Lived Experiences with Quality of Life Among Makonde Immigrants during Covid-19 Pandemic

Chapter 1

Since the outbreak of COVID-19 and its subsequent declaration as a pandemic, the Pandemic has since caused havoc in every aspect of individuals’ lives, from economic crises to adverse social and health impacts. One group of people who have arguably experienced the impact of the Pandemic much more are immigrants all over the world. While immigrants living in developed countries might have experienced less impact, the immigrants living in developing and underdeveloped nations could be experiencing harsher impacts. It is worth noting that immigrants experience several vulnerabilities such as increased poverty cases, overcrowded job spaces, and housing which further hinder the physical distance as a measure to control the spread of COVID-19 hence exposing them to many risks. One such immigrant groups are the Makonde in Kenya. Therefore, this chapter describes the perceived quality of life among the Makonde immigrants during the COVID-19 Pandemic. In addition, the chapter describes the gap in research knowledge, the purpose of the study, and a justification of the conceptual or theoretical framework.

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The Study Topic Relevance

This study focuses on the perceived quality of life among the Makonde immigrants during the Covid-19 Pandemic. As earlier indicated, the Pandemic has negatively impacted several groups of people, among them, the immigrants. Like many other groups of immigrants, the Makonde immigrated to Kenya and have been living in Kenya for years. Even though they have in the past experienced various problems as other immigrants do, not a lot has been known about the impact of COVID-19 on their quality of life. The study of the quality of life is key as the findings of such research can be instrumental when planning for health promotion efforts and strategies to improve the quality of life of similar populations or groups of people or make life better for individuals or groups of individuals under similar contexts.

According to Gonzales et al. (2021), quality of life is defined as concepts that include the perception people have regarding their life experience, such as cultural, emotional, social, and physical well-being. Current research indicates that quality of life can be determined by overall satisfaction on an individual based on health conditions, functional status, the availability of resources, policies that are enacted to effect social changes, and economic gains on the ground (Nangia and Gingrich, 2020). Therefore, it is imperative to study various circumstances surrounding various individuals to ensure that the quality of their lives is affected for the better. Rocha et al. (2021) explained that the pandemic outbreak affected every sphere of daily life and devastated and impacted marginalized groups like refugees and immigrants in equal measures.

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As of this writing, there had been numerous research conducted on how Covid-19 has impacted Latino immigrants, African Americans in the United States, people in Europe, and another part of the globe, but few or none of these writing mentions Makonde immigrants in Kenya. Little is known about how Covid-19 impacted Makonde immigrants and the effects on their quality of life. Currently, there are no studies that have specifically explored the quality of life of the Makonde immigrants in connection to the Covid-19 Pandemic. The International Organization of Migration (IOM, 2020) reported that immigrants, in general, are vulnerable people in their new homes, and their well-being has been impacted by the Covid-19 Pandemic due to losing employment, being sick, and losing their loved ones from the Pandemic.

According to UNHCR (2020), the lockdown imposed by the governments across the globe affected migrants and refugees who depend on hard labor to support their families, resulting in increased risks to diseases, malnutrition, and domestic violence. During such lockdowns, families were forced to stay at home, hence loss of income, which even worsened the condition of the immigrants. Other researchers have also conducted various research regarding immigration or immigrants and the Covid-19 Pandemic. For example, Andale et al. (2020) asserted that social, economic, and political problems facing migrants cause mental and psychological problems and, therefore, a need to conduct more research on their quality of life. Also, Machado and Goldenberg (2021) found that the Covid-19 Pandemic affected the quality of people’s lives by causing fear, anxiety, and depression.

Social change implications.

Social changes refer to various changes in relationships and interactions capable of transforming the social and cultural institution. Such changes are known to happen over a duration of time and usually have substantial long-term impacts on society. Therefore, this section focuses on the social change implications of the project. The study is significant in that the quality of care of immigrants is a social problem. Afonso (2005) explains that when the government adopts policies that curtail immigrants from being employed, social problems arise and lead to massive unemployment and the inability to financially support themselves and their families. Inability to be employed leads to poverty and the inability to be medically covered by employees.

