Experiences of adults with acquired physical disabilities of social work support in a South African context

Muller-Kluits, Noreth (2020-12)

Thesis (DPhil)--Stellenbosch University, 2020.

Thesis

ENGLISH ABSTRACT: Almost every person will experience a form of impairment or disability at some point in their lives. Different types of impairment could occur at any given moment. In a New York University Hospital study with persons who acquired paraplegia, a four-stage process similar to the stages of grief identified by Kübler-Ross was identified for person with disabilities coming to terms with their disability, these being shock, denial, anger and depression. This correlation could assist in understanding the adjustments persons who acquire a disability later in life must make as they ‘grieve’ the life prior to the disability onset. It is further argued that the social worker’s task is to help people with disabilities through these adjustment phases. Taking this into account, the research question for this study was identified after a reviewing of previous research done on similar topics. The COVID-19 pandemic also influenced the research design and approach. Accordingly, this study stemmed from the research question: What are the experiences of adults with acquired physical disabilities with regards to social work support (especially in assisting them after they acquired the physical disability)? A combination of descriptive and exploratory research was implemented to answer this research question. The research study made use of a qualitative approach with some quantitative elements in terms of the identifying particulars of participants. Qualitative research is seen as a valuable social work approach. It is helpful in researching social problems and vulnerable populations. Further it allows for the social work profession to learn from those they serve. Both of these aspects were true for this study as the qualitative research was done in part with a vulnerable service user group (adults with an acquired physical disability) regarding their experiences of social work services. This information derived from the perspectives of these participants can be utilised to plan future social work services to this group. Within this research approach both deductive and inductive reasoning were used. The literature review in this research study took place over three chapters aligned with the first three objectives of the study. During the literature review similar studies were explored and discussed, although, there were no studies available with the same researchable variables as this study. Despite this limitation, the literature review provided valuable insight on similar topics. Due to the impact and restrictions of the COVID-19 pandemic, the three methods that were decided on for this research study, once it was restructured to be done remotely, included cell phone calls, WhatsApp or Zoom. The research project took place with two Cohorts. The first Cohort included nineteen adults with acquired physical disabilities and the second five social workers who had experience working with persons with disabilities. While most participants were identified through purposive sampling some were included through snowball sampling. One participant from Cohort One also shared a story they had written on acquiring a disability which they offered to be used for the study. Another participant from Cohort Two did both a questionnaire interview (through e-mail) and an interview by means of Zoom. This essentially provided 26 sources with 24 participants. From the literature review and the empirical data collected six themes were developed. These themes include: biological experiences of adults with an acquired physical disability according to the biopsychosocial and ICF model, psychological experiences of adults with an acquired disability, support services used by adults with an acquired disability according to the ecological perspective, support needs of adults with an acquired disability according to the ecological perspective, cultural experiences of adults with an acquired disability within their community as well as social work support services to persons with acquired physical disabilities aligned with policies in South Africa. The themes were further divided into sub-themes and categories. The study provided conclusions and recommendations in the last chapter based on the findings of the empirical study. It was found that the participating organisation, provided services aligned with policies and the roles of the social worker. An overall bottom-up approach was suggested in service delivery and planning to adults with an acquired physical disability in terms of social work services. A few limitations to the study were discussed and recommendations for future studies made.

