Elderly South Africans in transition : : : The daily life circumstances, beliefs concerning health and illness and the influences on caring and family structure

Detta är en avhandling från Stockholm : Karolinska Institutet, Department of Neurobiology, Care Sciences and Society

Sammanfattning: Elderly South Africans in transition the daily life circumstances, beliefs concerning health and illlness and the influences on caring and family structure. The overall aim of this thesis was to shed light on different aspects of elderly South Africans experiences in a transitional period in order to reach culturally contextual knowledge within gerontological care. The research objectives were to: identify and describe daily life and related concerns and interests as expressed by a group of elderly (I), illuminate how a group of elderly South Africans experience being old in a transitional period. (II), Study how a group of aged South Africans and their family members describe their intergenerational relations in a transitional period i.e. from a traditional to an industrialized society and how the transition influence the care of the aged in the extended family (III), illuminate beliefs in relation to health and illness expressed by elderly Africans within a South African context, in light of a society in transition (IV). The research takes an ethnographic approach concerned with the perspective of individuals; the life world and the lived body of an individual, to enable an in-depth understanding of the influence of culture and an understanding of the processes by which people develop meaning in their daily lives, acknowledging the existing mutual influence between the world, context, and the individual. Two analysis methods were used: qualitative content analysis (I-III), and interpretive phenomenology (IV). Altogether sixteen elderly individuals were engaged in the research project, including ten females and six males (aged 52-76 years) (I-IV). In study II-IV individual in depth interviews were conducted with altogether ten elderly, nine female and one male participant from previous group interviews. In study III, nine elderly female from previous groups and individual interviews were engaged together with thirteen family members. The results show four main themes: Being old in a changing society, Interpersonal and intergenerational relations, Reciprocal care and Beliefs in a transitional period. The participants are reflecting on life and the changes that occurred during their life span and they return to disappointments and enjoyments in life (II). They express a growing frustration due to their powerlessness of not knowing what will happen to themselves and their family members also the loss of cultural norms and values are of great concern among the participants (I, II, III). Relations are essential in the lives of the participants and are viewed as a reassurance of support and care within the extended family (III). Interpersonal have a essential position in relation to health and illness, where illness may be caused due to disrupted interpersonal relations and on the other hand keeps one healthy when experiencing good relationships (II, IV). Caring is closely linked to respect and the role of reciprocity is emphasized (II, III). Believing is seen as an essential source for improving and maintaining health and being cured. Being sick is normal and suffering and illness is perceived as both natural and a way of purification. HIV/AIDS is regarded as a new and modern disease, but the consequences of it cannot be explained through normal reasoning of an illness making a person stronger and is instead explained as misfortune or bad luck (IV). The overall conclusion of the thesis is the importance of contextualized gerontological care and to acknowledge individuals beliefs in relation to health and illness. It further sheds light on the need of an African approach to gerontological care and the necessitate to be sensitive to local conditions. In a wider perspective the findings of this thesis can be used in education to create understanding for the life world of an individual and the importance of being aware of a person s cultural, socio-economical, spiritual and environmental circumstance to avoid the notion of otherness in caring.

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