Substance Misuse and Addiction

CHAPTER 1

1. Effects of Substance Misuse Among Young People

1.1 Substance Misuse

Substance misuse refers to the use of substances such as alcohol and drugs which are harmful to human health. The drugs are used for the wrong purposes other than the medicinal use which requires a doctor’s prescription. Most commonly, the misuse of drugs arises from illegal drugs whose consumptions are banned internationally. Other legal drugs such as alcohol can also be misused as when they are consumed by young people who are not permitted to use them. Other substances commonly abused by the young generation include nicotine, glue, and even caffeine. The consumers of such drugs often experience addiction which makes it difficult to stop the consumption even at an advanced age.

1.2 Influence on the young people

The young people are at great risk of being influenced into the practice due to peer pressure from friends, influence from the media, as an adventure, lack of proper parental guidance or even poverty (Hasin et al., 2013). The children are used in most cases as agents for the sales of the drugs and this influences them to start the use of such drugs. The other category of vulnerable children are the orphans who experience difficulties in meeting their daily needs hence resort to the streets where they easily access the drugs. These substances are so addictive such that a person will always feel the need for more experiences after the first trial.

1.3 Global problem

Substance misuse can be accredited to a disorder which brings the addictive component in a person to a point the person is not likely to stop its use despite the negative health consequences. This is a global challenge since the largest population in the world are the youths who are at risk of being under the influence of drugs. The use of alcohol, drugs, and cigarette are major health risks in the whole world. World Health Organization (WHO) list the use of such substances as the main causes of chronic diseases, heart attacks, breathing problems, and cancer. Cancer is the world’s number one killer disease and there is no proper treatment which has been invented to tame it (Dunne et al., 2015). The youth are the leaders of tomorrow hence should be prevented from the use of such substances. The world currently relies on innovations and technology with the aim of improving the economy and solving the current challenges. When young people are under threat, there will be shortages of people who can steer the required projects to a better world.

1.4 The problem and purpose of the research in the UK

Substance abuse is a reportedly big problem in the world and the UK as a whole. The current statistics reveal that most children are at great risks of being affected by drugs. The affected population by drugs have been on the rise which has led to the research in order to investigate the effects of these substances on youths. Drugs affect the teenager’s performances in schools where they are equipped with knowledge on how to transform the world (Jansen et al., 2011). The country relies on the youth to boost the economy by addressing the economic challenges and providing solutions. The research will help in addressing the challenges experienced by the youth as it will evaluate the factors which lead to the high rates of consumption which is observed in the entire country. The report will offer the necessary recommendations on ways of curbing the problem and keeping the young people safe from such influences.

1.4.1 Effects of Substance misuse

Drug misuse eventually brings about various effects and consequences. Its effects serve as one of the biggest problems countries constantly face worldwide, not only the UK. Generally, there are three main categories recognized by various researchers; Physical, mental/ psychological and social effects. Physical effects are effects that can be associated with systems of the body of an individual (Natasha, 2016). These kinds of effects vary by drug and some may affect the brain while most affect how the body works. Mental or psychological effects are those mainly associated with the brain. Most of these effects occur upon the onset of addiction of the individual. Social effects are effects that mainly involve a third or second party. Social effects are effects that can be generated from the behavior and seeable changes of an individual.