AFRIKAANSE OPSOMMING: Meeste mense sal een of ander tyd in hul lewe ʼn vorm van gebrek of gestremdheid ervaar. Verskillende tipes gebrekke kan op enige oomblik voorkom. In ’n New York Universiteitshospitaal studie met persone wat parapleë geword het, is ’n vier-fase proses soortgelyk aan die fases van rou wat deur Kübler-Ross geïdentifiseer is ontwikkel vir persone met gestremdhede wat tot aanvaarding moet kom van hul gestremdheid. Hierdie fases bestaan uit skok, ontkenning, woede en depressie. Hierdie ooreenkoms kan help om die aanpassing wat persone wat ’n gestremdheid later in hul lewe verkry te verstaan terwyl hulle rou oor die verlies van die lewe wat hulle gehad het voor die gestremdheid. Dit word verder gemotiveer dat dit die maatskaplike werker se taak is om persone met gestremdhede te help deur hierdie aanpassingsfases.Met hierdie agtergrond in gedagte is die navorsingsvraag vir hierdie studie geïdentifiseer nadat vorige navorsing oor soortgelyke onderwerpe nagegaan is. Die COVID-19 pandemie het ook ’n invloed op die navorsingsontwerp en benadering gehad, wat later in hierdie opsomming verder bespreek sal word. Die studie ontstaan gevolglik uit die navorsingsvraag: Wat is die ondervindinge van volwassenes met ’n verkrygde fisiese gestremdheid in terme van maatskaplike werk ondersteuning (veral in die ondersteuning nadat hul die fisiese gestremdheid verkry het)? Die navorsingstudie het gebruik gemaak van ʼn kombinasie van beskrywende en verkennendenavorsingsontwerpe. Daar is gebruik gemaak van ʼn kwalitatiewe benadering met sommige elemente van ʼn kwantitatiewe benadering ten opsigte van die identifiserende besonderhede van die deelnemers. Kwalitatiewe navorsing word gesien as ’n waardevolle maatskaplike werk benadering. Dit is behulpsaam in die navorsing van maatskaplike probleme en kwesbare bevolkingsgroepe, omdat dit minder indringend, deur die gebruik van ’n semi-gestruktureerde onderhoudskedule te werk gaan. Hierdie navorsing laat ook die maatskaplike professie toe om te leer van diegene aan wie hul dienste lewer. Beide van hierdie aspekte was op hierdie studie van toepassing siende dat die kwalitatiewe studie grotendeels plaasgevind het met ’n kwesbare bevolkingsgroep (volwassenes met ’n verkrygde fisiese gestremdheid) rakende hul ondervindings van maatskaplike dienste. Hierdie inligting wat uit die perspektiewe van die deelnemers verkry is, kan gebruik word om te help vir die beplanning van toekomstige maatskaplike dienste aan hierdie teikengroep. Die beredenering in hierdie navorsingstudie was beide induktief en deduktief. Die literatuurstudie het oor drie hoofstukke plaasgevind ooreenstemmend met die eerste drie doelwitte van die studie. Gedurende die literatuurstudie, is soortgelyke studies verken en bespreek, alhoewel daar geen ander studies met dieselfde navorsingsveranderlikes soos hierdie studie bestaan het nie. Nietemin het die literatuurstudie geldige insig gelewer op soortgelyke onderwerpe. Weens die impak en beperkinge van die COVID-19 pandemie, was die drie metodes wat gekies is vir hierdie studie, nadat dit geherstruktureer is om oor ’n afstand te gedoen te word selfoonoproepe, WhatsApp en Zoom. Die navorsingsprojek het plaasgevind met twee Kohorte. Die eerste Kohort het negentien volwassenes met ’n verkrygde fisiese gestremdheid ingesluit terwyl die tweede uit vyf maatskaplike werkers met ondervinding in dienslewering aan persone met gestremdhede bestaan het. Deelnemers vir hierdie studie is grotendeels verkry deur doelgerigte steekproeftrekking en sommige deur sneeubal-proefneming. Een deelnemer van Kohort Een het ’n storie gedeel met die studie. ’n Ander deelnemer van Kohort Twee het beide ’n vraelys onderhoud (deur middel van e-pos) en ’n onderhoud deur Zoom gelewer. Dit het 26 bronne uit 24 deelnemers gelewer. Uit die literatuurstudie en die empiriese data wat versamel is, is ses temas ontwikkel. Hierdie temas sluit in: biologiese ondervindinge van volwassenes met ’n verkrygde fisiese gestremdheid volgens die biopsigososiale en ICF modelle, sielkundige ondervindings van volwassene wat ’n fisiese gestremdheid verkry het volgens die biopsigososiale model en die fases van rou, maatskaplike/omgewingsondervindings van volwassene wat ’n fisiese gestremdheid verkry het volgens die ekologiese perspektief (Bronfenbrenner), ondersteuningsbehoeftes van volwassenes met ’n verkrygde fisiese gestremdheid volgens die ekologiese perspektief (Bronfenbrnner), kulturele ondervindings van volwassene wat ’n fisiese gestremdheid verkry het en maatskaplike ondersteuningsdienste aan volwassenes met ’n verkrygde fisiese gestremdheid in terme van beleide in binne ’n Suid-Afrikaanse konteks. Hierdie temas is verder onderverdeel in sub-temas en kategorieë. Die studie het gevolgtrekkings en aanbevelings gehad in die laaste hoofstuk wat gebaseer is op die bevindings van die empiriese studie. Dit is gevind dat die deelnemende organisasie dienste volgens die beleide en die rolle van ’n maatskaplike werker gelewer het. ’n Oorhoofse onder-na-bo benadering is voorgestel in dienslewering en beplanning aan volwassenes met ’n verkrygde fisiese gestremdheid in terme van maatskaplike werk dienste. ’n Paar beperkinge in die studie is bepreek en aanbevelings vir toekomstige studies is gemaak.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/109156
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