FACTORS THAT INFLUENCE UNHEALTHY TRANSITIONS

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CHAPTER 4 PHASE I: QUALITATIVE FINDINGS, INTERPRETATIONS AND DISCUSSIONS

INTRODUCTION

Chapter 3 discussed mixed method of data collection method the researcher used to arrive at the findings. In this chapter, the researcher outlined various data analysis methods used to arrive at the findings. Data analysis unfolded into two phases and the researcher started with qualitative data analysis and followed by quantitative data analysis. The purpose of this chapter was to discuss the data analysis methods used in order to arrive at the findings. In this study, a variety of data analysis methods was used relevant to the mixed method as undertaken in this study.

STRATEGIES TO ENSURE TRUSTWORTHINESS OF QUALITATIVE DATA ANALYSIS

To enhance trustworthiness in this study, different data sources in different settings were used. According to Creswell (2014:201), qualitative rigour means the use of different procedures to evaluate accuracy of the findings. In this study, to ensure the strategy of credibility member checking was done by conducting follow-up interviews with the participants to evaluate the emerging themes, if they were a true reflection of what they have said or not. Follow-up interviews were digitally recorded. In addition to add value to the truthfulness of the data, triangulation was employed by collecting data from different settings such as from Special Schools, Non-Governmental Organisations (NGOs), Homes and Rehabilitation Centres. A variety of data collection methods used include semi-structured individual and focus group interviews, narratives, field notes and observation to obtain rich descriptive findings. To ensure the strategy of prolonged engagement, the researcher spent considerable time in different settings in order to develop an in-depth understanding of the phenomenon under study. Information obtained from different sources and settings were transcribed, analysed and interpreted into themes. The researcher used the same interview guide for individual and group interviews to ensure accuracy and consistency.
To ensure credibility in this study, during transcription, the researcher repeatedly checked and read the transcripts independently in order to obtain rich thick data analysis. An independent transcriber was also used to enhance quality in this study (Annexure W and X). The supervisor also checked and rechecked transcripts in order to identify similarities and dissimilarities. No dissimilarities were detected; all reached a consensus. According to Creswell (2014:203), qualitative reliability refers to checking as to whether findings were consistent, reliable and stable across different researchers and settings. Transcripts (raw data) were transcribed into meanings where categories and sub-categories emerged. The researcher grouped information obtained into categories in order to maintain order and sequence. Through reading and rereading of the transcripts, the researcher familiarised and immersed herself into the topic and categories were identified linked to the subcategories.
Both the researcher and supervisor coded data independently and only slight differences were noted in arranging main headings. Following discussion with the supervisor. consensus was reached with regard to the emerged categories. An independent co-coder was used to co-check the findings and to ensure consistency in coding. Out of that, similar findings emerged. An agreement of 70 to 80% was reached. The differences were in terms of main headings, instead of themes and sub-themes, the coder used categories and sub-categories.

Qualitative data analysis method

To avoid ambiguity in data analysis, a five step interpretative analysis of Terre Blanche et al (2006) as outlined in Botma et al (2010:226) of which it was as follows:

Familiarisation and immersion

In this study, the researcher collected data in order to familiarise and immerse herself into the topic. This facilitated deeper understanding and knowledge about the topic under study. After data collection, the researcher repeatedly listened to the digitally recorded interviews, read through the narratives and field notes. To maintain the sequence, data collected were grouped into categories. Grouping and classifying data facilitated thoughts and enhanced understanding of the data meanings.

Development of themes

After listening and reading the transcripts several times, the researcher analysed data of which main headings were formulated. Main headings were identified as categories. Data with same meanings were analysed and identified as categories. Emerged categories were linked to sub-categories.

Coding

The researcher coded independently and linked the codes to the identified categories and sub-categories in order to provide clarity and evidence on how categories and sub-categories emerged. In this study, the researcher used phrases and sentences obtained from the participants.