1.4.2 Social, Economic and Physical Effects of Substance misuse

Drugs make the youth to be withdrawn from their family members and even lose interests in the hobbies they once had passion in (Johnston et al., 2011). This makes them neglect their responsibilities which can even make those in the employment sector to risk their jobs. It can also lead to engagement in some unhealthy practices which may lead to their being infected by HIV/AIDS. The use of the same injecting needles with infected persons will spread the disease among all the users. Treatment of such children becomes a burden to the family members since the treatment process is expensive and it can also lead to a neurological problem. There are other long-term effects of the use of drugs. Some of them include the development of mental problems, cancer, and HIV/AIDS. These are problems that are not realized at the early stages but develops within sometimes and a person can only realize being affected after a longer time. Addiction is another consequence which is difficult to stop. Drug addiction is difficult to control as the body demands for more components of blood in the body for the person to feel comfortable. Apart from infectious diseases contracted through injection and other methods used by addicts, other direct physical effects are imminent upon the individual. Effects such as heart rate irregularities, pains in the abdomen, kidney and liver damage are examples of such dangerous effects. There are also indirect effects of drugs due to the influences of the users on the people around them (Peterson, 2013). Once the body has been weakened by the drugs, the family members have to cater to the hospital bills due to a weak immune hence diseases easily attack the body. The resulting consequences of drug abuse is lower productivity of the individual hence the economic growth of the country is slowed down.

1.5 Consequences of Substance Misuse

Misuse of drugs has serious health complications in a person’s life. The effects range from short term to long term consequences. The effects vary on the type of drugs used by a person and some of the consequences can be felt indirectly within the human body. Some of the short-term consequences include increased blood pressure, heart attack, weak body, fluctuations in appetite and mood swings. The young people lack proper concentrations in their studies hence resort to other harmful activities such as criminal activities. Since the drugs change the normal body functioning systems of a person, the drug users always have the wrong judgments. This makes them neglect their responsibilities which can even make those in the employment sector to risk their jobs. The aftermath of the drug abuse is lower productivity of the individual hence the economic growth of the country is slowed down.

1.6 Benefits of use of drugs

Drugs should be used within the normal prescriptions of a clinical officer. Drugs help fight diseases in the body hence should be used for the right purposes. There are no benefits attached to the misuse of drugs as it destroys the body system of a person. The illegal drugs should be barred from reaching into the country thus preventing their flow to the public where the young people find access to. Consumption of alcohol and smoking of tobacco increases the chances of developing cancer. This, therefore, means that for a person to live a healthier life, there should not be a misuse of drugs.

1.7 Addressing the challenges brought by substance misuse

The young generation are the pioneers towards a fruitful future hence should be taken care of. There should be proper education given to the youth on how to resist peer pressure and desist from situations that may prompt the use of drugs. The public should be given enough information on the dangers of engaging in drug misuse as it brings the other health complications. The law should be enforced within the country that prohibits the usage and sale of the drugs to the teenagers.

CHAPTER 2 LITERATURE REVIEW

Introduction

Drug and substance misuse is and has been a big problem among the youth from all over the world. The UK, in particular, is also faced with this problem. There are various reasons as to why these youth may fall into this kind of practice, the main being because of peer pressure (Hasin et al., 2013). Drug and substance abuse affect a greater number of the youth globally and this chapter will look at the theoretical aspect of researchers and writers altogether. There are many reports, articles and books published on substance misuse all over the world. Most countries, if not all, are affected by this practice.

Literature

Substance misuse has proven to be a common phenomenon in the modern world, it has impacted the society today and is ranked to be the most important social damage (Winters K., 2013). This practice among the youth results in adverse consequences and problems which entails a set of physical, mental or psychological, cognitive and behavioral symptoms (Madadi et al., 2014) Various researches have been conducted on the various subtopics of substance and drug misuse among the youth. These have included research on the misuse, statistics all over the world and in specified countries, the effects of this practice and the possible treatment of the practice. Various drugs are involved, but misuse basically entails the abusive use of illicit and illegal drugs. Generally classified as stimulants, depressants, among others. Specifically, some of the drugs include methaqualone, opioids, cannabis, alcohol, cocaine and barbiturates. There are various countries in the world to which a high contamination has been reported. Although the UK also indicates a high prevalence of opiate addicts, Iran reported the highest prevalence according to the World Health Organization’s report of 2005. The report further indicated that there are about 200 million opiate addicts in the world. Studies have shown that substance misuse among the youth is often related to alcohol and cigarette consumption (Farhadinasab et al., 2013). Results have also indicated that the inclination and positive thoughts of smoking of an adolescent might have its origin on the existence of a cigarette smoker in the family (Mohammadpoorasl et al, 2012). Moreover, according to various studies, the chance of becoming a cigarette smoker among the youth is almost the same (11.2%), however, there is a slight difference when it comes to alcohol consumption where prevalence in males is 3.1% higher than in females (Simantov., 2014)

