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Reflecting on language as an inclusion criterion
Language is a contentious issue. Heidegger made reference to an expressive ontology where people find ways to disclose their social worlds (Smith & Osborn, 2009). While language is determined by one’s culture, people’s stories go beyond what is culturally significant. Smith (2004) considers the limitations of language and concludes that the copiousness of data gathered is not reliant on socio-economic determinants, as long as the phenomenon under investigation has significant meaning to the participant. He recommends greater involvement on the part of the researcher to keep the discussion flowing if necessary and the use of professional skills to enable effective communication. As reflected earlier, this recommendation was followed.
In terms of the socio-political context of the current study, participants and/or their relatives may have previously found themselves marginalised and without their own voice in apartheid South Africa. Also, languages of the oppressor may have been imposed on them in different forms and contexts, which may have had implications for conversations in the current study. It is also a fact that some participants may have been more comfortable expressing themselves in their mother tongue.
Identification of potential participants
The identification of potential participants was achieved as follows:
Since the researcher is a clinical psychologist at the hospital, she is a member of the clinical psychology team assigned to treat patients in the medical wards. As such, the researcher belongs to a WhatsApp group on which all new hospital referrals are posted. The clinical psychology team and the administrative manager at the psychology department were kind enough to indicate the ages of ‘para-suicide’ referrals on this WhatsApp group. If the researcher saw a referral for a ‘para-suicide’ patient between the ages of 13 and 21, the referral would be identified as a potential participant.
One of the clinical psychologists on the team would indicate that he/she would consult with the referred patient and commence individual psychotherapy, as is the treatment protocol.
Depending on the researcher’s availability and schedule, she would go to the ward and make contact with the referred adolescent ‘para-suicide’ patient. If the patient was willing to hear her out, the researcher would then introduce herself and provide information about the study. The patient would be invited to take part in the study by participating in an interview with the researcher.
Reflecting on the identification of participants
Time was of the essence, and the process had to take place very quickly. In most cases, ‘para-suicide’ patients only stay one night in hospital. If they are found to be physically well (which they are in most cases) and had made some kind of contact with the psychologist and/or social worker, the patient would be discharged. It therefore often happened that, by the time I got to the ward, the potential participant had already been discharged. I realised that I had to act quickly to reach potential informants before they left. This also had significant implications for aspects of the consent process, as will be discussed under ethics.
– The good response rate may have been a result of the contextual reality of being in the ward, as opposed to a specific interest in the research topic. In most, if not all cases, the adolescents indicated that they were bored in the ward. They were mostly in adult medical wards where the patients were seriously ill, therefore they usually did not have company in the wards. There was no other stimulation such as television available. Most of them seemed to enjoy a different activity, i.e. participating in this research project.
Chapter 1 – Orientation and Aim
1.1 Background to the Study
1.2 Motivation
1.3 Aim
1.4 Research Question
1.5 Research Methodology
1.6 Significance of the Study
1.7 Outline of Chapters
1.8 Conclusion
Chapter 2 – Literature Review: Suicidality and Adolescence
2.1 Suicidality
2.2 Adolescence
2.3 Chapter Conclusion
Chapter 3 – Literature Review: The South African Health Care System
3.1 Introduction
3.2 Political Framework of the Hospital Context
3.3 Medical Professions involved in the Current Study
3.4 Health Care Professionals and NFSB
3.5 The Debate around NFSB as a Psychiatric Responsibility
3.6 Health Care and Adolescents
3.7 Conclusion
Chapter 4 – Research Methodology
4.1 Introduction
4.2 Paradigmatic Point of Departure
4.3 Research Question
4.4 Research Context: Dr. George Mukhari Academic Hospital
4.5 Data Collection Time Line
4.6 Adolescent Sample
4.7 Health Care Provider Sample
4.8 Data Analysis
4.9 Trustworthiness
4.10 Ethical considerations
4.11 Conclusion
Chapter 5 – Findings: Adolescent Participants
5.1 Introduction
5.2 Biographical details of participants
5.3 Analysis of Transcripts
5.5 Conclusion
Chapter 6 – Findings: Health Care Providers
6.1 Introduction
6.2 Biographical details of participants
6.3 Analysis of transcripts
6.4 Conclusion
Chapter 7 – Discussion and Conclusions
7.1 Introduction
7.2 Themes
7.3 Chapter Conclusion
Chapter 8 – Limitations and Recommendations
8.1 Introduction
8.2 Limitations
8.3 Recommendations
References
