A biopsychosocial perspective on social work intervention to address emotional poverty of older persons in residential facilities

Date
2024-03
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Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH ABSTRACT: Older persons are often referred to as the ‘forgotten generation’. However, worldwide the population is rapidly ageing. According to the World Health Organization it is estimated that by 2030 one in every eight people will be over 65. Several older persons must move to residential facilities due to unforeseen circumstances such as a deterioration in their health. Social workers form part of the multidisciplinary team that render services to older persons in residential facilities. This study explored the emotional poverty of older persons in residential facilities. Emotional poverty can be described as a condition in which an older person is lacking in the basic needs for a minimum standard of wellbeing, including biological, psychological and social aspects, with specific focus on social wellbeing. Indicators of emotional poverty are social isolation, loneliness, feelings of depression and minimal or no contact with the outside world. The goal of this study was to gain an understanding of a biopsychosocial perspective on social work intervention to address the emotional poverty of older persons in residential facilities. A qualitative approach was followed with an explorative and descriptive nature. Purposive sampling was done to obtain the sample. The sample consisted of two groups, namely 20 older persons in residential facilities and 10 social workers that render services to older persons in residential facilities. Semi-structured interview guides were utilised to collect the data. Faceto- face interviews were conducted with the participants of this study. Ethical clearance was obtained for this medium risk study before interviews commenced and all participants signed informed consent forms before interviews were conducted. Interviews were transcribed and thematic analysis was done to order the data into themes, subthemes and categories. Data were also verified in order to ensure the credibility, transferability, conformability and dependability of the study. Seven themes were identified from the data collected, namely, the reason for moving to a residential facility; physical health and the impact it has on older persons; the awareness of emotional poverty; psychological health and wellbeing; family and friends’ involvement and connection; views of residents on the residential facility and staff; and social work intervention to older persons in residential facilities. Findings from this study indicated a decline in health is the main reason for older persons moving into a residential facility and that physical health plays a significant role in the older persons’ daily functioning and emotional health. It was also found that a loss of independence affected participants’ wellbeing. Regarding the awareness of emotional poverty, it was found that most participants were not aware or familiar with this concept. It was also found that participants of group1 would often deny feelings of loneliness due to a possible stigma attached to feeling lonely as well as to avoid negative comments from fellow residents. Findings from group 2 indicated that the biopsychosocial perspective was useful to assess the wellbeing and psychological health of older persons. Another finding of the study was the invaluable role family and friends play to reduce emotional poverty of older persons in residential facilities. Findings regarding the care older persons received in the residential facilities were mostly positive, although a few participants indicated that the nursing staff were not supportive. It was also found that the social work profession plays a vital part in residential facilities to enhance the wellbeing of older persons and that social workers form a significant part of the multidisciplinary team responsible for the wellbeing of older persons in these facilities. The recommendations of the study mainly emphasised the importance of social workers to assist older persons in residential facilities to strive for high levels of gerotranscendence (the natural progression towards maturation and wisdom) as well as their important role in the multidisciplinary team to combat emotional poverty.