Many immigrants do not have medical coverage thus unable to access medical care during the Covid-19 Pandemic. The quality of life of immigrants is a social problem. According to Mocanu (2020), when inquiring about immigrants’ quality of life, factors such as healthcare, education, social belonging, religious beliefs, social belonging, and life expectancy are important and need to be addressed. Like many other immigrants in various parts of the world, the Makonde immigrants in Kenya have been experiencing various challenges and difficulties. However, such challenges and difficulties have only been compounded by the coming of the Covid-19 Pandemic. This study is significant as it seeks to find out the quality of life of Makonde immigrants in Kenya and how it had been impacted by the Covid-19 Pandemic. The findings of the study may suggest what to improve about the quality of life among the Makonde community.

The Gap in Research Knowledge

Although researchers have investigated this issue, the topic has not been explored in this way. Little is known about Makonde immigrants who are considered vulnerable populations and who have lived in Kenya for many years as immigrants and their lived experience with the Covid-19 Pandemic. There is a gap in knowledge regarding their Experience with Covid 19 pandemic. Even though Covid-19 has had serious health implications on everyone around the globe, from millions of deaths to hundreds of millions of infections, there is a glaring gap that few studies have explored the perceived quality of life among immigrants. Specifically, no study exists that explores the impacts of the Covid-19 Pandemic on the perceived quality of life among the Makonde immigrants in Kenya during the Covid-19 Pandemic. Madzivhandila (2020) asserted that the Experience of Covid-19 and its impact on quality of life on immigrants had been extensively researched in Europe, Asia, and the United States of America and none in developing countries like Kenya, Zimbabwe, and other Sub-Saharan countries. The gap in knowledge causes concern for governments and the international community to assist vulnerable groups of people, more especially in developing countries with no resources and inadequate healthcare, to combat the Pandemic.

Justification of The Research Problem

Immigrants as a group of people have faced several problems wherever they go, from economic to social problems. The implication is that the immigrants are usually vulnerable due to these problems, therefore threatening their quality of life. From the Centers for Disease Control and Prevention recent data, factors such as underlying medical conditions coupled with limited health care access have proven to expose the immigrants to an enhanced risk of more severe pandemic illness when compared to other populations. Besides, immigrants are more likely to have their residences and places of work in highly populated environments which are high-spreading environments for the virus (Rafieifar et al., 2021).

Before the COVID-19 outbreak, the experiences and perceived quality of life of immigrants have had been studied under the focus of other life quality threatening situations. Even though various researchers have studied the impact of the Pandemic on various immigrants and other groups, not a lot is known about the effects of the Pandemic on the perceived quality of life of the Makonde immigrants in Kenya. This study, therefore, is relevant to the field as it will shed more light on how the Pandemic has impacted these immigrants’ perceived quality of life. There is a lack of information and literature on how the Makonde immigrants of Kenya detailing their quality of life and lived daily experiences with the Covid-19 Pandemic. However, various existing studies look into other groups of people, such as Latinos and other ethnic minorities in the United States of America.

The Purpose of the Study

The purpose of this qualitative study is to explore the lived experience related to the quality of life among Makonde immigrants related to their experience with the Covid-19 Pandemic in Kenya. This study will utilize a qualitative phenomenology design. According to Akar (2020), phenomenological research can be useful to learn and learn the lived daily Experience of Makonde Immigrants in Kenya with the outbreak of a covid-19 pandemic. About 10-15 participants will be recruited into the study and will be presented with qualitative questions regarding their daily lived experience to covid-19. According to Criswell et al. (2007), the phenomenological study aims to collect views and how participants experience and their perception of the phenomena. The experiences and statements from the participants are recorded or written, and themes are made and analyzed to understand the phenomena (Patton, 2015).

The purpose of the qualitative study is to explore the lived experience related to the Quality of life among Makonde immigrants and their lived daily experience with the covid-19 Pandemic in Kenya. UNHCR.org (2021) approximated Makonde immigrants in Kenya to be around 6000 persons. Originated from Tanzania and Mozambique to work in sisal and sugarcane plantations in Kenya in the 1930s due to political conflicts and economic conflicts (Paolo, 2020). They settled in the coastal towns of Kilifi and Kwale Counties in Kenya without recognition, and this made it difficult to obtain identification cards, register for phone services, seek employment, granted loans to start a business, or pay for school fees to attend colleges.

