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LitNet Akademies Jaargang 9(2), Augustus 2012 Faktore wat kan bydra tot die ontwikkeling van ’n kultuurtoepaslike milieu vir Sesotho/Setswanabejaarde persone in residensiële-sorg-eenhede Opsomming Sanet du Toit, T. van der Merwe, W. Böning, R. van der Merwe, M. de Villiers, A. Higgo, A. Kruger, N. Olivier en G. Viljoen Sanet du Toit en T. van der Merwe: Departement Arbeidsterapie, Universiteit van die Vrystaat W. Böning en R. van der Merwe, Gemeenskapsdiensterapeute, Departement Gesondheid M. de Villiers, A. Higgo, A. Kruger, N. Olivier en G. Viljoen: Departement Arbeidsterapie, Universiteit van die Vrystaat Die kliëntgesentreerde benadering word binne arbeidsterapie aangewend om die lewensgehalte van die individu te optimaliseer. Dit behels onder andere deelname aan en betrokkenheid in aktiwiteite wat ’n unieke betekenis vir die persoon inhou en in samewerking met hom/haar gekies en aangebied word. Konsepte binne die wetenskap van aktiwiteitsdeelname 1 wat dien as grondslag van terapeutiese en etiese praktykvoering, is steeds grootliks op Westerse lewens- en wêreldbeskouinge geskoei. Plaaslik asook internasionaal is literatuur aangaande kultuurtoepaslike aktiwiteit uiters beperk. Aangesien arbeidsterapeute wat tans by verskeie instansies in die Vrystaat praktiseer, oorwegend wit en vroulik is, maar hoofsaaklik ’n bevolking bedien wat van Sesotho/Setswana oorsprong is, bied die lewering van eiesoortige kliëntgesentreerde dienste ’n uitdaging. ’n Deel van hierdie Sesotho/Setswana-bevolking is bejaarde persone wat as gevolg van modernisasie en verstedeliking genoodsaak word om in die tradisioneel Westerse omgewing van ’n residensiële-sorg-eenheid ’n tuiste te skep. Tydens hierdie studie is daar van ’n kwalitatiewe navorsingsontwerp gebruik gemaak. Nominalegroepstegniek-onderhoude (NGT-onderhoude) met twee groepe professionele persone wat voorheen, of gedurende die studie, met Sesotho/Setswana-bejaarde persone in ’n residensiële-sorg-eenheid werksaam was, is aangebied. Daar is gepoog om deur middel van NGT-onderhoude faktore te identifiseer wat kan bydra tot die skep van ’n kultuurtoepaslike milieu vir Sesotho/Setswana-bejaarde persone in residensiële-sorg-eenhede in die Vrystaat en derhalwe sodoende betekenisvolle aktiwiteitsdeelname vir hierdie bejaarde persone moontlik sal maak. Die vyf belangrikste response van albei groepe is geprioritiseer. Die universele kwessie van erkenning van menswaardigheid is deur dié response beklemtoon, eerder as voorstelle vir kulturele aanpassings binne die residensiële-sorg-eenheid. Na aanleiding van terugvoer deur hierdie twee groepe het die navorsers se begrip van “aktiwiteit” en betekenisvolle aktiwiteitsdeelname verbreed, aangesien dit duidelik na vore gekom het dat menswaardigheid die basis vir betekenisvolle aktiwiteitsdeelname en lewensgehalte is. Trefwoorde: arbeidsterapie; kultuurtoepaslike aktiwiteite; Sesotho/Setswana-bejaarde persone; menswaardigheid; lewensgehalte 583
Abstract LitNet Akademies Jaargang 9(2), Augustus 2012 Potential contributing factors in the creation of a therapeutic milieu for Sesotho/Setswana elderly persons in residential care facilities in the Free Sate Occupational therapy practice is based on the paradigm of an intrinsic connection between a human’s fundamental need to participate in a wide range of occupations as both a means and an end in order to attain, restore or maintain health. Choices for occupational participation that give meaning and purpose are often culturally bound. For that reason the occupational therapy profession views the client-centred approach as a very important avenue to promote wellbeing and enhance the quality of life for each person as a unique individual. The clientcentred approach entails participation and engagement in occupations that have particular significance for such an individual. As part of the occupational therapy process occupations are selected and presented in collaboration with the client. Occupational therapy practice is informed by, and to a certain extent informative to, its young foundational discipline, viz. occupational science. However, some essential concepts within occupational science are founded on Western philosophies and world views. Locally and internationally, literature regarding cultural aspects of activity participation lacks an in-depth understanding. Occupational therapists serving the Free State community currently comprise mainly a white, female population who were usually also educated and trained in a hegemonic environment in terms of gender and race. This presents a great challenge with regard to insightful clientcentred practice to the Sesotho/Setswana community. Within this Sesotho/Setswana community numerous elderly individuals are forced by modernisation and urbanisation to embrace the unconventional environment of a residential care unit as a homestead. The recognition of individual needs in terms of customs, values, convictions and beliefs is overshadowed by the fulfilment of seemingly other important needs, such as medical and physical care. Occupational therapy practice is also bound by the concept of occupational justice, which is an extension of social justice and human dignity. The restoration of social justice by means of client-centred intervention and fulfilling occupational engagement is therefore compromised by a lack of cultural awareness and by preconceived ideas. The aim of this study, therefore, was the exploration of factors that could contribute to the creation of a more culturally acceptable residential care environment. A qualitative study design was applied during this study. Nominal Group Technique (NGT) interviews were conducted with two groups of professionals who had previously been involved, or who were currently involved, in Sesotho/Setswana elderly care. The aim of these NGT interviews was not to produce scientific or theoretical facts, but rather to provide a platform to participants to voice their opinions. The question posed to the groups was: “What can be done to create more appropriate experiences for the Sesotho/Setswana group of elderly individuals in an old-age home?” Since the participants were regarded as experts in the field of elderly care, their knowledge and experience produced a wealth of information concerning the promotion of meaningful activity participation for Sesotho/Setswana elderly persons in residential care units. Of all the given responses, five were prioritised by each group as the most significant. Rather than suggestions for cultural adaptations in residential care units or suggestions for cultural activities, the central theme of the feedback was clear: Acknowledging the human dignity of every elderly individual is non-negotiable. Human dignity is, however, regarded as a universal need of every human being. The real issue that needed further investigation, then, 584
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