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Faculty of Arts and Design

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    The caring practices, coping mechanisms and learning experiences of elderly caregivers of adolescent AIDS orphans in one residential area in Harare : implications for adult education in Zimbabwe
    (2023-08-09) Paradzai, Angeline; Mukeredzi, Tabitha Grace; Preece, Julia
    Recent studies (Kidman and Thurman 2014; Zvinavashe et al. 2015) have established caregiving in an HIV/AIDS context as a burden; however, the caring practices, coping mechanisms and learning experiences of the elderly caregivers of adolescent AIDS orphans have not been well documented. Being an elderly caregiver in this situation brings difficulties as far as the whole caring for an adolescent is concerned (Omotoso 2007; Zaky 2016). This phenomenology research, whose dictates derive from the interpretivist paradigm and the qualitative approach, drew on a sample of twenty elderly caregivers. Snowball sampling, a subdivision of the purposive sampling method, within the non-probability type of sampling, was adopted. The study implemented a qualitative approach, where in-depth one-on-one interviews, observations of the home environments and focus group discussions were used for data generation. Data analysis utilised the six steps of Creswell (2014). Transformative Learning Theory (TLT) (Mezirow 2009), as well as the three models of the Transactional Model of Stress and Coping (TMSC) (Lazarus and Folkman 1984) were the theoretical lenses embraced for the study. With regard to the nature of caring practice what emerged was that the process involved nurturing character development of the orphans. Approaches for character development were modelling adolescent behaviour, talking to and working with them, task delegation, and encouraging church attendance, among others. Provision of basic needs such as food, shelter, school fees and assistance from extended families were also evident as additional caring practices. Challenges faced in the caring practices were of a social, financial and psychological nature. In terms of coping, the more pronounced approaches were problem-centred and emotion-centred coping, with maladaptive coping having been minimally utilised. Coping strategies involved seeking counselling, cutting meal sizes and frequencies of eating the meals, and assistance from their extended families. The elderly carers indicated deficiencies in knowledge of how to look after adolescent AIDS orphans and, also, the resources to use during their care. The new insights emerging from the study were that caring was age-sensitive and collaborative, bringing caregiver, clinic, school, community and extended family together. Elderly caregivers are now bound by the legal orientation in orphan care. Ways of knowing about these insights by the participants were primarily experiential – that is, learning as the processes unfolded. Nevertheless, print and electronic media, and observation also emerged. Educational implications are drawn on a number of issues, such as the need to conscientise caregivers on legal requirements, modern ways of child rearing, imparting entrepreneurial skills as the caregivers had no regular incomes and caregiving in a traditional thoughtful manner. The elderly caregivers went through eight of the ten stages of the Mezirow theory in their learning, leaving out stages three and four which deal with a sense of alienation and relating discontent to others respectively. Not experiencing these two stages may be attributed to stigma and discrimination often associated with HIV/AIDS issues, so they were less likely to disclose their concerns as a means of further learning. Elderly caregivers seemed to lack information on caring for the young in view of AIDS, as well as material resources. Failures of caregivers to join relevant groups like support groups seem to suggest denial of the HIV/AIDS situation they find themselves in. It is recommended that adult educational programmes be designed to reduce stigma and discrimination among the elderly living in HIV/AIDS circumstances
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    A reflection on ethical and methodological challenges of using separate interviews with adolescent-older carer dyads in rural South Africa.
    (Springer Science and Business Media LLC, 2019-07-08) Gumede, Dumile; Ngwenya, Nothando B.; Namukwaya, Stella; Bernays, Sarah; Seeley, Janet
    This article discusses our reflections on ethical and methodological challenges when conducting separate interviews with individuals in dyads in the uMkhanyakude district, South Africa. Our work is embedded in an ethnographic study exploring care relationships between adolescents and their older carers in the context of a large-donor funded HIV programme. We use these reflections to discuss some of the challenges and present possible management strategies that may be adopted in conducting dyadic health research in resource-poor settings.

    Methods

    Drawing from the relational agency, three rounds of separate interviews and participant observation were undertaken with dyads of adolescents aged between 13 and 19 and their older carers aged 50+ from October 2017 to September 2018. A reflexive journal was kept to record the interviewer's experiences of the whole research process. We identified methodological and ethical challenges from these data during the thematic analysis.

    Results

    A total of 36 separate interviews were conducted with six pairs of adolescent-older carer dyads (n = 12 participants). Five themes emerged: recruitment of dyads, consenting dyads, confidentiality, conducting separate interviews with adolescents and older carers, and interviewer-dyad interaction. We also illustrated how we dealt with these challenges.

    Conclusions

    Results from this study can guide the recruitment, consenting and collecting data for health studies that employ a similar form of enquiry in LMICs. However, ethical and methodological challenges should be recognised as features of the relationships between cross-generation dyads rather than weaknesses of the method.