- Title
- Dealing with the ‘double-whammy’: women’s experiences of schizophrenia and weight gain
- Creator
- Haracz, Kirsti Elise
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2016
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- In this study I explored the experience of women diagnosed with schizophrenia spectrum disorders (SSDs) of managing their weight and what they thought had, or would support them to do this more effectively. I carried out the study according to the principles of constructivist grounded theory. Participants in the study were women, who had been diagnosed with SSDs, were not acutely unwell, and were able to give informed consent. I recruited the participants through community mental health rehabilitation services in the Hunter Region of New South Wales. Data was generated through in-depth, semi-structured interviews. Each of the 11 women who participated in my study engaged in between one and three interviews over a two-year period. I carried out data analysis alongside the data generation, with each process informing the other. Data analysis involved a two-stage coding process characteristic of grounded theory. I also employed other analytical tools including writing analytical memos, constant comparison, theoretical sorting and storyline. The findings of the study comprise a theoretical framework that has four components. The first component is the basic social problem that was shared by all of the participants in the study. Labelled using the words of one of the participants, the double-whammy describes the women’s experience of weight gain, often resulting in obesity, as a second whammy that came along with the diagnosis and treatment of their SSD and brought with it additional challenges. The remaining three components comprise the basic social process, which was the women’s response to the double-whammy. This response centres on the core category of doing as much as I can. This category includes the women’s engagement in what they saw as doing the right things, in a somewhat cyclical process of starting to do it on more than one occasion due to the challenges of sticking with it. They also described an ongoing process of adjusting expectations, both in terms of their engagement in doing the right things, and the outcomes they expected to achieve. The women’s ability to do what they saw as necessary to manage their weight fluctuated in response to a range of mediating factors, which formed the second category in the basic social process. These mediating factors included, knowing about the potential for weight gain and how to address it, mental health and wellbeing, and practical issues such as living on a limited income and prioritising managing their weight among competing demands. The final component of the findings was the facilitating factors that the women thought had helped, or would help them to manage their weight. These included, talking about it, having a plan, and having someone to do it with. This study is significant in that it provides insight into the experience of women, who are generally underrepresented in research about SSDs. The study also provides a longitudinal and holistic perspective that has not been present in existing research. Based on the findings above I suggest that interventions to address weight gain and obesity for women with SSDs should: be integrated with interventions for mental health, commence concurrently with treatment for their SSD, be long term, be flexible and individualised, support development of competence in associated activities, address environmental and contextual factors, and happen in the context of supportive relationships. These suggestions have implications for mental health service providers including addressing culture and attitudes and developing knowledge and skills among staff and allocating sufficient resources to enable obesity to be effectively addressed in mental health services. Implications for occupational therapy include validation of occupation centred practice in this field given the identification of developing competence in associated activities as one of the core elements of interventions to address weight gain and obesity in women with SSDs.
- Subject
- schizophrenia; occupational therapy; obesity; grounded theory
- Identifier
- http://hdl.handle.net/1959.13/1312754
- Identifier
- uon:22458
- Rights
- Copyright 2016 Kirsti Elise Haracz
- Language
- eng
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| Thumbnail | File | Description | Size | Format | |||
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| View Details Download | ATTACHMENT01 | Abstract | 230 KB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Thesis | 3 MB | Adobe Acrobat PDF | View Details Download |