2. 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

3. 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

4. What is Wellness?

5. 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)

6. 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

7. Context of Study Undertaken at newly merged (2005) NMMU Former UPE, PET & Vista University (PE)

8. 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

9. 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

10. SAWQ - 7 Wellness Dimensions Career Environmental Social Spiritual Physical Intellectual Emotional

11. Wellness – origins in USA Concept theoretically described from a Western perspective Question: Relevance of wellness concept for SA students?

13. The understanding of health and wellness is dependent on various factors, e.g.: (Cowen, 1994; Schlebusch, 1990; Spector, 1996) Values Culture Education Age SEbackgroundSEbackground

14. Enterprising

15. SE background

17. 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).

18. Aim of study To validate the SAWQ structure and items against a USA & South African conceptualisation of wellness

19. 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

20. Secondary data sources

21. 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)

22. 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?

23. Wellness Trends 1999-2005 Highest Lowest Emotional Borderline - Excellent Spiritual Good Career Social Intellectual Physical Borderline – Room for improvement

24. 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?

25. Primary data sources

26. Student wellness - 2006

28. 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

29. Trends: CVI score vs qual comments Financial  Negative  Positive Self-responsibility Perceptions

30. 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

31. Qualitative comments: Financial - positive [turning off electrical appliances] “you need to save money” [not wasting resources] “don’t want to pay more”

32. Self-responsibility “ [regular self- examination] is unneccessary regular check-ups to the doctor should be done instead”

33. 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”

34. Additional themes Differing perceptions re health & wellness Family responsibility Learned helplessness Financial wellness

36. 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”

37. 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

38. 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…

39. Learnings  verbal better than written data Methodological constraints Expressive Linguistic Comprehension

40. Learnings Not to underestimate the importance of qualitative data!!!

41. 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

42. Thank you.