Meaning making while living and working with a chronic disease: a multiple case study inquiry

Abstract

Abstracts in English, Afrikaans, Zulu, Sepedi, Northen Sotho

The purpose of this hermeneutic phenomenological multiple case study was to explore, describe and explain how people make meaning while living and working with a chronic disease, with a view to developing an organisational support framework centred on meaning making, to facilitate and enhance the wellbeing of employees with chronic diseases. Frankl’s meaning-making principles served as the a priori theory and conceptual framework from which the propositions were derived and on which the study was built. The data was gathered through a multi-method approach by using semi-structured interviews, document analysis, diaries, image-based methods and observations. Data analyses were conducted using interpretative phenomenological analysis and pattern matching to replicate and enhance Frankl’s theory. The patterns of Frankl’s meaning-making principles were confirmed in the data and it was found that central to the meaning making of people with chronic diseases is the reconstruction of a self-identity resulting from self-determination. This process of reconstructing a meaningful self was built on the self-transcendent will to a meaningful self through existential reflection and cognitive reconstruction using Frankl’s meaning-making creative, experiential and attitudinal pathways. A framework is proposed to support the reconstruction of a meaningful self, based on a culture of care and psychological safety, adjusted work arrangement policies, individual support programmes like mentoring, coaching and counselling and opportunities to engage in prosocial projects.

Die doel van hierdie hermeneuties fenomenologiese, veelvuldige gevallestudie was om te ondersoek, te beskryf en te verduidelik hoe mense betekenis skep terwyl hulle met ʼn chroniese siekte saamleef en werk, met die doel om ʼn organisatoriese ondersteuningsraamwerk te ontwikkel wat op betekenisskepping gevestig is, ter bevordering en versterking van die welstand van werknemers met chroniese siektes. Frankl se betekenisskeppingsbeginsels het as die a priori-teorie en konseptuele raamwerk gedien waaruit die stellings spruit en waarop die studie gebou is. Die data is deur ʼn veelmetode benadering versamel deur middel van deels gestruktureerde onderhoude, dokumentontleding, dagboeke, beeldgebaseede metodes en waarnemings. Data-ontledings is gedoen met behulp van verklarende fenomenologiese ontleding en patroonpassing om Frankl se teorie te dupliseer en te versterk. Die patrone van Frankl se betekenisskeppingsbeginsels is in die data bevestig en daar is bevind dat die kern van die betekenisskepping van mense met chroniese siektes die rekonstruksie van ʼn self-identiteit vanweë selfbeskikking is. Hierdie rekonstruksieproses van ʼn betekenisvolle self berus op die self- transendentale wil tot ʼn betekenisvolle self deur eksistensiële oorweging en kognitiewe rekonstruksie met behulp van Frankl se betekenisskeppende kreatiewe, eksperimentele en houdingspaaie. ʼn Raamwerk is voorgestel om die rekonstruksie van ʼn betekenisvolle self te ondersteun, gebaseer op ʼn kultuur van sorg en sielkundige veiligheid, aangepaste werkreëlingsbeleide, individuele ondersteunings-programme soos raadgewing, afrigting en voorligting asook geleenthede om by prososiale projekte betrokke te wees.

