Psychological well-being, health and the quality of life of farm workers in South Africa

Thesis (Ph.D. (Psychology))--North-West University, Potchefstroom Campus, 2009.While it is a presumably accepted fact that rural and farming communities represent an important sector in the life of every nation due to their contribution to food security and nutrition, there is limited available empirical knowledge on their lives. This study intended to explore the health profile of the rural and farming communities in South Africa, and to explore the relationships between the physical and psychological health, the needs and quality of life facets of a specific group of farm workers and to provide guidelines for intervention in the said areas. This objective was achieved through a literature review, empirical study and suggested guidelines for bio psychosocial health promotion. The end product of this study is presented in three separate, but related manuscripts or articles. A holistic conceptual framework was adopted in the literature review and is described in manuscript 1. This overview focused on life on farms and in rural areas through both the social and natural sciences lenses in a parallel and integrative manner. The needs domain was conceptualised in its broad and narrow uses, and health was broadly defined in terms of the World Health Organization's (WHO, 1999:6) conceptualisation. The term "rural" was narrowly described for the purposes of the current study, i.e. according to the typical descriptive aspects of population dynamics, geographic, economic and other social considerations. Although studies from elsewhere in the world were used to provide a clearer picture of rural contexts, the focus was on available local South African literature. The literature review suggested a situation of serious disparities in the lives of the rural communities in comparison to their counterparts living in urbanised settings in South Africa. They suffer poor socioeconomic status, poor access to services, physical infrastructure problems, food insecurity and nutritional problems, physical and mental health problems, and violence and violations of their human rights. Manuscript 2 reports on an empirical, mixed-methods investigation that was conducted on a convenience sample of 52 farm workers (18-60 years) from three farms near Potchefstroom, in the North West Province. All participants completed quantitative measures and interviews were conducted with a random sample of 25 participants. As a conceptual framework, health was defined comprehensively in terms of physical, psychological and social dimensions (World Health Organization, 1999). Psychological well-being was defined on a continuum from symptoms of stress to a focus on strengths, capacities, mental well-being or psychological health (Wissing & Van Eeden, 2002, 1997; Deci & Ryan, 2000; Ryan & Frederick, 1997) and measured with the Sense of Coherence Scale (SOC) Scale (Antonovsky, 1987), the Satisfaction With Life Scale (SWLS) (Diener, Emmons, Larsen & Griffin, 1985), the Affectometer 2 (AFM) (Kammann & Flett, 1983), the General Health Questionnaire (GHQ) (Goldberg & Hiller, 1979) the Need Satisfaction Scale (NSC) (La Guardia et al., 2000), and the Subjective Vitality Scale (SVS) (Ryan & Frederick, 1997). Quality of life was operationalised in terms of the Quality of Life Inventory (QOLI) (Frisch, 1994). Physical health was operationalised in terms of standardised measures of blood pressure heart rate body mass index, waist-hip ratio and a nutritional intake measure, the Quantitative Food Frequency Questionnaire (QFFQ) (Vorster et al. 2000). Participants reported relatively poor states of physical health nutritional deficiencies poor mental health and poor quality of life. In manuscript 3 specific guidelines for the promotion of the bio psychosocial health of farm workers were suggested to address the specific and identified problems in an integrated manner. The guidelines were grouped into operational and administrative/bureaucratic interventions. Recommendations were also made for further exploration of the relationship between the farm workers' context and the bio psychosocial health indicators. Farm workers suffer problems of physical and psychological distress as well as shortages of health care providers, lack of the necessary health infrastructure and other social and physical infrastructure amenities. For successful and sustainable interventions health professionals and health workers, policy makers and bureaucrats, human rights activists and rural/farm employee organisations as well as the broader social movement and other interested/affected parties need to jointly contribute to health programmes aimed at addressing the challenges facing rural communities in general, and farm workers in particular.Doctora