Browsing by Author "Chikwanha, Theodora Mildred"
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- ItemExploring factors shaping family involvement in promoting the participation of adults with substance use disorders in meaningful occupations(Stellenbosch : Stellenbosch University, 2019-04) Chikwanha, Theodora Mildred; Van Niekerk, Lana; Ikiugu, Moses; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health & Rehabilitation Sciences. Occupational Therapy.ENGLISH SUMMARY : Background and rationale: Approximately 60% of re-admissions at the main acute mental health units at two of the referral hospitals in Zimbabwe comprise of adults with substance use disorders. Occupational therapy management of individuals recovering from substance use disorders at these institutions begins in the acute phase when clients are hospitalised. There are no rehabilitation programmes with defined minimum care standards in which occupational therapy is available to people with substance use disorders. Follow up of clients in their homes is also not possible due to limited financial and human resources. There is therefore no further psychosocial support or follow up rehabilitative care for clients with substance use disorders post discharge, their families take over the caring role. Aim: In this study, I explored the influence of the family on rehabilitation outcomes by examining the extent to which family involvement promoted participation in meaningful occupations by adults recovering from substance use disorders. Specific objectives: The specific objectives of this study were to: - Explore how a family member’s substance use affected his/her occupational patterns as well as those of other family members - Investigate what made it difficult or easier for families to support a family member who was undergoing occupational therapy to help modify substance use behaviour - Investigate how involvement of family members in occupational therapy interventions influenced participation in meaningful occupations by adults with substance use disorders - Develop a treatment framework for family based occupational therapy interventions for substance use disorders in the Zimbabwean context Methodology: This study was positioned within a decoloniality perspective. A qualitative design using a narrative inquiry approach was used to conduct this study. Fourteen family units with an adult family member recovering from substance use disorders participated in the study. Purposive maximum variation sampling was used during recruitment. Narrative interviews on the family`s experiences of living with an adult family member with a substance use disorder were conducted. Data were transcribed and analysed using interpretive narrative analysis strategies. Results: The theme “Reconstructing occupational participation through transactions enacted within the family context” emerged as the overarching theme during data analysis. The overarching theme comprised of two subthemes namely i) Occupational disruption from an intrapersonal and interpersonal perspective and ii) The centrality of the family in creating opportunities for participating in occupations. Exploring the connections between these subthemes and the overarching theme afforded the exploration of factors shaping family involvement in promoting the participation of adults with substance use disorders in meaningful occupations. Conclusion: The findings indicated that the family is extremely important in the management of substance use disorders. Through support from family members, the relatives who were recovering from substance use disorders were able to identify new occupational opportunities and reconstruct occupational participation. The new opportunities for occupational participation facilitated future participation in occupations that were health enhancing. These findings provided useful insights into the occupational therapy services that would be contextually relevant for individuals recovering from substance use disorders in Zimbabwe. A treatment framework which is occupation based and initiated by the families was proposed as a sustainable approach to providing post discharge occupational therapy services.