Inhloso yalolu cwaningo-nhlonza oluphindaphindekile lwe hermeneutic phenomenological ukuhlwaya, ukuchaza nokuhumusha ukuthi abantu bayithola kanjani incazelo ngenkathi besebenza ngezifo ezingelapheki, okuyinhloso yokwakha kabusha inhlangano yokweseka incazelo esungulwayo, ukuhola nokukhuthaza inhlalakahle yabasebenzi abanezifo ezingelapheki. Imigomo enikeza incazelo kaFrankl’s ithathwa njengenjulalwazi esemqoka nensizakucwaninga okusuka kuyo ukuqanjwa kwezimiso ezakhe lolu cwaningo. Ulwazi luqoqwe ngokusebenzisa izinhlolokhono ezisakuhleleka, ukuhumusha imiqulu, iziggcinalwazi zosuku, ukuhlola nezindlela ezigxile ezithombeni. Ukuhlaziywa kolwazi kwenziwe ngendlela yokuhumusha nokulandela inqubo ehambisana nekhuthaza injulalwazi kaFrankl. Izindlela zikaFrankl zemigomo enikeza incazelo zifakazelwe ulwazi oluzuziwe ngencazelo mayelana nabantu abanezifo ezingelapheki okuwukuthi kugcina kwakheka ukwazi izimo ababhekane nazo bese beyazinikela ekuzinakekeleni. Le nqubo yokwakha incazelo kabusha ibunjwe ngentando yokushintsha kwesimo okuba nomphumela yokubheka emuva ngenhloso yokwakha ikusasa elisha elinokuhluzeka komqondo kusetshenziswa izindlela zikaFrankI zemigomo enikeza incazelo okuyiyona eqambayo, ehlonzayo nesimo somqondo esiya phambili. Le nsizakuhlaziya ineziphakamiso ezeseka ukwakha kabusha incazelo ngaye umuntu ngqo, ehambisana nosikompilo nezokuphepha komqondo, ukuhlelwa kwezinqubo nemithetho yemisebenzi, izinhlelo ezeseka ukucathuliswa, ukwelulekwa, ukuyalwa namathuba okubonisana ngezinhlelo zokunqanda imiphakathi.

Maikemisetso a nyakisiso ye ya thuto ya mohlala wa bontsi ya heremeneuthiki fenomenolotsikhale e be e le go utolla, go hlalosa le go hlatholla ka mokgwa woo batho ba dirago merero ba dutse ba phela le go soma ka bolwetsi bja khoroniki, ka pono ya go godisa foreimeweke ya thekgo ya mokgatlo ye e nepisitsego go dira morero, go nolofatsa le go godisa boiketlo bja basomi ba malwetsi a khoroniki. Melawana ya Frankl ya go dira morero e dirisitswe bjalo ka teori ya priori le foreimeweke ya kgopolo moo elego gore ditshisinyo di ile tsa hwetswa le moo nyakisiso e ile ya agwa. Datha e kgobokeditswe ka mokgwa wa go dirisa mekgwa e mentsi ka go somisa dipoledisano tse di sego tsa rulaganywa gabotse, tshekatsheko ya ditokomane, dipukutsatsi, mekgwa ye e theilwego godimo ga diswantsho le dipono. Ditshekatsheko tsa datha di dirilwe ka go somisa tshekatsheko ya fenomenolotsikhale ya tlhathollo le go nyalelanya dipaterone go boeletsa le go godisa teori ya Frankl. Dipaterone tsa melawana ya Frankl ya go dira tlhaloso di ile tsa tiisetswa ka gare ga datha gomme go hweditswe gore bogareng bja go dira tlhaloso ya batho bao ba nago le malwetsi a khoroniki ke go aga leswa ga boitshupo bjo bo hlolwago ke go ikemela. Tshepetso ye ya go aga leswa boithati bjo bo nago le mohola e agilwe godimo ga thato yeo e fetago go boithati bjo bo nago le mohola ka go naganisisa ka go ba gona le go aga lefsa temogo ka go somisa ditsela tsa Frankl tsa go dira morero wa boitlhamelo, wa maitemogelo le wa ditsela tsa maikutlo. Foreimeweke e sisintswe go thekga go aga leswa ga boithati bjo bo nago le mohola, bjo bo theilwego godimo ga setlwaedi sa tlhokomelo le polokego ya monagano, dipholisi tsa peakanyo ya mosomo ye e fetotswego, mananeo a thekgo ya motho ka o tee ka o tee a go swana le tlhahlo, tlwaetso le keletso le dibaka tsa go tsenela diprotseke tsa go thusa leago.