Families of Makonde immigrants who have properties were unable to register and receive ownership due to a lack of identification documents (Waruru, 2017). Also, according to Higuera and Ramirez (2018), Makonde immigrants were forced to move from their original homeland due to Chikungunya fever that became a global pandemic in 1953. They lived in these two counties for many years as stateless people until 2017, when the Kenyan Government decided to grant them citizenship. On immigration, education, sense of community, and mental well-being, Agyekum et al. (2020) highlighted the need to conduct more research on immigrants and their quality of life since one of the reasons why individuals move from a place to settle elsewhere is because of the quest to improve quality of life. Although there is research on immigrants and the quality of life in their host countries, none has been conducted on Makonde immigrants in Kenya and their daily lived Experience of the Covid-19 Pandemic.

According to Urzua et al. (2019), quality of life is attributed to psychological well-being and positively linked to people having purposeful engagement in life, being able to realize personal goals and achievement, and the ability to self-knowledge. Quality of life can enhance a stable equilibrium and balance that can be altered by daily life or alteration in daily experience and events like immigration and legal status. To improve quality of life, immigrants often face many challenges to adapt to their host countries. There is a need to research the quality of life of immigrants even after gaining citizenship in their host countries. Understanding factors to improve well-being to a quality of life, more especially to immigrants like Makonde in Kenya.

The international organization of Migration (IOM,2020) explained that immigrants are vulnerable people in the region. Their livelihood has been impacted by the Covid-19 Pandemic due to losing employment, being sick, and losing loved ones from the Pandemic, thus highlighting the need to study the quality of life of immigrants. According to UNHCR (2020), the lockdown imposed by the governments across the globe affected immigrants and refugees who depend on hard labor to support their families and increased risks to diseases, malnutrition, and domestic violence.

Andale et al. (2020) asserted that social, economic, and political problems facing migrants are the greater cause of mental and psychological problems and, therefore, a need to conduct more research on their quality of life. Also, Machado and Goldenberg (2021), in their research, found that the Covid-19 Pandemic provided insight into social and economic inequalities facing immigrants. Thus, more research needs to be carried out on how to address equity, discrimination, and interventions and to put policies in place that meaningfully improves the quality of life of immigrants and everyone in communities both locally and internationally.

Research Questions

Research questions are an integral part of a research effort or research process as it acts as the guiding light for the researcher. Therefore, it helps the researcher to remain on course as they accomplish the research effort. Therefore, the following research questions were developed to guide this research:

What is the perceived effect of Covid-19 on the quality of life among Makonde Kenyan Immigrants?
What are the lived experiences related to the quality of life among Makonde

Immigrants?

The Theoretical or Conceptual Framework Justification

The theories and/or concepts that ground this study include the quality of life conceptual framework. This framework covers a multidimensional aspect ranging from the positive and negative aspects of life. These life aspects cut across environmental health, religious beliefs, freedom, security, wealth, employment, education, family, mental health, and physical health (Zubritsky et al., 2013). At the environmental level, the quality of life framework entails functional status, actions, and practices that impact the population’s health perceptions, policies, conditions, and resources. On the other hand, the mental and physical health perceptions such as socioeconomic status, social support, functional status, and health conditions and risks.

The quality of life conceptual framework has been applied widely to measure social perspectives concerning the effects of illnesses with the focus of improving patient safety and efficacy of various interventions (Zubritsky et al., 2013). This model will be useful in examining the experiences of the Makonde immigrants regarding the Covid-19 Pandemic and the impacts of the same since the model also deals with the well-being components, which are usually impacted by progressive changes in social support healthcare, and health status. The adverse impacts of Covid-19 on various groups of people are well documented the world over; therefore, the quality of life model is a key construct in the evaluation of the impacts of Covid-19 on the quality of life of the Makonde immigrants.

According to Ojelabi et al., 2017, the most used quality of life framework is the proposed model by Wilson and Cleary. This model categorized patient outcome measures depending on the underlying health concepts that they depict and puts for the particular causal relationships between various health concepts. Even though spiritual, cultural, political, and economic factors can impact an individual’s life quality, health care professionals focus more on the clinical aspects. The proponents of this conceptual framework, therefore, proposed various domains such as general health perceptions, mental health role functioning, social functioning, and physical function (Wilson & Cleary, 1995). Therefore, this model is key in understanding the impacts of Covid-19 on various life aspects of the Makonde immigrants. In addition, the research question is aligned to the model in that the theory’s underpinnings can be used to enhance an understanding of the Makonde’s daily lived experience during the Covid-19 Pandemic and therefore improve their quality of life. Abal et al. (2021) explained that quality of life gives individuals provisions and opportunities in the society in which they live to thrive in happiness, well-being, and satisfaction in their daily endeavors.

