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Redefining wellness within an African context Dalray de la Harpe & Hanna van Lingen Student Counselling, Career and Development Centre Nelson Mandela Metropolitan University Port Elizabeth SSCSA Conference, Mpekweni, September 2006
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Paper Outline Context of study Wellness defined The history of wellness theory and assessment at UPE / NMMU The development of the SAWQ Culture fair assessment A South African investigation Methodology Results Recommendations The way forward
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What is Wellness?
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Wellness Definition Wellness is a conscious and continuous process of holistic self-development based on personally determined goals for wellbeing, and leading towards the enhancement of individual, organisational, and community health and wellbeing. (Van Lingen, 2000)
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Core Aspects of Wellness Self-responsibility Continuous process Not prescriptive Subjective Holistic and systemic All spheres of life Interrelatedness of domains Recognizes the importance of context Maximization of potential
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Context of Study Undertaken at newly merged (2005) NMMU Former UPE, PET & Vista University (PE)
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Context of Study (cont.) UPE – first SA HE institution to adopt the wellness model as a basis for counselling services 1996/1997 UPE SCCDC initiated the development of SAWQ in 2000
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Reliability and Validity in SA context Expense Practical inconvenience - adaptation Questionable transferability of wellness construct TestadaptationOR… Search for alternative wellness inventory Need for development of SAWQ
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SAWQ - 7 Wellness Dimensions Career Environmental Social Spiritual Physical Intellectual Emotional
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Wellness – origins in USA Concept theoretically described from a Western perspective Question: Relevance of wellness concept for SA students?
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The understanding of health and wellness is dependent on various factors, e.g.: (Cowen, 1994; Schlebusch, 1990; Spector, 1996) Values Culture Education Age SEbackgroundSEbackground
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Enterprising
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SE background
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It is therefore important for health professionals to be knowledgeable about the perceptions of health and wellness of their clients, in order to target interventions and service delivery appropriately (Schlebusch, 1990; Spector, 1996).
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Aim of study To validate the SAWQ structure and items against a USA & South African conceptualisation of wellness
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Methodology Triangulatory research design Data sources (purposive, convenience sampling) Primary expert review – USA expert review – SA focus groups – NMMU Vista students Secondary past student wellness research
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Secondary data sources
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Wellness Research at NMMU Qualitative 2001 Understanding of wellness 2001; in press Experience of wellness 2006 Relevance of SAWQ items i.r.t. personal definitions of wellness Quantitative: Wellness Levels 1997 & 1998 (Testwell) 1999 & 2000 (LAQ) 2002 – 2006 (SAWQ) Psychometric properties 1998 (Testwell) 2000 (LAQ) 2001 – 2006 (SAWQ)
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Mean scores for 1 st -years Wellness Dimension Wellness Assessment Instrument LAQSAWQ 1999 N = 149 2000 N = 411 2002 N = 417 2003 N = 423 2004 N = 68 2005 N = 55 Physical6970 6971 Emotional81 78798178 Spiritual7980757779 Social/Env.737475747778 Intellectual717270717372 Career/Occ.76777678 79 Dalray: Sample? Dalray: Sample?
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Wellness Trends 1999-2005 Highest Lowest Emotional Borderline - Excellent Spiritual Good Career Social Intellectual Physical Borderline – Room for improvement
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Understanding of Wellness in relation to theoretical description DimensionComment HolisticEmphasis on social aspect Physical Emotional Spiritual Social EnvironmentalXEmphasis on systemic context Intellectual CareerNo mention of avocational life roles Dalray: Sample? Dalray: Sample?
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Primary data sources
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Student wellness - 2006
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Expert review (where CVI <0.75) DimensionN items flagged: International expert review (n=4) N items flagged: National expert review (n=2) N items flagged: Student review (n=37) Action Physical50Edit x 3; No change x 2 Career40No change Intellectual40No change Environmental11No change Social03No change x 2; Edit x 1 Emotional01No change Spiritual10No change Total155NO deletions & 4 edits
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Trends: CVI score vs qual comments Financial Negative Positive Self-responsibility Perceptions
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Qualitative comments: Financial - negative “In our culture these things [ Water, fruit juice, herbal tea or milk]: are seen as a luxury and not health conscious” [recycled materials]: “sometimes when I have money I do so” “Cannot afford them” [Water, fruit juice, herbal tea or milk] [limited fat intake] “because as black we cannot afford to eat nutrio food” [regular check-ups] “going to a doctor will be seen as a waste of medical for times when really needed” [recycling – shopping bags] “they cost money
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Qualitative comments: Financial - positive [turning off electrical appliances] “you need to save money” [not wasting resources] “don’t want to pay more”
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Self-responsibility “ [regular self- examination] is unneccessary regular check-ups to the doctor should be done instead”
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Perceptions Regular checkups: “when I’m very sick” Limited fat intake: “you need those things to be healthy, low fat food doesn’t do it for me”
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Additional themes Differing perceptions re health & wellness Family responsibility Learned helplessness Financial wellness
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Conclusions Few items given low CVI scores 15/119 – USA review 5/119 – students Social responsibility low time Money fear “I will never do that its not safe” / “I am afraid to do so”
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Conclusions, cont… Links with past student research? Quant similar findings (level of wellness) Qual: Supportive –Addition of financial wellness section –Helplessness & psychological wellness Additive –Supports need for replicated research SA behind times with latest trends? Physical wellness Environmental wellness
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Conclusions, cont… This research supports the continued use of the SAWQ in its current form (+ editorial changes) with different grps. Good transferability of the wellness construct to SA context! So far…
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Learnings verbal better than written data Methodological constraints Expressive Linguistic Comprehension
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Learnings Not to underestimate the importance of qualitative data!!!
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Recommendations Study needs to be replicated Targeting clearly delineated grps Future research into student wellness Unpack career wellness of this group The SAWQ Adaptations to the SAWQ Language check Spiritual wellness revisited Stages of change – SAWQ Additions: Financial wellness Psychological wellness
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Thank you.
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