Browsing by Author "October, Caitlin Danielle"

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    Exploring narratives as a tool to manage psychosocial distress in children hospitalised for tuberculosis in the Western Cape, South Africa
    (Stellenbosch : Stellenbosch University, 2024-03) October, Caitlin Danielle; Hoddinott, Graeme; Coetzee, Bronwyne; Stellenbosch University. Faculty of Arts and Social Sciences. Department of Psychology.
    ENGLISH ABSTRACT: Background: Children who are hospitalised for long periods are at risk of developing emotional, behavioural and social difficulties. Hospitalisation for any reason is known to be a stressful experience for children. Some interventions aimed at alleviating the psychosocial distress associated with long-term hospitalisation among children have been successful, although none have focused specifically on children hospitalised for tuberculosis care in South Africa. “Courageous Curly” is a set of narrative tools (a story with activities for use by hospital staff to facilitate the child’s understanding of their hospitalisation) adapted from successful interventions and further developed in Cape Town. Aims: I aimed to explore children’s experiences of a pilot implementation of Courageous Curly to inform further refinement. My specific objectives were: 1) To describe how children talk about their experiences of being in hospital for TB, 2) To observe and document how children interact with the teacher and each other during the presentation of Courageous Curly, and 3) To describe how children talk about their experiences of being in hospital for TB treatment after they have participated in Courageous Curly. Methods: The study followed an exploratory qualitative design situated within the narrative paradigm. To achieve objective 1, I analysed case descriptions of interviews by doing a secondary analysis with children hospitalised with MDR-TB at Brooklyn Chest Hospital to identify the negative experiences children had during hospitalisation. To achieve objective 2, I conducted observations of the Courageous Curly story being told to children at the school situated at BCH over a period of 13 days. To achieve objective 3, I interviewed children (n=6) about their experience of hearing the Courageous Curly story. I analysed the data of all three objectives through thematic analysis. Findings: Children had four types of negative experiences due to hospitalisation, namely: negative emotions, behavioural responses, a lack of knowledge of being admitted to BCH, and a lack of understanding of other individuals at BCH. Children were able to participate in Courageous Curly and interacted well during implementation. Children who had experienced Courageous Curly said that they enjoyed it and that it made them feel better about being in hospital. Conclusion: Similar to children hospitalised for other reasons, children who are hospitalised for TB care experience psychosocial distress due to long-term hospitalisation. Participants in this study enjoyed participating in the narrative intervention, Courageous Curly, and they used it to narrate their own experiences while participating in the activities as part of the story. Such interventions are crucial for mitigating the potential negative effects on psychological, social, emotional development and well-being in children who are hospitalised for prolonged periods. The initial evidence of the pilot project with Courageous Curly is that it is possible to implement it with good participation from children. Children enjoyed participating in Courageous Curly, and it positively influenced their experience of hospitalisation. Further research is needed to refine and evaluate its effectiveness in multiple contexts.