According to Nangia and Gingrich (2020), immigrants have been identified in the literature to be more likely to be at risk to have diminished health and reduced healthcare access, thus affecting their quality of life. Covid-19 pandemic outbreak around the globe led to several measures to curb its spread, among them working from home, unemployment because people would not access the working place, curfews ware enacted, and transport halted. These activities led to several stressors such as economic downtown and the inability to access basic needs due to curfews. The quality of life model can be used to further gain an insight into the resultant impacts, particularly among the Makonde immigrants.

The quality of life conceptual framework proposed by Wilson and Cleary has widely been used in research showing its versatility. In one of the studies, Brunault et al., 2015 conducted a cohort study on obesity to determine the postoperative change predictors in various quality of life dimensions using the quality of life model. The model was effectively used, and the researchers obtained various results. Key among them is the improvement in the quality of life connected to the psychosocial factors was connected to higher weight loss, the severity of binge eating, and the lower preoperative depression severity. The research also revealed that there was enhanced comfort with food connected to the lower preoperative binge eating extent.

According to Carlson et al. 2014, ethnicity/race, gender, and age are predictors of overall perceived health. This research was conducted on heart failure as a chronic condition to determine the overall perceived health predictors. According to this study, the model was key in studying various factors connected to the overall perceived health. Race, particularly being white or black, symptom stability, comorbid burden, social functioning, and perceived income sufficiency were found to be independent predictors of the overall perceived health.

Eilayyan et al., 2015, also conducted a study based on the quality of life model to identify the indirect and direct predictors of perceived asthma control in a chosen population. By using the model as a foundation, this research revealed various important points regarding asthma. For instance, they found out that asthma symptoms are influenced by self-efficacy while emotional status is impacted by self-efficacy and symptoms. In addition, while physical activity was impacted by self-efficacy, emotional status, and symptoms, the perceived asthma control at the baseline was influenced by smoking, self-efficacy, physical activity, and asthma symptoms.

From the studies showing the use of the model in various research efforts, it is evident that this is a robust model that can be used applied in various incidences and circumstances to underpin a study. Therefore, the model applies to Makonde immigrants in Kenya who have been impacted by Covid-19 to study the perceived effects of Covid-19 on their quality of life and the lived experiences related to their quality of life.

The Nature of The Study

To address the research questions in this Qualitative study, the specific research design will include Qualitative research with a phenomenological design where participants will be purposefully be selected. The selection of the participants will be voluntary. About 10-15, both men and women aged 18 years and above participants will be sought for this study from among Makonde immigrants from Kwale and Kilifi counties in the coastal town of Kenya. Data will be collected via in-depth interviews with open-ended questions and through observation. Data collected from participants will be analyzed using Colizzi’s phenomenological approach, where themes and categories will be widely and extensively be scrutinized analyzed to bring forth the essence of the phenomena (Jesmi et al., 2021). Upon accepting to be part of this study. The consent form will contain my contact and school information in case they have further questions that need to be answered. (Patton, 2015).

Chapter 2

For years, migration to new countries or environments has been a mainstay since individuals and families travel and live in new places with the hope that they would have better life opportunities. When individuals migrate, they settle among new people exhibiting, in most cases, completely different cultures and cultural practices. As such, the well-being, health, and quality of life of such immigrants depend on various factors such as the kind of reception received and the integration into their new community.

While the immigrants can be integrated into their new communities and live a normal life, in most cases, they remain vulnerable to various life threats that threaten their quality of life. Among them include disease outbreaks, illnesses, and pandemics. The implication is that the health, well-being, and quality of life exhibited by immigrants remain an area of interest as researchers strive to solve the problems facing immigrants and how best to improve their quality of life. Therefore, this chapter focuses on the literature review of the relevant material that relates to a meaningful and justified gap in research for this thesis. In addition, the chapter also explores the ground dissertation research in a theoretical or conceptual framework related to the social-educational problem.