AFRIKAANSE OPSOMMING: Daar word dikwels na ouer persone verwys as die generasie wat ‘vergete’ is. Wêreldwyd verouder die populasie egter met rasse skrede. Volgens die Wêreld Gesondheidsorganisasie word daar gereken dat teen 2030 een uit elke 8 persone oor 65 jaar oud sal wees. Verskeie ouer persone word genoodsaak om na residensiële fasiliteite te trek weens verswakte gesondheid. Maatskaplike werkers vorm deel van die multidissiplinêre span wat dienste aan ouer persone in residensiële fasiliteite lewer. Hierdie studie het die emosionele armoede van ouer persone in residensiële fasiliteite ondersoek. Emosionele armoede kan beskryf word as ’n toestand waarin ’n ouer persoon gebrek ervaar in die basiese behoeftes nodig vir ’n minimum standaard van welstand wat biologiese, sielkundige en sosiale aspekte insluit, met ’n spesifieke fokus op sosiale welstand. Aanwysers van emosionele armoede is sosiale isolasie, eensaamheid, gevoelens van depressie en min of geen kontak met die buite buitewêreld nie. Die doel van die studie was om ‘n begrip te ontwikkel van ’n biospigososiale perspektief oor maatskaplike werk intervensie om emosionele armoede van ouer persone in residensiële fasiliteite aan te spreek. In hierdie studie is ’n kwalitatiewe benadering gevolg met ’n verkennende en beskrywende aard. Doelbewuste steekproeftrekking is gedoen om die steekproef te verkry. Die steekproef het uit twee groepe bestaan naamlik, 20 ouer persone in residensiële fasiliteite (groep1) en 10 maatskaplike werkers wat dienste lewer aan ouer persone (groep 2) in residensiële fasiliteite. Semi-gestruktureerde onderhoude is gebruik om data in te samel. Onderhoude is persoonlik met die deelnemers van hierdie studie gedoen. Etiese klaring is verkry vir hierdie medium-risiko studie en deelnemers het ingeligte toestemmingsvorms geteken voor onderhoude gedoen is. Onderhoude is getranskribeer en ’n tematiese analise is gedoen om dit in temas, subtemas en kategorieë te deel. Die data is ook geverifieer deur die geloofwaardigheid, oordraagbaarheid, betroubaarheid en bevestiging van die studie te verseker. Uit die data is sewe temas is geïdentifiseer, naamlik die rede waarom daar na ’n residensiële fasiliteit toe getrek is; fisiese gesondheid en die impak wat dit het op ouer persone; bewustheid van emosionele armoede; sielkundige gesondheid en welstand; familie en vriende se betrokkenheid en inskakeling; sienings van inwoners oor die residensiële fasiliteit en personeel en maatskaplike werk intervensies aan ouer persone in residensiële fasiliteite. Bevindinge van die studie het aangedui dat ’n verswakking in gesondheid die hoofrede was vir ouer persone om na ’n residensiële fasiliteit te trek en dat fisiese gesondheid ’n betekenisvolle rol in ouer persone se daaglikse funksionering en emosionele gesondheid speel. Daar is ook bevind dat die verlies van onafhanklikheid deelnemers se welstand beïnvloed het. Rakende die bewustheid van die betekenis van emosionele armoede is bevind dat meeste deelnemers nie vertroud was met hierdie konsep nie. Daar is verder bevind dat deelnemers van groep 1 dikwels gevoelens van eensaamheid ontken het vanweë ’n moontlike stigma met betrekking tot gevoelens van eensaamheid asook om negatiewe aanmerkings van mede-inwoners te vermy. Bevindinge data verkry van groep 2 het aangedui dat die biopsigososiale perspektief nuttig was om die welstand en sielkundige gesondheid van ouer mense te assesseer. ’n Ander bevinding van die studie was bevestiging van die onskatbare rol wat familie en vriende speel om emosionele armoede van ouer persone in residensiële fasiliteite te verminder. Bevindinge oor die versorging wat ouer persone in residensiële fasiliteite ontvang was meestal positief, alhoewel ’n klein aantal deelnemers gemeld het dat die verpleegpersoneel nie ondersteunend was nie. Dit is ook bevind dat die maatskaplikewerk professie ’n noodsaaklike rol speel in residensiële fasiliteite om die welstand van ouer persone te versterk en dat maatskaplike werkers ’n beduidende deel vorm van die multidissiplinêre span. Die aanbevelings van die studie, het hoofsaaklik die belangrikheid van maatskaplike werkers uitgewys om ouer persone in residensiële fasiliteite by te staan om te streef na gerotransendensie (die natuurlike progressie na volwassenheid en wysheid), sowel as hulle belangrike rol in die multidissiplinêre span om emosionele armoede te bekamp.
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Thesis (DPhil)--Stellenbosch University, 2024.
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