title: Life within chronic care: is this a service or sentence?
abstract: BACKGROUND
  Understanding the meaning of one's lived experiences improves one's understanding of what it means to be human, in association with the social, cultural and historical context in which being a human occurs. The authors in this study describe the lived experiences of residents within a chronic care facility including the practitioner and family perspectives.
  
  
  METHODS
  A qualitative approach was employed with a single-site, descriptive, instrumental case study design. Purposive sampling was utilised to select the chronic facility. Multiple sources of evidence included narratives, semi-structured interviews with staff, residents and family members, and activity profiles of the residents augmented by an ergonomic evaluation of the facility. Content analysis using within-case analysis was implemented.
  
  
  RESULTS
  The greatest impact on the quality of the resident's lived experiences emanates from the physical, organisational and social environments in which they reside. Limited resources, poor staff attitudes and routines that are enforced both on the staff of the facility and the residents appear to reduce optimal functioning within the facility. Furthermore the residents' intrinsic motivation, presence of enforced idleness, learned helplessness and institutionalisation is often intensified and becomes characteristic of the residents lived experiences.
  
  
  CONCLUSIONS
  The lived experiences of the residents are described according to quality of life indicators that were identified during the study and supported by literature. These include the influence of the physical, social and organizational environments on the residents' functional status, which comprises physical well-being and emotional well-being and engagement in meaningful occupations including social interaction and relationships with other individuals.
  
  
  CONCLUSIONS
  Findings of this study may be valuable in understanding and facilitating a positive change in service delivery within chronic care centres.
authors.affiliation: Discipline of Occupational Therapy, School of Health Sciences, University of KwaZulu-Natal (Westville campus) Private Bag × 54001, Durban4000.
authors.forename: Pragashnie
authors.initials: P
authors.lastname: Govender
authors.affiliation: Discipline of Occupational Therapy, School of Health Sciences, University of KwaZulu-Natal (Westville campus) Private Bag × 54001, Durban4000.
authors.forename: Jacqui
authors.initials: J
authors.lastname: Boyd
authors.affiliation: Discipline of Occupational Therapy, School of Health Sciences, University of KwaZulu-Natal (Westville campus) Private Bag × 54001, Durban4000.
authors.forename: Aadila
authors.initials: A
authors.lastname: Hassim
authors.affiliation: Discipline of Occupational Therapy, School of Health Sciences, University of KwaZulu-Natal (Westville campus) Private Bag × 54001, Durban4000.
authors.forename: Tamryn
authors.initials: T
authors.lastname: Jordaan
authors.affiliation: Discipline of Occupational Therapy, School of Health Sciences, University of KwaZulu-Natal (Westville campus) Private Bag × 54001, Durban4000.
authors.forename: Nazmeera
authors.initials: N
authors.lastname: Mahomed
authors.affiliation: Discipline of Occupational Therapy, School of Health Sciences, University of KwaZulu-Natal (Westville campus) Private Bag × 54001, Durban4000.
authors.forename: Daniela
authors.initials: D
authors.lastname: Straeuli-Paul
mesh_terms: D001291:Attitude of Health Personnel; D002908:Chronic Disease / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D011368:Professional-Family Relations; D036301:Qualitative Research; D011787:Quality of Health Care; D011788:Quality of Life / Q000523:psychology*
keywords: chronic care; institutionalisation; lived experiences; occupational deprivation; residents