Literature Review

In one of the recent studies, Agudelo-Suarez et al. (2019) conducted a study to determine the health-related quality of life and connected factors among immigrants in Spain. This source described the factors related to the quality of life of immigrants, including socioeconomic, political, and environmental factors. The researchers analyzed the variables using bivariate analysis of OHIP-14 dimensions. In addition, they also used a multivariate linear model to examine the associations between individuals’ immigration status and the quality of life. From the analysis, the researchers found out that some of the factors that affect the quality of life of immigrants are unemployment, immigration status, and lack of medical insurance coverage (Agudelo-Suarez et al., 2019). This is important to the current study because it supports my research question by explaining the factors that affect the quality of life of immigrants.

In a similar study, Sanchez-Ojeda et al. (2020) conducted a study with the aim of attitudes towards the immigrant population. Part of the study focused on immigrants around the globe and their reasons for emigrating. Among the prominent reasons discussed in this article include the urge for better life quality. From the analysis of these researchers, they observed that due to immigration, there exists diversity and intercultural interactions among the immigrants and the indigenous people. The researchers also argue that the problems facing immigrants can be addressed from various perspectives. For example, various contents should be included as part of the curriculum for nursing students to help them develop a better and more positive attitude towards immigrants. Some of the contents they describe include cultural competence, interculturality, cultural diversity, migration. When taught in schools and colleges, these concepts can be instrumental in eliminating stereotyped and prejudicial attitudes towards immigrants, hence contributing to improved quality of life among the immigrants (Sanchez-Ojeda et al., 2020). As in the previous study, the findings of this study are important because it supports my research that immigrants immigrate to improve quality of life and what can be done to improve their quality of life.

Zhiwen et al. (2020) also conducted a study focusing on Asian immigrants, especially the Vietnamese and the Koreans. These researchers focused on health literacy, health status, and the quality of life. These researchers conducted an analysis using structural equation modeling. Several factors were found to affect the life quality of these individuals, for example, health status, health literacy, utilization of health services, health insurance, English proficiency, marital status, education, and demographic differences. From the accomplished analysis, the researchers noted that communication about health could alleviate health illiteracy (Zhiwen et al., 2020). Besides, they also noted that immigrants and ethnic people are likely to have health illiteracy and lower quality of life. Of importance, the study also revealed that individuals from the Asian continent are all usually referred to as Asian immigrants; however, the perceived quality of health differ from one group to the next. For example, the immigrants from Vietnam and Korea explored in this study were found to present different aspects, indicators, or factors that contribute to the quality of health. They include health insurance, English proficiency, education, visit to the doctors, colorectal screening, self-perceived health status, and health literacy (Zhiwen et al., 2020). This study is also important because it describes factors that can improve quality of life, thus in support of the qualitative research question.

In another recent research, Kim et al. (2019) conducted a study to examine the connection between social capital, living conditions, and quality of life among the older immigrants of Chinese origin. From the analysis, it was noted that these older Chinese immigrants’ quality of life is substantially impacted by various factors such as whether they have children and spouses or not (Kim et al., 2019). Other factors noted include political participation, community partnerships, trust, and social capital. In addition, various findings were noted from the study. For example, quality of life encompasses factors that affect social-economic, well-being, religious, and environmental factors (Kim et al., 2019). Also, social capital is described as a way to connect with the community, the government, and the public. Therefore, this research is equally important because these factors touch on the quality of life, which is also an area of focus for this study among Makonde immigrants in Kenya.

Another study also focused on the impact of isolation on older immigrant individuals. Lai et al. (2020) carried out this study with an effort to explore the impact of a peer-based intervention when used in reducing social isolation loneliness and enhancing the older Chinese immigrants’ psychosocial well-being. The researchers focused on immigrants and their problems in settling down in their host countries due to cultural and language issues. Various solutions were found to be instrumental in addressing the problems. For example, peer-based groups can help address issues coming such as depression, isolation, and helplessness (Lai et al., 2020). Peer-based groups address issues of self-maintaining, physical activities, and health behavior like avoiding drinking and smoking. The findings of this research are important since it supports the qualitative research question by describing factors that can improve the quality of life among immigrants.