Elaboration

In this study, the researcher grouped various sections of the texts together in order to identify similarities and finer differences of the meanings in the text. In this study, texts were subdivided into smaller data in order to give a new and a different perspective on the data.

Interpretation and checking

After breaking down the texts into small manageable information, the researcher analysed, interpreted and provided written account of the analysed data. Themes were linked to the analysed texts and data were interpreted into a deeper understanding. Data were interpreted in order to unearth the underlying meanings. Analysed data was checked and compared with other previous and existing literature reviews.

DEMOGRAPHIC FINDINGS

To obtain a variety of experiences and complementary information appropriate to the mixed method design, 29 participants participated in this study. A variety of data collection methods was used from different sources and different settings. Parents. teachers, health care workers and multidisciplinary teams participated in this study.
Individual interviews were conducted with 17 participants, which included parents. teachers, principals and occupational therapists working in state and private special schools. Five focus group interviews were conducted in different NGOs both in urban and rural areas. Each focus group consisted of two-three participants because in all the NGOs only 2-3 were accessible for interviews. Twelve (12) participants took part in focus group interviews from five different settings. Majority of the participants were health care workers from NGOs. Regarding education background, most participants were having diploma. Most of the participants had less experience to deal with ID with IDs.
Having multi-disciplinary team participating in this study was of great importance in order to arrive at the findings. The demographic profile of participants was illustrated as follows:

CATEGORIES AND SUBCATEGORIES

Through the process of data analysis, six categories were developed linked to the 19 sub-categories. Categories and sub-categories emerged from analysis and interpretation of verbatim transcripts through semi-structured individual and focus groups interviews. Summary of the categories, themes and sub-themes were outlined in Table 4.2.
Central Theme: The roles of the educator, parent, occupational therapists, and care workers is crucial in assisting the intellectually disabled children to transit into adulthood by the following for:
Guidance and support.
Caring.
Independence.
Patience.
Provision/developing of working skills.
The roles of various caregivers in assisting the intellectually disabled children to transition into adulthood through the provision and development of working skills emerged as the central theme. Illustrations of the emerged categories and sub-categories as stated below in Table 4.2.

Category 1: Working with intellectually disabled children

Participants shared their experiences of working with intellectually disabled children. Although working with intellectually disabled individuals is a challenged positive experiences outweigh negative experiences. Two subthemes merged under the experiences of working with intellectually disabled individuals, which are as follows:

SubcategoryExperiences of working with intellectually disabled children

Under subcategory 1.1, two subthemes emerged as challenges in teaching and positive experiences of working with intellectually disabled children. They are as follows:

Challenges in teaching

Participants shared the challenges the encounter in teaching the intellectually disabled children. Participants indicated the following quotes:
According to my experience mhhh…is not easy but I’m used to teach them…” (P12)
“It is a challenge; it is a challenge is not the same as a mainstream because that is where I started and then learners with different learning challenges of disabilities they are different…” (P9)
“…is not easy to teach them but I’m used to teach them…” (P8)
“…so far it was most difficult at first…they are very…very or they were very slow…” (P2)
A previous study by Mudhovozi, Maphula and Mashamba (2012:148) conducted in South Africa indicates that working with intellectually disabled individuals is challenging owing to school-related problems, emotional problems, social problems, financial problems and scarcity of resources. Most participants reported that it is a challenging task and not easy at all. This relates to the fact that there is no specific curriculum for intellectually disabled individuals. They usually used the mainstream curriculum and adapted the curriculum to the learners with intellectually disability.
Positive experiences of working with intellectually disabled children
Most participants expressed positive experiences of working with intellectually disabled children. Quotes were expressed as follows:
“The experience is exciting, it’s great, it’s fun and you get to know the children…”
“It’s good; it’s good to be with them. To show also them love and to care…”
“I am feeling good with these children. Especially when I am spending my time here…”
“I know them and I am feeling very well. Working with them and when you are working with them…you must have the love and they need love…”
Most participants indicated positive experiences for working with individuals suffering from IDs. Participants alluded that it is good and exciting to work with intellectually disabled individuals, although at first, it was not easy, but you get used to do that. This
indicates resilience and ability to adapt to difficult situations from the participants. This was quiet surprising as in most cases working with intellectual disability is associated with negative experiences such as stigma, burden and stress. A previous study indicated that working with families and individuals with IDs could be positive and rewarding aspects and on the contrary can be a negative and a burden or stress aspects (Aldersey, 2012:2).

