Doctoral Degrees (Health Systems and Public Health)

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Browsing Doctoral Degrees (Health Systems and Public Health) by Author "Misbach, Sadia"

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    A grounded theory study exploring the participation of persons with disabilities in the Saudi Arabian culture
    (Stellenbosch : Stellenbosch University, 2023-03) Misbach, Sadia; Mji, Gubela; Kahonde, Callista; Eide, Arne; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Health Systems and Public Health.
    ENGLISH SUMMARY: This study set out to explore the ways that Saudi Arabian persons with acquired disabilities participate in society. In the context of concerns raised about value-based rehabilitation and readmissions of patients with disabilities in Saudi Arabia, suggestions have been made about harnessing indigenous knowledge to address unfulfilled needs for participation. Theoretical frameworks used to explore subjective dimensions of participation embody Western approaches, which when used in contexts other than the West such as Saudi Arabia, may not be suitable. Furthermore, rehabilitation practices have largely been underdeveloped to address the psychosocial dimensions related to participation of persons with acquired physical disabilities. This study explores an indigenous understanding of participation in everyday life to answer the research question of how participation is processed by persons with disabilities in Saudi Arabia. The study’s primary aim was to generate a substantive theory that explained the main processes involved in participation of persons with acquired disabilities in Saudi Arabia; useful for rehabilitation. The study is positioned within an indigenous interpretive paradigm using a grounded theory approach. The strengths of the interpretive indigenous grounded theory research design affirm and legitimises indigenous-based values based on Islamic religious beliefs. This project’s innovation lies in the application of key elements of indigenous research methodology scaffolded onto classical grounded theory, not found in previous studies on participation. The study was conducted at a large rehabilitation hospital in Saudi Arabia. The iterative cyclical data collection and analysis grounded theory methodology was followed. Twenty-eight persons with disabilities were interviewed, following Arab oral traditions of sharing information and lessons learnt. Three focus group discussions were held with Saudi nationals without disabilities to gain perspectives of disability. Persons with disabilities in Saudi Arabia understand participation as a process that involves their relations with others and Allah. Within the context of religious beliefs, their biographical disruption following an acquired disability, is explained as destiny. The process of overcoming is to rework their biographies within the context of religious and spiritual beliefs that provide meaning and purpose to life. Participants in the study experienced multiple tensions over time as they navigated various aspects of their life to reconstruct their identities, reinterpret participation and cultivate dignity of self. The narratives of persons with disabilities draw on their knowledge of Islamic religious beliefs, norms and expected behaviours. The Theory of Cultivating Dignity in Participation Spaces builds on the participants’ lived experiences and conceptualises a culturally embedded social process of multiple interacting transitions. The staged-transition theory describes patterns of behaviour underpinned by relational dignity, relational autonomy and interdependence for meaningful participation. The proposed theory provides a framework that demonstrate the interaction of participation, identity and dignity that can be further developed to extract active ingredients for context-based rehabilitation interventions. The study begins to inform an indigenous holistic approach to participation.