A self-management programme to empower adults suffering from Gout and their caregivers in the Omaheke region, Namibia
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Date
2019
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University of Namibia
Abstract
The prevalence of gout has increased over the last few decades. Of the 291 conditions studied in the Global Burden of Disease (GBD) (2010), gout ranked 138th for disability and 173rd for the overall burden of disability-adjusted life years. Statistics assume that in a population of 71,233 there are 200 people in the Omaheke region suffering from gout (Extrapolation of Prevalence Rate of Gout to Countries and Regions, 2015). This is evidence for a need to optimize management of the disease. This study explores the experience of adults suffering from gout and of their
caregivers in the Omaheke region, with the aim of developing a self-management programme to provide participants with education for diet and lifestyle changes for better management of their ill-health. The researcher adopted a qualitative, phenomenological, exploratory, and descriptive approach. Two groups of participants (fourteen adults suffering from gout; and seven caregivers) were interviewed to learn their responses. Those suffering from gout were asked to report their experience of suffering from gout, and the caregivers were asked about their experiences of caring for their relatives. The research questions for those with gout and two caregivers were answered in unstructured individual indepth interviews; five caregivers took part in a focus group discussion. Observations of the participants’ reactions were also noted. During Phase 1 of the research—a situation analysis—the phenomenological
approach for collecting data from selected participants was used. The resultant inductive data analysis was used to develop a self-management programme. During Phase 2, the conceptualization framework guided the development of a selfmanagement
programme, using the Practice Oriented Theory of Dickoff et al.
(1968). During Phase 3—the development of a self-management programme —an adapted version of three theories was used. The most prominent of these was the framework of the Chronic Disease Self-management Programme (CDSMP) which has shown improvements in several areas. The Person-centered Care Theory—based on Carl Rogers’s belief that the person is the expert concerning their needs, and Knowles’s Adult Learner Theory in which the adult learner is seen as self-directed to learn, were theories used to inform the educational process.
In Phase 4, in a two-day training workshop the self-management programme was implemented and evaluated. Evaluation occurred immediately after every session and a summative evaluation at the end of the programme, to verify whether its
interventions were likely to bring about the desired change among the participants. A programme outcomes evaluation was carried out three months after implementation of the programme.
Responses revealed great physical and psychological discomfort from gout, accompanied by disrupted sleep, decreased self-efficacy and social disconnectedness. Information was also seen as important for reducing predisposing factors and managing the illness, and recommendations were made for extending the
impacts of the programme.
Description
A dissertation submitted in fulfillment of the requirements for the Degree of Doctor of Philosophy in Science (Nursing Science)