Psychological reasons for constant experience of stress

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Qualitative aspect of design

This study was conducted in the qualitative approach. Qualitative research is based on a philosophic orientation that adopts a person-centred and holistic perspective (Burns & Grove 2001:27). These authors continue to say the qualitative design focuses on discovery that is a 26 systematic inquiry with the understanding of human beings (Burns & Grove 2001:28). Qualitative research develops an understanding with human opinions about own life, behaviour and environmental circumstances (Binoliel 1984 in Brink & Wood 1998:335). Denzin and Lincoln (1994:2) have defined qualitative research as a « bricolage; that is a pieced-together, close knit set of practices that provide solutions to a problem in a concrete situation ». Parse, Coyne and Smith (1985) in Van der Wal (1999:56) concur by stating that, in qualitative studies new perceptions (gestalts) are formed as the researcher identifies characteristics and the significance of human experiences as described by the participants.

Descriptive aspect of design

In a descriptive design the main purpose is to examine relationships among variables and provide an accurate description of a phenomenon that is being researched (Wilson 1993:11). Researchers must observe, count, delineate and classify as means to obtain facts that provide truthful description of a phenomenon (Mouton 2002:102). There is accurate portrayal of characteristics of persons; situations or groups add Polit and Hungler (1999:643). Polit and Beck (2004:20) contend that a descriptive design is suited for an in depth and probing nature that describes dimensions of a phenomenon, its importance and variations. This fact is confirmed by Babbie (2001:91) when stating that researchers in descriptive studies examine why the observed patterns exist and their implications. « Descriptive » in this study refers to the experiential meaning of lived experiences of nurses and clients in VCT centres.

Contextual design

Burns and Grove (2001:793) describe context as the body, the world and the concerns unique to each person within which the person can be understood. Thus a contextual design is one where a phenomenon of interest is studied in terms of its immediate context (Mouton 2002:133). Denzin and Lincoln (1994:339) assert that a contextual design studies a phenomenon for its intrinsic and contextual significance with a focus on specific events. Contextual studies are conducted where participants are in the various life worlds, which are naturalistic settings and are uncontrolled real life situations (Franfort-Nachmias & Nachmias 1996:284; Munhall 2001:168). Streubert and Carpenter (1999:331) confirm that research done in naturalistic settings is free from manipulation. This research was conducted in some VCT centres in Swaziland where VCT services are provided. The study is contextual in the sense that VCT centres are the nurses’ and clients’ « world », thus the experience will not be separated from participants for articulation of context.

Informed consent

Informed consent is based on the principle of respect for the participants. Obtaining it is not merely the signing of the consent form but should be voluntary and informed. An informed consent requires that here is disclosure of sufficient and appropriate information so that participants can make an informed choice to participate voluntarily in the research (Gillis & Jackson 2002:333; Terre Blanche & Durrheim 1999:66). The informed consent for participants in this study was obtained from the MOHSW, heads of VCT centres, nurses working in the identified VCT centres and clients receiving VCT services. Participants signed a written consent form; the MOHSW and heads of VCT centres wrote letters of approval after they had seen a copy of the research proposal.

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Sample and sampling of nurses and clients

A sample can be described as a selected element of the population considered for actual inclusion in a study (De Vos 2002:198). Since data collection for both nurses and clients is through unstructured in-depth interviews, the sampling methods for both groups were similar. Sampling is defined as a subset of the population selected to participate in a research study (Burns & Grove 2001:365). This may be a group of elements such as individuals as will be the case in this study. Nurses who had been trained as HIV/AIDS counsellors and have worked in VCT services for over a year counselling, testing, treating opportunistic infections and distributing antiretroviral drugs constituted the sample.