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Category 2: Needs of intellectually disabled children

Needs of intellectually disabled children emerged as the second category under which three subcategories emerged: method of teaching intellectually disabled children, role of teacher and commitment of teaching

Subcategory 2.1: Method of teaching intellectually disabled children

Method of teaching intellectually disabled children emerged as subcategory 2 and indicated as follows:
“…if they don’t understand the work then I need to repeat a few times ehhh… is not enough to present one lesson during the day then you are finished and done like the mainstream school. Those work ja…actually the next week I need to repeat the same work again…”
“…is good that you prepare that I’m going to teach. I’m going to do that and that but you might be surprised when you arrive in class and then the learner just take you out of your planning and needs to be assisted somewhere or to be supported somewhere”
“…The other issue is that they learn through repetition so, you have to repeat the topic time and again. Rather than saying that we have done it today and that’s it. You have to repeat, until they grasp…”
“I sit with them individually so that they can learn to read and I help them read word for word. In addition, I show them different methods of reading like I said. I show them phonetic reading, which is a strategy to show them how words come together. Moreover, the phonetic alphabets as well that is how I teach them to read. And I
find that it’s much easier when you teach them individually then they can understand you…”
“…When you asses you must also cater for ehhh assessment differentiation. You ask the same question but in different ways according to the level of an individual. That’s where you are catering for intellectual disability because this person intellectual is not gifted.”

 Role of teacher/parent/health care worker/occupational therapists

Participants shed light of various roles they play on a daily basis. Out of that, five roles emerged of teachers, parents, care workers, and occupational therapists, towards intellectually disabled adolescents, which are guidance, caring, independence, patience, and provision of working skills. They emerged as follows:

Guidance and support

“…to guide the child neh…to realise his potential and to become independent.”
“…I guide them I am a parent to them so I do sit down especially with my class I sit down with them you know just to have one on one talk as a parent…”
“The role is to guide them. you guide them…your duty is to find those people. those places….where you can recommend these kids to go to them…”
“My role is to guide them mostly…”
“…that is why we are here to give them love and then to support them…”
“I will say to that person, just be patient for your kids, take care of your kids, look at your kids and give your kids the support.”
“…and they also need someone who can support them so, that they achieve like other learners. So, the experience is that, when you are working at a…school, you should also be…. a life-long learner. Whereby you look for new strategies to support them…”

