Doctoral Degrees (Psychology)

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Browsing Doctoral Degrees (Psychology) by browse.metadata.advisor "Kathard, H."

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    Human occupation in the context of chronic poverty and psychiatric disability
    (Stellenbosch : University of Stellenbosch, 2009-12) Duncan, Madeleine; Swartz, Leslie; Kathard, H.; University of Stellenbosch. Faculty of Arts and Social Sciences. Dept. of Psychology.
    ABSTRACT: This study, within the fields of occupational therapy and occupational science, describes the occupations of isiXhosa-speaking individuals with longstanding histories of mental illness living in chronic poverty. Occupation refers to the daily tasks and purposeful activities which, in occupying people’s time, establish the patterns of their lives and give expression to their roles, identity, interests and abilities. The aim of this study was to describe how poor households and persons with psychiatric disability living in those households coped with their circumstances and how they viewed, orchestrated, drew meaning from and attributed purpose to the everyday things they did, in particular the self-identified, primary income generating occupation of the disabled person. The research questions elicited information about the genesis, characteristics, meanings and functions of occupation, in particular those occupations performed by the disabled member that contributed to the survival of the household. Using case study methodology, the research involved prolonged engagement with five households living in a peri-urban, informal settlement on the outskirts of Cape Town, South Africa. Qualitative data about occupation was derived through demographic screening, multiple interviews with key informants in each household, participant observation and focus group discussion. In addition, discussions were held with mental health professionals familiar with the context and the Xhosa culture. Four forms of data analysis and interpretation (Kavale, 1996; Stake,1995) were applied to develop substantive case studies: condensation (identification of major organising ideas); categorisation (thematic categorical aggregation); patterning (narrative structuring) and generalisation (naturalistic interpretation). In addition, discussions were held with mental health professionals familiar with the context and the Xhosa culture. Four forms of data analysis and interpretation (Kavale, 1996; Stake, 1995) were applied were applied to develop substantive case studies: condensation (identification of major organising ideas); categorisation (thematic categorical aggregation); patterning (narrative structuring) and generalisation (naturalistic interpretation). Thematic descriptions of the basics of occupation are used to illustrate the various ways participants negotiated the challenges of life at the margins of society through the ordinary things they did everyday. Cross case analysis provided insights into the financial and social costs of mental illness as well as the strategies, embedded in occupation, adopted by participants in dealing with their circumstances. The central thesis of this dissertation is that psychiatrically disabled people, as economic actors functioning in complex structural, social and occupational matrices, contribute in paradoxical ways to the survival of their households. While their illness behaviour may increase the vulnerability of the household from time to time, they nevertheless facilitate its functioning either as providers of a disability grant; as contributors of additional labour or as productive income generating agents. The individual, the social and the structural are co-constituted in what poor and disabled people are able to do everyday. The less resources that are available in the occupational form, the more effort is needed to perform occupations and the more reliance is placed on the informal relational economy. Relative mastery of constrained circumstances occurred by optimising the goodness of fit between occupational form and occupational performance through adaptive capacity, an under-recognised form of agency in the context of chronic poverty. Looking beyond the obscuring façade of psychiatric disability at the ordinary things people did everyday revealed their capacity to strategise practically and attitudinally in support of the household’s survival. The study heightens awareness of human experiences that have been overlooked in the occupational science and occupational therapy literature, in particular how the basics of occupation operate in resource constrained environments. This contribution to knowledge about human occupation will inform mental health occupational therapy practice and community based psychiatric services concerned with the inclusion of disabled people in promoting social development.