In the UK, around 4 million people use illicit drugs each year (opioids, stimulants and cannabis), cannabis being by far the type that is most commonly misused. The second and third most commonly abused are cocaine and ecstasy respectively (Man & Roe, 2016). Several reports on the effects of this practice have been released by several health institutions and practitioners, for example the World Health Organization and the National Institute on Drug Abuse. In regard to these effects in the UK, of all the 1,382 drug- related deaths reported in 2005 (National Programme on Substance Abuse Deaths, 2005), majority constituted cases of accidental poisoning (59%). A sizeable number, however, was as a result of intentional self-poisoning. Opioids accounted for 70% of the unfortunate occurrences whereas 13% was claimed by cocaine. Many occurrences of drug misuse were as a result of multiple drug toxicity. HIV infection has also proved itself as an existing effect to drug- injecting users with an increasing number of diagnoses of HIV over the years, and 5.6% of these diagnoses being attributed to drug- injecting users by the end of 2005 (Health Protection Agency et al., 2006). Another effect quite common in the drug misusing population is psychiatric comorbidity, depression and anxiety being two of the ones generally common. Other anti- social and personality disorders are common in opioid users (Ragier et al., 2014). With regard to treatment, drug misuse disorders, if complicated by other comorbid mental disorders, have been recognized to be more difficult to treat and having a poorer prognosis than disorders with no comorbid disorders. This is because it is highly likely that comorbid disorders would be disabling and maybe chronic, hence resulting in greater service utilization.

Theoretical framework

According to the world statistics, in 2015, drug and substance misuse caused the death 307, 400 people, which is higher than the 165,000 death tally in 1990. Of these deaths, alcohol use disorders contributed to 137,500, opioid caused 122,100, amphetamine 12,200 and cocaine contributed a total of 11,100 (GBD, 2016). It is estimated that of all people who misuse these illicit substances, a very high number have a high risk of recurrently using them thereof causing harm to their physical, social and psychological states, which in turn puts them at risk of various dangers (World Drug Report, 2012) In the UK, 7,545 hospital admissions with primary diagnoses of disorders that are drug related were recorded in 2018. There were 14,053 other admissions of primary poisoning by illicit drugs. In both Wales and England, 2016 registered 2,593 deaths related to drug and substance misuse, this marked a 58% increase in this number compared to 2006 (National Statistics, 2018). On the same note, in adults, in 2016/2017, at least one out of 12 individuals aged 16 to 60 had registered to have taken an illicit drug in the last year. In children, 24% of the children reported to have ever taken drugs. The likelihood of ever taking drugs was recorded to increase with age, from 11% in 11-year olds to around 37% in 15-year olds (National Statistics, 2018). Additionally, statistics have shown the alcohol and drug abuse costs the UK 21 and 15 billion sterling pounds respectively, relatedly, a lost productivity of about 7.3 billion is due to alcohol per year. Furthermore, 70% of substance abusers are in full time employment. Further research has shown that the use of drugs has been greatly associated with peer influence and pressure from friends, the media and also a sense of adventure accompanied with lack of proper moral and parental guidance (Hasin et al., 2013). These are the kind of reasons that can lead to the promotion of this kind of practice. In relation to this fact, it has been estimated that around 3% of all the children under 16 years have parents with drug problems.