Sampling methods

A purposive sampling method was used in this study when exploring experiences in VCT centres. Purposive sampling is judgemental since it involves the conscious selection by the researcher for informants to be included in the study (De Vos 2002:333). Selecting purposive sampling denotes a commitment to interviewing individuals who have had experience with a culture or phenomenon of interest (Streubert & Carpenter 1999:58). Creswell (1998:118) concurs when stating that selection of participants is crucial in qualitative studies as data must provide rich detailed and specific information. On interviewing participants, the researcher’s wishes would be to acquire a special perspective because of their experience and knowledge of working in VCT services and receiving such services (De Vos 2002:198).

TABLE OF CONTENTS :

CHAPTER 1 PHASE 1: Problem analysis and project planning
- 1.1 INTRODUCTION
- 1.2 BACKGROUND AND MOTIVATION
- 1.3 STATEMENT OF THE PROBLEM
- 1.4 RESEARCH QUESTIONS
- 1.5 PURPOSE OF THE STUDY
- 1.6 RESEARCH OBJECTIVES
- 1.7 SIGNIFICANCE OF THE STUDY
- 1.8 THE PARADIGMATIC PERSPECTIVE OF THE RESEARCH
  - 1.8.1 The paradigm approach f or this research
  - 1.8.2 Assumptions
    - 1.8.2.1 Meta-theoretical (Ontological) assumptions
    - 1.8.2.2 Theoretical (Epistemological) assumptions
    - 1.8.2.3 Methodological assumptions
1.9 CENTRAL THEORETICAL STATEMENT
1.10 RESEARCH DESIGN AND METHOD
- 1.10.1 Research Design
- 1.10.2 The Intervention Design and Development Model
1.11 TRUSTWORTHINESS
1.12 OUTLINE OF THESIS
1.13 CONCLUSION OF CHAPTER
CHAPTER 2 PHASE 2: Information gathering
- 2.1 INTRODUCTION
- 2.2 RESEARCH design
  - 2.2.1 Qualitative aspect of design
  - 2.2.2 Exploratory aspect of design
  - 2.2.3 Descriptive aspects of design
  - 2.2.4 Contextual design
- 2.3 RESEARCH METHODS
  - 2.3.1. Gaining entry and cooperation from setting
  - 2.3.2 Ethical and legal considerations
  - 2.3.3 Research population
  - 2.3.4 Method of data collection
    - 2.3.4.1 Unstructured in-depth interview
    - 2.3.4.2 Field notes
  - 2.3.5 Analyzing identified concerns
    - 2.3.5.1 Data analysis
2.4 PHASE 3 DISCUSSION OF FINDINGS AND LITERATURE CONTROL
2.5 PHASE 4 DESIGNING OF ANY EMPOWERMENT PROGRAMME
CHAPTER 3 PHASE 3: Information synthesis
- 3.1 INTRODUCTION
- 3.2 THE RESEARCHER’S EXPERIENCE OF THE FIELD
- 3.3 METHOD OF DATA ANALYSIS
- 3.4 THE THEME: CONSTANT EXPERIENCE OF STRESS
  - 3.4.1 Category 1 Psychological reasons for constant experience of stress
  - 3.4.2 Category 2 Physical reasons for constant experience of stress
    - 3.4.2.1 Sub-category 1 Constant exhaustion
    - 3.4.2.2 Sub-category 2 Development of Medical conditions
3.5 CONCLUSION
CHAPTER 4 PHASE 4: Designing an observational system
- 4.1 INTRODUCTION
- 4.2 CONCEPT SELECTION
  - 4.2.1 Dictionary Definitions of empowerment
  - 4.2.2 Subject usage of empowerment
  - 4.2.3 Benefits of empowerment
  - 4.2.4 Explanation of growth of empowerment
    - 4.2.4.1 Attributes of empowerment
    - 4.2.4.2 Antecedents of empowerment
  - 4.2.5 Definition of empowerment in this study
  - 4.2.6 Classification of concepts that form the empowerment programme
- 4.3 CONCLUSION
CHAPTER 5 PHASE 5: Early development and pilot testing
CHAPTER 6 PHASE 6: Evaluation and advanced development
CHAPTER 7 Conclusion, limitations and recommendations