The Public Health Contribution of Elderly Intermediate Care Rehabilitation: Perceptions, Experiences and Understandings of Mainstream Referrers

By

ACKNOWLEDGEMENT

My sincere appreciation and thanks is for; God the Almighty and I can truly say I can do all things through Christ who strengthens me. My Supervisor Russell Caplan for your encouragement and guidance towards the completion of this dissertation. Prof. Jane Wills For your contribution and your professional leadership you are my role model. My husband Mongie Mabuza for your love and understanding. My Children Sihle, Sivikelwe, Sibemusa for your unconditional love, support and understanding whilst mummy spent a lot of time in the library. I love you my muffins. My manager Liz Barry, Team leader Mark, Gina and all my colleagues for your support and putting up with numerous study days and accommodating this project The Local R and D office especially Judith, Thomas and the peer reviewers for your assistance and patience. To my dad Isaac Mkhonta and Mum, Gelane who have always believed in me. To my siblings, Zama, Dr Zandile Dlamini, Khangie and everyone who supported me. Thank you everyone from the bottom of my heart and this is dedicated to my dad who turned 70 this year.

DECLARATION

I, Dumsile Bella Mkhonta-Mabuza, declare that the contents of this dissertation represent my own unaided work and that the dissertation has not previously been submitted for academic examination for any qualification. Furthermore, it represents my own opinion and observations not necessarily of the university.

Signed:

Date: 16/09/12

ABSTRACT

The purpose of this study is to explore perceptions, understanding and experiences of mainstream referrers on the public health contribution of an elderly intermediate care rehabilitation offered by a 28 bed rehabilitation unit based in Enfield Borough. A qualitative research approach will be conducted through semi-structured voice recorded interviews to referrers in Enfield Borough who have made referrals within the past eighteen months. These will be sampled by going through the records of the referrals made to the unit and selecting the first 8 referrers who agree to be interviewed within the period of the final week of August 2012. For this research data has been transcribed and analysed through thematic analysis, it involves reordering to get chronological order straight and occasional insertion to complete or clarify a sentence. The findings reveal that doctors and nurses, have had meetings but it's never seemed to have come up with anything concrete, they have agreed things but that hasn't been forthcoming from just the meeting really. The research had have touched on this as well before, but this is the final question and it says; in the challenges that they have noted in their referral process then in their view, how should they be addressed and anything that they can contribute.

TABLE OF CONTENTS

ACKNOWLEDGEMENTII

DECLARATIONIII

ABSTRACTIV

CHAPTER 1: INTRODUCTION1

Background1

Research Aims and Objectives3

Conceptual Framework3

CHAPTER 2: LITERATURE REVIEW7

Inclusion criteria7

Exclusion criteria8

Literature10

CHAPTER 3: METHODOLOGY22

Reliability and Validity of Methods24

Research Instruments26

Sampling27

Data Collection29

Data Analysis31

Ethical Considerations32

Generalizability34

CHAPTER 4: FINDINGS36

Thematic Analysis36

Major Findings41

CHAPTER 5: CONCLUSION AND RECOMMENDATION47

REFERENCES54

APPENDIX56

Flowchart56

Interview Questions and Answers62

CHAPTER 1: INTRODUCTION

Background According to the Office of National Statistics (2008), Britain is an ageing population projected ...