Health researchers and practitioners have attempted to refer to this practice in relation to a broader perspective. Some have attempted to look past the individual and also emphasizing the role of the society as a whole, culture and the direct and indirect influences. In a bid to achieve this, other health professionals have chosen to milden the language by use of language such as ‘harmful/ problematic use of drugs’ and ‘substance and alcohol problems’ other than ‘drug and substance abuse/misuse’ (Fehrman et al., 2015). The use of drugs can be systematically categorized to both beneficial use and chronic dependence. Its effects are greatly significant in both ways and various substance- related disorders have been associated with this practice.

Conceptual Framework

The misuse and abuse of drugs and other illicit substances ultimately lead to various effects. Apart from the physical, social and psychological harm done by the use of these drugs, some cases have also arisen criminal and anti- social behaviors, these have also included long term personality changes in individuals affected as well (Charles, 2014). Physical, psychological and social harm caused by drug misuse may be controlled and treated in various health facilities, however, the misuse of some drugs may also lead to criminal charges and prosecution, the latter varies widely in accordance with the local jurisdictions (Mosby, 2015) With regard to the cause of substance misuse, there is no exact cause, however, two predominant theories have been established: first refers to the genetic disposition which is consequently learnt from others and the second refers to a habit which develops with addiction and eventually manifests itself into being a chronic debilitating disease (NIDA, 2014). The concept of addiction in the whole topic of the effects of substance misuse is crucial as it is the recurrent, and not the careful use of these drugs and substances that cause dangerous effects.

There are widespread effects as a result to the misuse of drugs and substances, categorized into physical, mental or psychologic and social effects. Its impact in work places has been associated with premature deaths/ fatal accidents, increased injuries/ accident rates, absenteeism from work and lowered productivity in general. On an individual basis, drug- related disorders and effects are different based on the type of drugs abused. For instance, opioids have several brain effects which are mediated through certain receptors, the key opioid receptor mediates euphoria and respiratory depression while other receptors are involved in mood regulation (Lingford- Hughes & Nutt, 2013). The subject experiences euphoric rush, followed by a warm flush, severe itching, sometimes nausea and vomiting. Other short-term effects include drowsiness and slow cardiac functioning and breathing (NIDA, 2015). Effects of opioid misuse are almost similar to the effects of methadone. The development of opioid dependence is an instance of a long-term effect. Subsequently, associated harms may have medical consequences such as scarring, infections to the blood, abscesses and compromised functioning of various important organs of the body such as the lungs, kidney and liver. Stimulants such as cocaine and amphetamine affect the neural system. Some acute primary effects include euphoria, heightened alertness, increased talkativeness, sexual arousal, increased heartrate, blood pressure and body temperature and pupil dilation. Secondary effects are experienced as soon as the primary effects wear off, include restlessness, anxiety, agitation and insomnia (NIDA, 2015)

Cannabis abuse affects almost every system in the body. Primary effects include increased heart rate and relaxation of the bronchial passages. Sometimes, anxiety and paranoia also occur, especially to first time or psychologically- vulnerable users (Marc G, 2015). As long-term effects, cannabis misuse may also impair memories, attention and motor coordination. A wide range of respiratory tract disorders may also be associated with chronic cannabis smoking (Hashibe et al., 2016) Apart from the medical consequences of drug and substance misuse, other effects such as anti- social or criminal behavior may be enjoined. Drugs ultimately make the youth withdraw from their families and even lose interests in their previous passions and hobbies. Such lead to indirect effects of this practice because of the influence by the user to other people related to him (Peterson, 2013). The effects of these eventually call for treatment and medication, which in some instances prove to be expensive and a burden to the families of the user. A number of medications have been approved and such include replacement therapies, antagonist medications and antipsychotic measures (Mark G., 2015).