Prapas & Mavreas. (2019) explored the quality of life of some immigrants living in Greece, focusing on life satisfaction, psychological well-being, and quality of life among Pontic Greeks and Albanian immigrants. The researchers looked at what is perceived as the quality of life and the daily life experience in the communities, friends, neighbors, and the surrounding. From the analysis, the researchers found out that quality of life includes physical health, mental health, relationships, and personal beliefs (Prapas & Mavreas, 2019). Again, the researchers noted that connecting immigrants with communities impact the quality of life. In addition, this research also revealed that governments enhance the access to resources that support the improvement of quality of life among immigrants, highlighting the importance of government support programs. The relevance of this study to the current research is that it gives evidence as to why immigrants need resources to improve their quality of life.

Urzua et al. (2017) also carried out a study to determine the impact of acculturation strategies on immigrants’ quality of life. The study focused on Peruvian and Colombian immigrants living in various cities of Chile. From the analysis, the quality of life is impacted by social and psychological factors. One of the factors that are more beneficial to the individuals is those factors that enhance retention and maintenance of the homeland culture. The study found out that lack of or insufficient strategies of maintaining the homeland cultural practices are is connected to lower quality of life among these Peruvian and Colombian immigrants (Urzua et al., 2017). Again, the marginalized strategy was also seen to be closely connected to reduced quality of life. The study also focused on the general issues of immigration and immigrants and documented that the immigration process can bring fear, loneliness, and longing problems. One of the consequences of immigration is isolation and isolation, which can cause depression and alter normal connections, thus affecting relationships (Urzua et al., 2017). Therefore, the study explored several factors that can hinder the quality of life among immigrants. Therefore, it also supports the focus of the current research.

Molina & Yalcinkaya (2020) also conducted a study focusing on immigrants. The study focused on the reasons why people migrate from one part to another and some of the factors that may make an individual or group of individuals seek naturalization and citizenship. One of the major reasons is to settle down in the countries of destination and to seek citizenship. Various factors motivate immigrants to seek citizenship in their host countries. For example, the Immigrants would like to be citizens in their host countries to be eligible to own properties, access healthcare, and be involved in the voting process (Molina & Yalcinkaya, 2020). In addition, this research found out that the immigrants also usually seek naturalization as a way to be recognized. Indeed, acquiring citizenship helps immigrants to have a better quality of life. This study is also important because it brings forth the issues of immigrants and the process of being citizens and the factors that can improve their quality of life, thus supporting the current research.

Tuohy (2020) focused on a discussion on the relationship between immigration, healthcare, and healthcare disparity. The author argues that immigrants and ethnic groups are more likely to have problems accessing healthcare due to immigration status, thus affecting the quality of life. In some cases, immigrants get restrictions when trying to acquire valid papers or documents that can make them stay legally in the host countries. The authors also argue that undocumented immigrant adults who managed to arrive in the USA as children are similar in various ways to the immigrant children born in the USA (Tuohy, 2020). However, they face more barriers in terms of integration; hence care access is caused by a lack of legal status. The enactment and application of the Obama Care or the Affordable Care Act has been playing a key function in improving access to care to the immigrants hence improving their quality of life (Tuohy, 2020). Therefore, the government and policymakers should enact policies that are non-discriminatory towards immigrants in accessing healthcare. This study is also relevant and important because it supports the notion of the need for high or better-quality care for immigrants. Therefore, the study supports qualitative research.

Albert. (2009) also performed a study to explore the citizenship status role on the possibility of immigrants living in poverty and the possibility of getting various social benefits. From the analysis, this paper found out that the children with citizenship but being taken care of immigrants have more possibilities of experiencing poverty, fewer chances of getting cash assistance, and likely to receive lunch subsidies than those with caretakers with citizenship (Albert, 2009). Besides, non-citizen children being taken care of by non-citizen caretakers are the highest likely to live in poverty and far much less likely to receive cash assistance, hence the lowest quality of life. The implication is that such children end up having a low life quality as compared to others, indicating the importance of factors like caretaking on the perceived quality of life among the immigrants (Albert, 2009). Besides, the paper focused on challenges immigrants face, such as poverty, unemployment, and social isolation. They also lead tougher lives as the income among immigrants appears to be lower than the income of the native population. The author also argues that factors such as unemployment and poverty can affect the quality of life as individuals lack sufficient amounts of money to access healthcare services and eat healthy foods (Albert, 2009). The findings of this research are important because it presents factors that can affect the quality of life of immigrants, thus supporting the study of the quality of Makonde immigrants in Kenya.