CHAPTER 1  OVERVIEW OF THE STUDY
1.1 INTRODUCTION
1.2 BACKGROUND TO THE RESEARCH PROBLEM
1.3 STATEMENT OF THE RESEARCH PROBLEM
1.4 RESEARCH GROUNDING
1.5 DEFINITION OF KEY CONCEPTS
1.6 OPERATIONAL DEFINITIONS
1.7 RESEARCH PURPOSE
1.8 RESEARCH OBJECTIVES
1.9 RESEARCH QUESTIONS AND/OR HYPOTHESIS
1.10 RESEARCH METHODOLOGY
1.11 ETHICAL CONSIDERATIONS
1.12 SIGNIFICANCE
1.13 SCOPE AND LIMITATIONS
1.14 DISSEMINATION OF THE RESULTS
1.15 CONCLUSION
CHAPTER 2  SYSTEMATIC REVIEW OF LITERATURE
2.1 INTRODUCTION
2.2 THE PURPOSE OF SYTEMATIC REVIEW
2.3 TRANSITION AS A CONCEPT
2.4 NEED FOR TRANSITION STRATEGY
2.5 FACTORS THAT INFLUENCE UNHEALTHY TRANSITIONS
2.6 TRANSITIONAL DOMAINS
2.7 CONCLUSION
CHAPTER 3  METHODOLOGY
3.1 INTRODUCTION.
3.2 THE RESEARCH DESIGN
3.3 MIXED METHOD RESEARCH
3.4 PHILOSOPHICAL PERSPECTIVE AND PARADIGMS
3.5 POPULATION AND SAMPLE SELECTION
3.6 SAMPLING METHOD
3.7 DATA COLLECTION
3.8 DATA ANALYSIS
3.9 TRUSTWORTHINESS. RELIABILITY AND VALIDITY
3.10 CONCLUSION
CHAPTER 4  PHASE I: QUALITATIVE FINDINGS, INTERPRETATIONS AND DISCUSSIONS 
4.1 INTRODUCTION.
4.2 STRATEGIES TO ENSURE TRUSTWORTHINESS OF QUALITATIVE DATA ANALYSIS
4.3 DEMOGRAPHIC FINDINGS
4.4 CATEGORIES AND SUBCATEGORIES
4.5 DISCUSSION OF THE NARRATIVE
4.6 DISCUSSION OF THE FILED NOTES
4.7 CONCLUSION
CHAPTER 5 PHASE II: QUANTITATIVE DATA ANALYSIS FINDINGS, INTERPRETATION AND
DISCUSSION 
5.1 INTRODUCTION
5.2 MEASURES TO ENHANCE RELIABILITY AND VALIDITY OF THE DATA RESULTS
5.3 SECTION A: RESPONDENT DEMOGRAPHIC PROFILE (N=120)
5.4 SECTION B: INFORMATION ABOUT ADOLESCENTS LIVING WITH
INTELLECTUAL DISABILITIES
5.4 SECTION C: NATURE OF TRANSITIONS
5.5 SECTION D: TRANSITION CONDITIONS
5.6 SECTION E: PATERNS OF RESPONSE
5.7 SECTION F: THERAPEUTIC INTERVENTIONS
5.8 GRAND ANSWER
5.9 QUANTITATIVE PREDICTORS
5.10 Analysis and interpretation of quantitative predictors
5.11 CONCLUSION
CHAPTER 6  INTEGRATION AND INTERPRETATION OF THE RESULTS 
6.1 INTRODUCTION
6.2 MAJOR QUALITATIVE FINDINGS
6.3 MAJOR QUANTITATIVE FINDINGS
6.4 MERGING AND INTEGRATING CENTRAL/KEY THEMES
6.5 CONCLUSIONS
CHAPTER 7  DEVELOPMENT OF STRATEGIES FOR TRANSITIONING ADOLESCENTS WITH
INTELLECTUAL DISABILITIES INTO ADULTHOOD 
7.1 INTRODUCTION
7.2 SETTING STRATEGIC GOALS AND CHOICES
7.3 FORMULATION OF STRATEGIES
7.4 STRATEGIC INITIATIVES FOR THE TRANSITION POSSIBILITIES
7.5 CONCLUSION
CHAPTER 8 CONCLUSION, JUSTIFICATIONS, CONTRIBUTIONS, IMPLICATIONS, LIMITATIONS AND DISSEMINATION OF THE RESULTS
8.1 INTRODUCTION
8.2 CONCLUSION OF THE STUDY
8.3 JUSTIFICATIONS OF THE STUDY
8.4 CONTRIBUTIONS OF THE STUDY
8.5 IMPLICATIONS
8.6 LIMITATIONS OF THE STUDY
8.7 DISSEMINATION OF THE RESULTS
8.8 CONCLUSION

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STRATEGY FOR TRANSITION OF ADOLESCENTS WITH INTELLECTUAL DISABILITIES INTO ADULTHOOD

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