Gaps in Literature

This paper looks at the substance misuse among the youth in the UK, the possible causes of this practice, the foreseeable effects of this kind of practice, treatment and medication and the possible recommendations and suggestions on the topic. Research conducted would look at both predominant theories of the cause of substance abuse, genetic disposition which is consequently learnt from others and the concept of habitual development which is linked to addiction. Furthermore, the research will highlight the various drugs and substance-related effects, being the focus of the research. The research looks at the effects systematically and categorically. Finally, the research conducted will outline all foreseeable positive steps towards a better society, therein including suggestions and recommendations on the problem

Summary of the chapter

Research has been conducted on various drug- related topics and articles, reports and papers published on the same. This chapter has endeavored to highlight various issues and sub issues that may arise from the research problem and associated these topically in regard to how they have been put in other pieces of literature. Researchers have outlined the causes of drug abuse practice in many different countries and have advanced to provide statistics on different uses and effects of drug and substance misuse. Various negative effects of this practice have been amplified and discussions thoroughly conducted. Researches on the positive treatment and steps towards better and healthy circumstances have also been conducted and reports on the same issued. On the same note, a number of tests have been conducted, results displayed, and conclusions and recommendations given.

Chapter 3: Research Methodology

Introduction

This chapter purposes to describe the research methodology that has been applied in this current study and to justify the selection. Accordingly, the chapter has discussions that relate to the various types of research and their consequent applicability to the topic of enquiry and how the grounded theory was chosen and executed. The chapter has been set into seven sections: The choice of the methodological approach comes first, which is basically a presentation of the overall research design, comparing the qualitative and quantitative approaches and concluding by describing the grounded theory and the inherent qualities that relate to social and human inquiry. The second section is the research context which is a presentation of the role of the researcher, the current study context, and its relevance to practice and finally the extent of reflexivity application. Thirdly, the research quality and rigor section considers the various pretest factors, comparing principal grounded theory tenets of validity, reliability, and credibility to relevance, fit and workability; concepts that are associated with conventional approaches in research. The fourth section, the ‘data collection, analysis, and theory development’ outlines data collection and analysis in both theoretical and procedural generation terms. Section five presents what was done and how it was done, in terms of recruitment, management, and manipulation of data, an appraisal of the executed grounded theory approach. The second last section entails the limitations of the current study while the last section is a summary of the important factors that have been discussed in this chapter.

Philosophical Aspects (Research Design)

This is a detailed discussion of the interplay between quantitative and qualitative paradigms of research (Taylor et al., 2016). A justification of the choice of grounded theory, as a theory of addressing data collection and analysis methods is also included.

Qualitative or Quantitative

Gordon (2019) describes quantitative research as predominantly concerned with the collection and analysis of data that are numerically presented by validated processes and generalizations, for instance, confirmatory data analysis. To carry out this type of research, pre-specified questions are necessitated and the subsequent data collection techniques are orientated on the discovery of significant information. On the other hand, he describes a qualitative study as one that assesses inherent qualities and properties that are less measurable as compared to quantitative data , but are still of satisfactory resonance to promote the understanding of the researcher’s experience. Among the range of the grounded theory that underlies qualitative studies, includes revealing of findings that can substantiate various theories (Tracy, 2013). To this end, this study implemented the qualitative research approach. This is because the objective of the study was not to explain human behavior based on universally applicable laws or generalizations, but to present a deeper understanding and interpretation of the intentions that underpin everyday human actions (Neuman, 2019).

Grounded Theory

Grounded theory is a subset of qualitative research in which the data that is collected is the principal source of theory development (In Bush et al., 2016). As such, it is impossible to avoid influences from data sources such as literature that is pertaining to the topic. The prefix ‘grounded’ is relevant since the concepts from the data from the basis of the theory. The theory stems directly from the data, that is, the theory if grounded in the data. Since the purpose of this study was to explore the effects of substance abuse among the young people, a qualitative approach is thus the more effective method to gain insights and perspectives on the subject matter.

Research Context/Setting

The research was undertaken across various social settings in the United Kingdom. However, the majority occurred in the direct school setting of the researcher. Substance abuse among the youth has been a pervasive problem in the UK and there are a number of rehabilitation centers all over, both private as well as state-owned (Drugabuse.gov., 2019).

