The occupations and socio-cultural context of Sesotho speaking adults with mental health problems

[摘要] English: The aim of this study was to explore the occupations and socio-cultural context of the Sesotho speaking adult with mental health problems, attending either of the group therapy programs at The Clinic or The Second Clinic (both psychiatric hospitals in the Free State, South Africa). This exploration was undertaken due to a lack of literature and formal guidance on providing culturally relevant and meaningful therapy to the Sesotho speaking adult with mental health problems. Most sources of literature on occupational therapy in the field of mental health, originates in Western societies, specifically the United States of America and the United Kingdom; and are therefore not directly applicable to practice settings in South Africa. Since the researcher wanted to 'understand' more about the daily experiences of the Sesotho speaking adult with mental health problems, a qualitative study of interpretive nature was conducted, with a collective case study as the strategy of inquiry. The first set of data was captured by conducting individual interviews with volunteering Sesotho adults as the sample. These interviews were based on the Kawa Model, a conceptual model of occupational therapy which uses the metaphor of 'life as river'. The sample of patients that participated in the individual interviews, consisted of Sesotho speaking adults with mental health problems, admitted to The Clinic by psychiatrists. All participants were permanently employed, in jobs ranging from teaching and policing, to traffic officers and performance managers. Data collected during the interviews based on the Kawa Model, needed to be supplemented specifically regarded the socio-cultural context of the Sesotho-speaking patient at The Clinic. A focus group interview was then conducted at The Second Clinic, to further explore the themes identified in the interviews. The sample of patients for the focus group at The Second Clinic, was included according to the same selection criteria than with the individual interviews, and the sample was very similar to that of the individual interviews at The Clinic. Data was analyzed by the researcher and two co-coders. The interpretive thematic analysis approach was used to first analyze the transcriptions of individual interviews, and thereafter the focus group interview. Findings elaborated on the occupations and socio-cultural context of participants, as per the aim of the study. Participants were found to experience much stress at work, relating to strained interpersonal relationships. At the same time, their personal finances, family responsibilities and lack of sleep were found to be stressors. Participation in leisure, as well as experiencing work and family as sources of support (in spite of also regarding those as stressors), were regarded as positives in their daily occupational participation. Values that may influence occupational participation, were described as involvement in community and family; having a positive mindset and an active spiritual life. The participants' socio-cultural context was described as a context containing habits and 'ways of doing' with a strong influence on their occupations and relationships. In conclusion, recommendations towards culturally relevant therapy, were made. These recommendations included suggestions for the content of an occupational therapy program, as well as suggestions for presenting such a program appropriately for the Sesotho speaking person with mental health problems. The limitations of the study were acknowledged and discussed, and recommendations for future research were set out.

[发布机构] University of the Free State