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(Title of the Thesis)* ADVANCING OUR UNDERSTANDING OF HOW PET OWNERSHIP IMPACTS HEALTH AND WELL-BEING AMONG COMMUNITY DWELLING PEOPLE LIVING WITH SERIOUS MENTAL ILLNESS by Ulrike Kunigunde Zimolag A thesis submitted to the School of Rehabilitation Therapy in conformity with the requirements for the degree of Doctor of Philosophy Queen’s University Kingston, Ontario, Canada (September, 2014) Copyright © Ulrike Zimolag, 2014 Abstract Objectives It is estimated that about 1 million (3%) Canadians will experience serious mental illness characterized by symptoms and impairments that are severe enough and of long enough duration to interfere with daily life (Canadian Mental Health Association, n.d; Kelly, 2002) including meaningful work and social engagement (Mental Health Commission of Canada, n.d.). Methods The purpose of this thesis was to develop the concept of pet ownership as an everyday North American occupation and to develop a theory of how pet ownership impacts on health and well-being. The first study used Rodgers’ (2000) evolutionary concept analysis approach to analyze North American newspapers and bestselling books. The second study used a grounded theory approach (Charmaz, 2006) to explore how pet ownership impacts (positively or negatively) on health and well-being among community dwelling people with serious mental illnesses. Data collection consisted primarily of individual interviews with 23 stakeholders with knowledge and experience related to pet ownership and serious mental illness. Results In study one, the findings demonstrate that pet ownership is a complex concept consisting of the attributes of: responsibility, investment, occupational engagement, entrepreneurship, relationships, morality, and attitude. Occupational engagement appeared as the central attribute. The Rubik’s Cube was used as a mental image representing the complexity of pet ownership. In study two, a theoretical model was developed that identified “transformation” through pet ownership as the overarching theme organizing the model of health and well-being through pet ownership. Transformation occurs through distinct processes at three levels: personal (psychosocial benefits), occupation (occupational engagement) ii and context (thinking outside the box of service delivery). Each main process consists of five subprocesses (e.g. unconditional love and acceptance is a subprocess of psychosocial benefits). Conclusion The two phases of this research highlight that pet ownership has a range of associated tasks, and that the performance and experience of these tasks is enabled by a range of competencies, meanings, and motivations. These are personal elements that could potentially be supported if service providers themselves developed foundational knowledge and skills, and if this knowledge and skill base was given legitimacy as a valid community support option. iii Acknowledgements To the research facilitators and participants, thank you for your honesty and willingness to open your homes and offices to share your stories. To Dr. Terry Krupa, thank you for your mentorship which had a profound influence on my life path and the quality of my life. You enabled me to leave a mark on the field of mental health with a topic of great importance to me. Upon undertaking this PhD thesis work, I was sure it would be a project of the greatest magnitude – and it was! – Little did I know that a much greater challenge was just ahead when I received a surprise diagnosis of advanced stage ovarian cancer on February 9, 2011. Thank you for your support during this difficult time. You are a person that I greatly respect and trust. Thank you to the members of my advisory committee Rosemary Lysaght and Diane Buchanan for your suggestions and support. Thank you to the people at the Queen’s School of Rehabilitation Therapy and, prior to that, the School of Nursing for letting me belong in order to grow. To Ed, my husband of 33 wonderful years, thank you for standing by me. You cheered me on when I wanted to give up and were my guiding light when I felt lost during the PhD work as well as the cancer experience. To Ed’s brothers and sisters - thank you for making me part of your family. To Heike, thank you for bringing Daisey (my beautiful and spirited sheepdog) into my life when I was starting to go through chemotherapy. Thanks also to Bella (our cat) and the following past notable pets: Senta, Kyra, Bandit, Hassan, Dinah, Felicia, Jasper, Tomiko, Willy, Sam, Lorenz and Alex for sharing/having shared your lives with us. To Sandy, Steve and family, thank you for listening to my troubles and for providing opportunities to eat healthy and to have fun and laughter during all major holidays and birthdays. Most notably thank you Sandy for sharing your son Matthew (since age 8) with Ed as his “Big Brother”. We all know it was a perfect match. Matthew (now age 25) – you inspired me the moment I met you. Being the “other parents” is such an honor! iv Thanks to my oncologists (Dr. Biagi, Dr. Francis, Dr. Martin and Dr. Harle) for helping me live long enough to complete this thesis. Thanks to my nurse practitioner Jan Giroux, the nurses and staff at the cancer clinic and the homecare nurses from Saint Elizabeth Health Care (especially Ruth and Amanda) for your interest and encouragement. Thank you to my parents, for your love and support and for encouraging me to follow my dreams. Thank you dad for your permission to bring home unwanted dogs and for supporting your family while struggling with mental illness. Mom, you are my hero for the way you stood by dad. As a volunteer, you profoundly impacted the lives of so many people. I loved caring for you during your last three Christmases and being with you during holidays. I also loved talking with you across the miles. Our talks accompanied me to almost the end of this thesis. I miss you both and wish you peace. This thesis is dedicated to people living with mental illness everywhere. You inspire me and this thesis is a gift for you! v Table of Contents Abstract ......................................................................................................................................................... ii Acknowledgements ...................................................................................................................................... iv List of Figures ............................................................................................................................................ viii List of Tables ............................................................................................................................................... ix Chapter 1 Introduction .................................................................................................................................. 1 1.1 Setting the Stage ................................................................................................................................. 1 1.2 Objectives ........................................................................................................................................... 3 1.3 Definition of Terms ............................................................................................................................. 6 1.4 Theoretical Framework ....................................................................................................................... 8 1.5 Structure of the Thesis ........................................................................................................................ 9 References 1 ............................................................................................................................................ 10 Chapter 2 An Evolutionary Concept Analysis of Caring for a Pet as an Everyday Occupation ................. 14 2.1 Introduction ....................................................................................................................................... 14 2.1.1 What is a Pet? ............................................................................................................................. 15 2.1.2 Defining Ownership ................................................................................................................... 15 2.1.3 Pet Ownership and Health and Well-being ................................................................................ 16 2.2 Method .............................................................................................................................................. 17 2.2.1 Data Collection .......................................................................................................................... 18 2.2.2 Sample ........................................................................................................................................ 18 2.2.3 Data analysis .............................................................................................................................. 19 2.3 Results ............................................................................................................................................... 20 2.3.1 Attributes of Pet Ownership and Their Expression through Occupation ................................... 21 2.3.2 Consequences of Pet Ownership ................................................................................................ 30 2.3.3 A Global Comparison of Attributes and Their Expression in Nine Contexts of Pet Ownership30 2.4 Limitations .......................................................................................................................................
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