Role of the Researcher

As a student, conducting this research within the specialist sphere required that the researcher communicates to fellow colleagues on the recruitment and data collection practicalities. Since the pre-existing relations are based on the role as a student, any research activity that was conducted had to be clearly defined.

Relevance to Practice

The role of the researcher demands that evidence based practice is ensured. This demand gives the researcher the authority to be able to carry out the research as required, with any accompanying support or funding if need be.

Application of Reflexivity

Reflexivity is an approach that conveys to the readers what is going during the research and the successive reasons why. Reflexivity demands a rationale for every research decision that leads to any particular direction (University of Pretoria, 2016). In adapting to this concept, the researcher was aware that despite observing data neutrally, personally bias was likely to be present, especially with regards to prior knowledge which might intrude on data collection and analysis.

Research Quality and Rigor (Pretest)

The researcher considered several significant quality concepts to show the overall quality and integrity of the study.

Construct Validity

The assessment of phenomena that entail human behavior such as substance abuse is a bit different from other studies of complex issues. This might make it a bit harder to achieve construct validity. Nevertheless, the researcher undertook to strengthen this current study by finding data from a wide range of sources as possible. By using multiple sources triangulation, the author constructed a research design that enabled collection and refining of relevant data (Williams, 2019).

Reliability and Credibility

Credibility and reliability deal with the focus of a study and the confidence in how well the intended inquiry is answered by the data collection and analysis processes. To ensure these, the author of the study made sure to only obtain the best sources of data. Further to this, consultations with the academic supervisor also helped in identification of any flaws.

Workability and Dependability

Workability and dependability entail the extent to which the study findings are applicable within other settings and to other groups. In order to facilitate this, the results of this study have been presented in way that reflects the experience and context to which they are true people in other settings.

Understanding and Modifiability

This is construct is concerned with the extent to which a research may be replicated in the future. To this end, a detailed description and in-depth coverage of all the study processes has been presented.

Data Collection

As previously mentioned, the grounded theory addresses various qualitative techniques in terms of data collection and analysis. The following section is therefore a description (in chronological order) of the procedure and approach adopted for the study.

Sampling

The sample design entails the selection of cases for observation. The study used both probability as well as non-probability methods of sampling at different stages. The probability sampling method that was used is the random sampling technique while the non-probability method; purposive sampling. The researcher randomly selected students, and then those who were willing consequently participated in the research. Purposive sampling was used to carry select participants who are experts in matters of substance abuse, for personal interviews.

Methods

The section sets out the procedures that were used in the data collection and analysis process. The selected participants from the random and purposive sampling were all interviewed while some were also invited to join and participate in focus group discussions. These interviews and focus group discussions were then recorded in audio tapes and then transcribed.

Collection of Data

Unstructured Interviews

The researcher carried out individual unstructured interviews in which the respondents and participants were asked to contribute by saying anything that they felt was interesting or significant or any experiences that relate to substance abuse among the youth (Sanders et al., 2010). In any case the participant could not talk freely; the researcher gave out prompts of a more general nature, for instance reminding them about drug abuse and then asking how, if at they had been previously affected in any way by it. After establishing a rapport, the participant then freely led the conversation. Since both of the participant and the researcher were all aware of the topic and the reason for the interview, cases of deviation were rare. In any case there was a deviation to another subject matter that was apparently unrelated, the researcher asked the participants why. Most of the times, a good reason was then presented and a logical connection, if any, described, which in turn reveals the breadth and depth that substance abuse had influenced their lives. A characteristic example may be disharmony or family breakdown (Petruzzi et al., 2018). Using an unstructured interview and meandering stories ensured better contextual detail and historical information on th experience. As such, the themes were anticipated to be led by the participants themselves and thus informed by their sense of salience and not the researcher’s.

