49 situations as the foundation for one's aims and values (Park, 2013). It has an impact on how stressors are perceived and the types of coping mechanisms employed to lessen their consequences. The advantages of religious coping with stress in the face of life's problems have been demonstrated through stress studies conducted worldwide. (Hodge
& Roby, 2010; Koenig, 2009) 2.8 Concluding Remarks
Chapter 2 reviewed literature regarding the history of mental health care delivery, the nature of chronic mental illness, phenomenological experiences of professional nurses, demands, challenges associated with caring for institutionalised mentally ill patients, nurses’ coping strategies and lastly, nurses’ support structures and programmes. In the following chapter, the researcher presents the theoretical framework utilised in the study.
CHAPTER THREE THEORETICAL FRAMEWORK 3.1 Introduction
According to Lederman and Lederman (2015) a theoretical framework comprises the theory created to project, explain, and understand phenomena and, in many cases, to critique and broaden existing knowledge within the boundaries of critically bound preconceptions. A theoretical framework is the beginning of conceptualisation at the foundation of a research study, which integrate certain beliefs and ideas that are linked to the phenomena being studied (du Plooy-Colliers et al., 2014). A practice-oriented theoretical framework was used to guide and direct this study. The researcher adopted the practice-oriented theory of Dickoff et al. (1968) as a lens through which to develop a support programme for nurses caring for patients with chronic mental illness.
50 varieties of routines that are not available to current sustainability strategies. The Dickoff et al. practice theory (1968) was utilised to steer the literature review, data analysis and presentation of the results. Dickoff and colleagues (1968) identified six aspects of operations. and their related key questions to consider when developing a programme.
These essential points that guided the developed of a support programme are who or what carries out the action? Who or what is the activity's recipient? What framework does the activity take place in? What happened to the activity? What are the guidelines, strategies, or protocol for the activity, as well as its source of energy that assisted the researcher to utter the research findings? The above-mentioned critical points by Dickoff et al. (1968) will be discussed in-depth below.
• Agent: Who or what performs the activity? An agent can be an individual executing the activity like giving healthcare services in a hospital (Dickoff et al., 1968). Studies by Maputle (2010), and Bodrick (2011) indicate that the agent's nature encourages inventive, fruitful, and crucial actions within the performance that is centered on achieving the goal. In the case of programme development, the researcher becomes the agent. Equivalently, in the present study, the researcher is the agent who will engage in the specific activity, which is the development of the support programme for nurses caring for chronic mentally ill patients in three mental health institutions in Limpopo Province.
• The recipient: Who or what is the recipient of the activity? A recipient is a person who benefits from the activity, according to Dickoff et al. (1968). They also point out that since there is frequently some kind of contact between the pair, a recipient is quite active in receiving actions from the agent. What this means is that the activity that the researcher engages in should target particular recipients. In the present study, the recipients are professional nurses who care for patients with chronic mental illness in three selected mental health institutions. Based on the experiences shared by the research participants, challenges faced by health professionals were highlighted. The experiences shared included both positive and negative experiences of the PNs while they provided care to the MHCUs. The suggested
51 support programmes by professional nurses were ultimately used for developing a support programme for professional nurses.
• Framework: What environment does the activity take place in? According to Dickoff et al. (1968), context refers to the location, environment, territory, and the ward's physical building, and hospital make up different facets of the environment in which the action takes place. Dickoff et al. (1968) state that the context in which the activity is performed must be clearly identified. In the present study, three mental health institutions in Limpopo Province were picked out by the researcher as the context of the study. The names of the MHIs are Evuxakani, Hayani, and Thabamoopo. The support programme was thus developed by considering the context of these three mental health institutions. The support programme will be conducted in chosen public hospitals in Limpopo Province.
• Terminus: What results from this activity? Wehmeier (2005) defines terminus as a point where something stops or reaches its end. According to Bodrick (2011), terminus is the goal outcome of the activity. What this means is that the researcher have to be certain about the end-product that will result from the activity. In the framework of the current study, the development programme was established in order to equip and empower professional nurses who care for chronic mentally ill patients with knowledge and skills that will help them handle their caring responsibilities far better.
• Procedure: In developing a programme, there is a need to generate guiding procedures, skills or protocols that will be associated with the intervention. Similarly, the development programme envisaged in the current study has guiding procedures, techniques or protocols that include outcomes, strategies and competencies that need to be realised. A support programme includes significant topics to enable professional nurses to have enhanced practice, professional and effective coping strategies to render care to mental ill patients.
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• Dynamics: What is the activity's energy source? The source of energy emanated from the researcher during the development of the support programme direted by reviewed literature related to the problem and the legislative context that guides the development of the support programme. The participants, who are professional nurses who care for patients with chronic mental illness, participated in interview sessions where they shared their experiences and ideas which guided the support programme. In other words, the researcher and the professional nurses in the present study provided the dynamic energy source required for the development of the programme. A support programme should address prevalent challenges that confront professional nurses and prevents patient care and service delivery. In relation to the theoretical frameworks, a detailed overview of the study's findings will be discussed in Chapter 5.
53 Figure 1: Six aspects of activities in practice-oriented theory (Dickoff et al., 1968)