Exploring narratives as a tool to manage psychosocial distress in children hospitalised for tuberculosis in the Western Cape, South Africa

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dc.contributor.advisorHoddinott, Graemeen_ZA
dc.contributor.advisorCoetzee, Bronwyneen_ZA
dc.contributor.authorOctober, Caitlin Danielleen_ZA
dc.contributor.otherStellenbosch University. Faculty of Arts and Social Sciences. Department of Psychology.en_ZA
dc.date.accessioned2024-02-08T12:07:11Zen_ZA
dc.date.accessioned2024-04-27T01:04:47Zen_ZA
dc.date.available2024-02-08T12:07:11Zen_ZA
dc.date.available2024-04-27T01:04:47Zen_ZA
dc.date.issued2024-03en_ZA
dc.descriptionThesis (MA)--Stellenbosch University, 2024.en_ZA
dc.description.abstractENGLISH 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.en_ZA
dc.description.abstractAFRIKAANSE OPSOMMING: Agtergrond: Kinders wat vir lang tydperke in die hospitaal opgeneem is, loop die risiko om emosionele, gedrags- en sosiale probleme te ontwikkel. Hospitalisasie om enige rede is bekend as 'n stresvolle ervaring vir kinders. Sommige intervensies wat daarop gemik is om die psigososiale nood wat geassosieer word met langtermyn hospitalisasie onder kinders te verlig, was suksesvol, maar nie een het spesifiek gefokus op kinders wat vir tuberkulosesorg in Suid-Afrika gehospitaliseer is nie. "Courageous Curly" is 'n stel narratiewe hulpmiddels ('n storie met aktiwiteite wat deur hospitaalpersoneel gebruik word om die kind se begrip van hul hospitalisasie te fasiliteer) wat aangepas is uit suksesvolle intervensies en verder ontwikkel is in Kaapstad. Oogmerke: My doel was om kinders se ervarings van 'n loodsimplementering van Courageous Curly te verken om verdere verfyning toe te lig. My spesifieke doelwitte was: 1) Om te beskryf hoe kinders praat oor hulle ervaring daarvan om in die hospitaal te wees vir TB, 2) Om waar te neem en te dokumenteer hoe kinders omgaan met die onderwyser en met mekaar tydens die aanbieding van Courageous Curly, en 3) Om kinders se ervarings oor TB behandeling in die hospitaal nadat hulle aan Courageous Curly deelgeneem het, te beskryf. Metodes: Die studie volg 'n verkennende kwalitatiewe ontwerp wat binne die narratiewe paradigma geleë is. Om doelwit 1 te bereik, het ek gevalbeskrywings van onderhoude ontleed deur sekondêre analise te doen met kinders wat vir MDR-TB by BCH gehospitaliseer is en om negatiewe ervarings wat kinders gehad het as gevolg van die hospitalisasie te identifiseer. Om doelwit 2 te bereik, het ek oor 'n tydperk van 13 dae waarnemings gedoen wanneer die Courageous Curly-storie aan kinders by die skool by BCH vertel is. Om doelwit 3 te bereik, het ek onderhoude gevoer met kinders (n=6) oor hoe hulle die Courageous Curly-storie ervaar het. Ek het die data van al drie doelwitte deur tematiese analise ontleed. Resultate: Die deelnemende kinders het vier tipes negatiewe ervarings gehad wat verband hou met hul ervarings van hospitalisasie, naamlik: negatiewe emosies, gedragsreaksies, gebrek aan kennis rakende hulle opname in BCH en 'n gebrek aan begrip van ander individue by BCH. Kinders was in staat om deel te neem aan Courageous Curly en het goeie interaksie gehad tydens implementering. Die kinders wat aan die Courageous Curly vertelling deelgeneem het, het gesê dat hulle dit geniet het en dat dit hulle beter laat voel het oor hulle hospitalisasie. Afsluiting: Net soos kinders wat om ander redes in die hospitaal opgeneem word, het kinders wat vir TB-sorg gehospitaliseer is ook psigososiale nood ervaar weens langtermyn hospitalisasie. Kinders het dit geniet om aan die narratiewe intervensie, Courageous Curly, deel te neem en hulle het dit gebruik om hul eie ervarings te vertel terwyl hulle aan die aktiwiteite as deel van die storie deelgeneem het. Sulke intervensies is van kardinale belang om die potensiële negatiewe effek van langdurige hospitalisasie op sielkundige, sosiale, emosionele ontwikkeling en welstand by kinders te versag. Die aanvanklike bevindinge na die loodsing van Courageous Curly toon dat dit moontlik is om dit te implementeer met goeie deelname onder kinders. Die kinders geniet dit om aan Courageous Curly deel te neem, en dit het hul ervaring van hospitalisasie positief beïnvloed. Verdere navorsing is nodig om die doeltreffendheid daarvan in veelvuldige kontekste te verfyn en te evalueer.af_ZA
dc.description.abstractENGLISH 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.en_ZA