Focus Groups

Similarly, the focus group discussions were also unstructured, but nevertheless, confidentiality and other ground rules involving conduct, respect and politeness were highlighted and observed. The focus groups had a small enough number of members, usually between 2 - 10 individuals which in turn ensured that no social inhibitions were exerted. The discussion topics progressed as the themes were identified. For instance, themes on matters such as harm reduction, counselling, advice were all described, audio taped and written down in transcription (Skogen et al., 2014).

Data Sources

To recruit participants, permission was requested from the academic department to conduct the investigation within peers in the school. After a formal approval, the next step was to recruit the participants from a target population. The target population in this case consisted of both male and female students from the school. The various data collection methods described in the precious sections were then used to obtain information about the topic. Data was also collected from a critical and in-depth analysis of various literature and body of knowledge on the subject matter. This entailed searching for credible sources, and then accordingly developing theories based on the insights and findings of these previous works which include a wide range of academic articles, journals, books, magazines etc. that addressed the topic of substance abuse among the youths. The theory development section contains more detailed information on the data collection from these secondary sources.

Search Terms (Theory Development)

Theory Development

This section is a description of the theory development process on how the coded themes were deconstructed from an assessment of previous works of literature and existing body of knowledge on the subject matter.

Core Themes

For the facilitation of development of theories of generalizable proportions, this current study employed a comparative analysis. This was done by researching the subject matter of inquiry as a whole rather focusing one particular aspect, for instance a single unit or group. Constant comparison entailed the discovery of some of the basic conceptual elements from the data sources and then contrasting to find out any similarities or dissimilarities, in events or situations (Nishizaki et al., 2015). The concepts are elicited and then analyzed using a series various techniques that enable the development of substantive theories to support the hypotheses and propositions and then form a context for the theoretical comparison of aspects. The decision of where to collect the data from was vital and posed a little dilemma at a point. Therefore, high volume data collection was confined to various formal and informal information sources including newspapers and televisions.

Inclusion and Exclusion Criteria

The researcher carried out a key-word and key-phrase search for terms that are related to the core themes of the study. This was done ion electronic databases such as CINAHL, EMBASE, MEDLine, Cochrane and PsychLIT. Various internet search engines were also used. Consequently, themes that directly related to the current topic of inquiry were selected while those that didn’t were left out.

Data Analysis

The data analysis process entailed systematically arranging the various transcripts, organizing it, breaking into manageable units, synthesis, looking for any patterns and discovering what is significant (In Rezaul,2019). All the data sources, including the secondary existing literature, were analyzed thematically. This involved the identification, assessment and reporting of patterns and themes in the collected data. Thematic analysis is crucial for the unearthing of any themes that are salient in a text, in relation to the inquiry topic to facilitate structuring, depiction, as well as the development of the hypotheses and propositions.

Data Summary Table of Journals

Ethical Considerations

The various ethical issues considered in the study are as discussed below:

Permission to Conduct Study:

As aforementioned, permission to conduct the study was obtained from the academic department of the school and the supervisor.

Debriefing

During the selection of participants for interviews and focus groups, the purpose and procedures of the study were clearly explained. This was in an attempt to remove any misconceptions about the study that they might have had.

Voluntary Participation

Participants were all made aware that participation was voluntary and that they were free to withdraw any time should they decide so.

Informed Consent

The researcher made they had obtained informed consent from the willing participants

Confidentiality

All the participants were made aware that any information obtained from them were to be treated as confidential.

The only major limitation experienced is the wide array of secondary sources that are available with data and findings about the subject matter. This made it quite hard to specifically decide which sources to use and which to leave out. However, the author managed to work around the limitation by conducting in depth research before choosing the sources.

Chapter Summary

The chapter has given a rationale for the research methods that were employed in this current study. The aspects discussed include: the setting, data collection and analysis, ethical considerations, ways of participant recruitment and the limitations of the study. The next chapter will present an analysis of the data.

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