, follow-up interviews with selected school-going adolescents were used to solicit in-depth information on how hope, perceptions of support and life satisfaction were engendered. The interviews were also used to delve into the other resources that adolescents capitalised on to manage stressors they encountered. A modified version of a multi-stage cluster sampling was used to randomly select 717 participants from seven schools in the Northern region of Ghana. Using purposive sampling, 18 participants were selected from six of the schools that participated in the quantitative phase of the study. The quantitative data were analysed using structural equation modelling techniques. The qualitative data were analysed using thematic analyses. The results showed that the hypothesised model fit the observed data. Additionally, the model explained psychological well-being, but not psychological distress. Significant positive relationships were found between perceived social support and psychological well-being, as well as between life satisfaction and psychological well-being. There were also direct relationships between hope and life satisfaction, perceived social support and life satisfaction, and between perceived social support and hope. The following hypothesised mediated relationships were significant: hope and psychological well-being via life satisfaction; perceived social support and psychological well-being via life satisfaction; and perceived social support and life satisfaction via hope. Moreover, there were also some gender differences in the hypothesised relationships. Qualitative data on interpretations of hope, perceptions of support and life satisfaction yielded noteworthy results. Firstly, adolescents ascribed hopefulness to confidence in the future, this being engendered through interactions with significant others in their network systems. Secondly, emotional support from parents and instrumental support received from friends emerged as important markers of perceived support from significant others. Thirdly, life satisfaction was tied to the fulfilment of the needs and the maintenance of positive relations with peers. Fourthly, resistant resources for coping involved engagement with the adolescents’ network systems and non-governmental organisations to manage academic and financial constraints. Given that even in low-resource contexts, the pathways to psychological well-being comprised psychological strengths such as hope, perceived social support and life satisfaction, mental health promotion programmes should be aimed at solidifying these strengths to promote adolescents’ overall well-being.

AFRIKAANSE OPSOMMING : In Ghana is daar feitelik geen navorsing wat op die belangrikheid van sielkundige kragte vir adolessente geestesgesondheid toegespits is nie. As gevolg hiervan is die weë na geestesgesondheid onder Ghanese adolessente nog onbekend. Die doel van hierdie studie was om ’n strukturele model te toets wat die moontlike weë na sielkundige welstand en sielkundige nood onder ’n steekproef van skoolgaande adolessente uit die noordelike streek van Ghana sou uitwys. Genderverskille in die hipotetiese model wat opgestel is, is ook ondersoek. ’n Sekondêre doel van die studie was om kwalitatief die adolessente se ervarings van hoop, persepsies van ondersteuning en lewenstevredenheid, sowel as die weerstandshulpbronne vir hanteringsgedrag, te ondersoek. ’n Gemengdemetode-, dwarssneeontwerp is gebruik om die kwantitatiewe en kwalitatiewe ervarings ten opsigte van geestesgesondheid in te samel. Wat betref die kwantitatiewe data, is vraelyste gebruik om inligting oor adolessente se ervaring van hoop, waargenome sosiale ondersteuning, lewenstevredenheid en geestesgesondheid in te samel. Vir die kwalitatiewe data is opvolgonderhoude met geselekteerde skoolgaande adolessente gebruik om indiepte-inligting te verkry oor hoe hoop, persepsies van ondersteuning en lewenstevredenheid opgewek is. Die onderhoude is ook gebruik om te fokus op die ander hulpbronne waarop adolessente gekapitaliseer het om stressors waarmee hulle gekonfronteer is te hanteer. ’n Aangepaste weergawe van ’n multifase-trossteekproef is gebruik om ewekansig 717 deelnemers uit sewe skole in die noordelike streek van Ghana te selekteer. Deur gebruik te maak van doelbewuste steekproefneming, is 18 deelnemers uit ses van die skole geselekteer om aan die kwantitatiewe fase van die studie deel te neem. Die kwantitatiewe data is geanaliseer deur gebruik te maak van strukturelevergelyking-modelleringstegnieke. Die kwalitatiewe data is geanaliseer deur tematiese analises te gebruik. Die resultate het getoon dat die opgestelde hipotetiese model met die waargenome data ooreengestem het. Bykomend het die model sielkundige welstand verduidelik, maar nie sielkundige nood nie. Betekenisvolle positiewe verhoudings is tussen waargenome sosiale ondersteuning en sielkundige welstand gevind, sowel as tussen lewenstevredenheid en sielkundige welstand. Daar was ook direkte verhoudings tussen hoop en lewenstevredenheid, waargenome sosiale ondersteuning en lewenstevredenheid, en tussen waargenome sosiale ondersteuning en hoop. Die volgende bemiddelde verhoudings, wat as hipotese opgestel is, was beduidend: hoop en sielkundige welstand via lewenstevredenheid, waargenome sosiale ondersteuning en sielkundige welstand via lewenstevredenheid; en waargenome sosiale ondersteuning en lewenstevredenheid via hoop. Verder was daar ook ’n paar genderverskille in die verhoudings, wat as hipotese opgestel is. Kwalitatiewe data oor interpretasies van hoop, persepsies van ondersteuning en lewenstevredenheid het noemenswaardige resultate opgelewer. Eerstens het adolessente hoopvolheid aan vertroue in die toekoms toegeskryf, en dit is opgewek deur interaksies met betekenisvolle persone (significant others) in hulle netwerkstelsels. Tweedens het emosionele ondersteuning van ouers en instrumentele ondersteuning ontvang van vriende geblyk om belangrike merkers van waargenome ondersteuning van betekenisvolle persone te wees. Derdens is lewenstevredenheid gekoppel aan die vervulling van die behoeftes en die handhawing van positiewe verhoudings met eweknieë. Vierdens het weerstandshulpbronne vir hanteringsgedrag behels dat daar skakeling met die adolessente se netwerkstelsels en nieregeringsorganisasies was om akademiese en finansiële beperkings te kon hanteer. Gegewe dat, selfs in laehulpbronkontekste, die weë na sielkundige welstand bestaan het uit sielkundige kragte soos hoop, waargenome sosiale ondersteuning en lewenstevredenheid, is dit belangrike dat geestesgesondheidbevorderingsprogramme gerig word daarop om hierdie kragte te solidifiseer om sodoende adolessente se algehele welstand te bevorder.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/97898
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