dc.description.abstractAFRIKAANSE OPSOMMING: Agtergrond: Kinders wat vir lang tydperke in die hospitaal opgeneem is, loop die risiko om emosionele, gedrags- en sosiale probleme te ontwikkel. Hospitalisasie om enige rede is bekend as 'n stresvolle ervaring vir kinders. Sommige intervensies wat daarop gemik is om die psigososiale nood wat geassosieer word met langtermyn hospitalisasie onder kinders te verlig, was suksesvol, maar nie een het spesifiek gefokus op kinders wat vir tuberkulosesorg in Suid-Afrika gehospitaliseer is nie. "Courageous Curly" is 'n stel narratiewe hulpmiddels ('n storie met aktiwiteite wat deur hospitaalpersoneel gebruik word om die kind se begrip van hul hospitalisasie te fasiliteer) wat aangepas is uit suksesvolle intervensies en verder ontwikkel is in Kaapstad. Oogmerke: My doel was om kinders se ervarings van 'n loodsimplementering van Courageous Curly te verken om verdere verfyning toe te lig. My spesifieke doelwitte was: 1) Om te beskryf hoe kinders praat oor hulle ervaring daarvan om in die hospitaal te wees vir TB, 2) Om waar te neem en te dokumenteer hoe kinders omgaan met die onderwyser en met mekaar tydens die aanbieding van Courageous Curly, en 3) Om kinders se ervarings oor TB behandeling in die hospitaal nadat hulle aan Courageous Curly deelgeneem het, te beskryf. Metodes: Die studie volg 'n verkennende kwalitatiewe ontwerp wat binne die narratiewe paradigma geleë is. Om doelwit 1 te bereik, het ek gevalbeskrywings van onderhoude ontleed deur sekondêre analise te doen met kinders wat vir MDR-TB by BCH gehospitaliseer is en om negatiewe ervarings wat kinders gehad het as gevolg van die hospitalisasie te identifiseer. Om doelwit 2 te bereik, het ek oor 'n tydperk van 13 dae waarnemings gedoen wanneer die Courageous Curly-storie aan kinders by die skool by BCH vertel is. Om doelwit 3 te bereik, het ek onderhoude gevoer met kinders (n=6) oor hoe hulle die Courageous Curly-storie ervaar het. Ek het die data van al drie doelwitte deur tematiese analise ontleed. Resultate: Die deelnemende kinders het vier tipes negatiewe ervarings gehad wat verband hou met hul ervarings van hospitalisasie, naamlik: negatiewe emosies, gedragsreaksies, gebrek aan kennis rakende hulle opname in BCH en 'n gebrek aan begrip van ander individue by BCH. Kinders was in staat om deel te neem aan Courageous Curly en het goeie interaksie gehad tydens implementering. Die kinders wat aan die Courageous Curly vertelling deelgeneem het, het gesê dat hulle dit geniet het en dat dit hulle beter laat voel het oor hulle hospitalisasie. Afsluiting: Net soos kinders wat om ander redes in die hospitaal opgeneem word, het kinders wat vir TB-sorg gehospitaliseer is ook psigososiale nood ervaar weens langtermyn hospitalisasie. Kinders het dit geniet om aan die narratiewe intervensie, Courageous Curly, deel te neem en hulle het dit gebruik om hul eie ervarings te vertel terwyl hulle aan die aktiwiteite as deel van die storie deelgeneem het. Sulke intervensies is van kardinale belang om die potensiële negatiewe effek van langdurige hospitalisasie op sielkundige, sosiale, emosionele ontwikkeling en welstand by kinders te versag. Die aanvanklike bevindinge na die loodsing van Courageous Curly toon dat dit moontlik is om dit te implementeer met goeie deelname onder kinders. Die kinders geniet dit om aan Courageous Curly deel te neem, en dit het hul ervaring van hospitalisasie positief beïnvloed. Verdere navorsing is nodig om die doeltreffendheid daarvan in veelvuldige kontekste te verfyn en te evalueer.en_ZA
dc.description.versionMastersen_ZA
dc.format.extentxvi, 165 pagesen_ZA
dc.identifier.urihttps://scholar.sun.ac.za/handle/10019.1/130643en
dc.language.isoen_ZAen_ZA
dc.language.isoen_ZAen_ZA
dc.publisherStellenbosch : Stellenbosch Universityen_ZA
dc.rights.holderStellenbosch Universityen_ZA
dc.subject.lcshChildren -- Hospital care -- Western Cape (South Africa)en_ZA
dc.subject.lcshTuberculosis in children -- Western Cape (South Africa)en_ZA
dc.subject.lcshOperant behavior -- Western Cape (South Africa)en_ZA
dc.subject.lcshStorytelling -- Psychological aspects -- Western Cape (South Africa)en_ZA
dc.titleExploring narratives as a tool to manage psychosocial distress in children hospitalised for tuberculosis in the Western Cape, South Africaen_ZA
dc.typeThesisen_ZA
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