Régimen Plástico

 What are the experiences and perceptions of Swazi women living with schizophrenia?

 What are the perceptions and experiences of recovery from schizophrenia of Swazi women diagnosed with this mental illness?

 What promotes and/or hinders their recovery within the context of the SNPH, home and community?

2.6 Conclusion

While a number of studies have been undertaken in developed countries, few studies of recovery from schizophrenia have been carried out in developing countries. The studies outlined in this chapter regarding patients living with severe mental illness, such as schizophrenia, have provided evidence that recovery is possible. The process of recovery can lead to a self-directed fulfilling life, with or without the symptoms of the illness. In developed countries there is evidence to suggest there are positive outcomes when using a contemporary recovery model in supporting SUs living with schizophrenia.

Although there is disagreement in terms of defining recovery, albeit in medical or psychosocial terms, most users of mental health services acknowledged the importance of human contact and a genuine, caring therapeutic relationship as enhancers of the recovery process. Through giving voice to patients, in terms of professional education, service design and health research, their recovery from mental illness can be enhanced through raising awareness in others.

People living with mental illness acknowledge that they have responsibility for their recovery, but at the same time appreciate ongoing support given by others. Recovery from mental illness is defined by SUs as a journey, unique to each individual. This being the case, support must be

91 individualized, and structured around patients’ needs. The stories of people having recovered from schizophrenia can be used as evidence that people diagnosed with mental illness, including schizophrenia, do recover. Taking account of these findings will enable health professionals to gain more insight and develop a better understanding of living with schizophrenia and how the process of recovery can be promoted, as well as challenging their attitudes towards people living with mental illness, andsubsequently providing better quality person centered care.

The aim of this study was to understand the meaning of recovery from schizophrenia, as perceived by Swazi women living with this type of mental illness and to explore what enhances and /or hinders their process of recovery. On completion of this PhD the body of knowledge in relation to women recovering from schizophrenia in Swaziland will add to a very limited body of knowledge in Sub-Saharan Africa and hopefully improve care for those living with this illness. A study of this kind has not been carried out in Africa and in order to find out what Swazi women, who have used mental health services, describe as important to their recovery, I have used the articles reviewed as a starting point to understand and inform my own research. This literature review has revealed that there are limited studies on women and schizophrenia (Rice, 2006), and yet specific studies are significant in the development of mental health services that would be sensitive to the unique needs of either males or females (Kohn & Hudson, 2002;Saha, 2005; Bhurgra, 2005; Hopper et al, 2007). This research is therefore based on the subjective experiences of women living with schizophrenia, in Swaziland. A theoretical approach which ensured justifies the theoretical approach chosen to conduct this study.

Chapter 3

Methodology and Method

3.1 Introduction

The review of literature informed the methodology and the design I chose to use forthis study. The majority of the previous studies reviewed in chapter 2, regarding SUs’ experiences and perceptions of mental illness/schizophrenia, used a qualitative design to influence their approach. The aim of this chapter is to discuss the theoretical perspective (methodology) that guides this study, and to delineate the steps undertaken during data collection and analysis. Two paradigms used in research studies are discussed: objectivism (quantitative) and subjectivism (qualitative), with social constructionism and interpretivism being considered with regard to the latter. Central to this study is the qualitative design and in relation to this there will be further deliberation on three types of qualitative research (ethnography, grounded theory, and phenomenology), the latter considered to be the most suitable to answer my research questions. Four theorists of phenomenology, Husserl, Heidegger, Gadamer and Ricoeur, are then briefly described, as they have been influential on IPA, the phenomenological approach used in this study. IPA and its link to phenomenology is described, followed by a deliberation on the distinctive features of IPA. The method of conducting this study is them explained, and this entails: ethical considerations, participants, data collection and analysis. Finally, is a discussion on how I ensured rigour within this study.

3.1.1 Research aim, questions and objects

The aim of this study was to understand the process of recovery from the perspective of Swazi women living with schizophrenia. The following research questions were identified:

93 What are the perceptions and experiences of recovery from schizophrenia of Swazi women diagnosed with this mental illness?

What promotes and/or hinders their recovery within the context of the SNPH, home and community?

To address the research aim and answer the research questions the following objectives have been identified:

• To gain an understanding of the meaning of recovery from schizophrenia as perceived by Swazi women living with this mental illness.

• To gain an understanding of the perceptions and experiences of recovery from schizophrenia, as portrayed by Swazi women

• To identify issues that promote and/or hinder their recovery

• To add to the limited body of knowledge regarding the experiences and needs of women living with schizophrenia in Swaziland.

• Recommend how mental health services at SNPH could effectively meet the needs of women diagnosed with schizophrenia to promote recovery.