Again, Parsuad (2020) focused on the problem of immigrants and the challenges they meet in their host countries. The author argues that government should strive to help immigrants to access healthcare for a better quality of life. Even though COVID-19 impacted everyone negatively, the undocumented immigrants and various ethnic minorities were most affected during the outbreak of COVID-19. The implication is that better efforts and improved strategies should be applied in ensuring the immigrants and the ethnic minorities get enough assistance during such times. The findings from the research are relevant and important because this article provides evidence that immigrants around the globe were severely affected and that policies and laws need to be enacted to support them, thus supporting my research topic.

Recently, Cleaveland & Waslin (2021) studied COVID-19 in relation to vulnerability and threat among Latina immigrants. The authors observed that the rates of death and infection from COVID-19 have been distributed inequitably in the United States of America, which as a result, has produced adverse health outcomes among vulnerable populations such as the Latina immigrants. Central to such a trend is insufficient access to health care and health insurance as well as low-paying jobs. Therefore, this paper focused on the vulnerability of immigrants and their problems with accessing healthcare. From the findings, the researchers noted that the government could help immigrants to access healthcare and health insurance for better life quality (Cleaveland & Waslin, 2021). A problem of immigrants with accessing healthcare can affect their quality of life and be vulnerable to diseases like COVID-19. This article discusses the vulnerability of immigrants to be more likely affected by a pandemic like Covid-19 and therefore supports my qualitative questions, which are looking at Makonde immigrants and their quality of life with the Covid-19 outbreak.

Ground Dissertation Research in a Theoretical/Conceptual Framework

Among the most important aspects of research efforts is the theoretical framework. This theory-driven acting and thinking have to be emphasized in connection to the research analysis plan, research design, literature review conceptualization, formulation of research questions, and even topic selections. The importance of a theoretical framework in a research process has been discussed for years. It offers a foundation from which a researcher constructs (both literally and metaphorically) all the research study knowledge (Osanloo & Grant, 2016). It acts as an anchor and a foundation for the research questions, the research significance, the research purpose, the problem statement, and the rationale of the study. Therefore, this section focuses on the theoretical framework upon which this study will be based.

The Model Description

The theory and/or concepts that ground this study is the quality of life conceptual framework. This model categorized patient outcome measures depending on the underlying health concepts that they depict and puts for the particular causal relationships between various health concepts. Even though spiritual, cultural, political, and economic factors can impact an individual’s life quality, health care professionals focus more on the clinical aspects (Wilson & Cleary, 1995). The proponents of this conceptual framework, therefore, proposed various domains such as general health perceptions, overall quality of life, functioning, symptoms, and physical and biological factors.

As earlier indicated, among the domains are physiological and biological factors. They are important to this model as they are usually applied, measured, and conceptualized in routine clinical practice. This domain addresses the organ and organ systems and cells function. At this level, diagnoses of various conditions are included, for example, pulmonary wheezes. Again, factors whose impacts on health are primarily driven by changes in the function of the organ system, organ, and cell are included (Wilson & Cleary, 1995).

The other important component of this model is symptoms, whose assessments allow clinicians to give attention to the organism as a whole instead of focusing on a cell or organs. The model addresses various categories of symptoms such as physical symptoms psychophysical symptoms, which are usually connected to mental health, psychological or emotional symptoms. The model, therefore, describes the aspect of the symptom as a patient’s perception of abnormal cognitive, emotional, and physical states (Wilson & Cleary, 1995). The patient-reported symptoms play a big role in the costs and use of medical care and also allow the patient to be part of the medical system. This aspect will particularly be key in achieving the project’s goals as the Makonde immigrants will be asked through questionnaires to write down some of the impacts that Covid-19 has had on them.

The other part or domain of this model is functioning or functional status. This status is a measure of a person’s ability to undertake a specific task. The functioning status is impacted by various aspects, such as symptom status. For example, a person experiencing extreme pain due to a particular condition aggravating usually has a reduced functioning status. In addition, other aspects such as social environment such as supportive friends, families, and an overall enabling environment can all impact functioning status (Wilson & Cleary, 1995). Under this domain are four main sub-domains such as psychological function, role function, social function, and physical function.

The next component is the general health perception. This domain integrates various health concepts such as physical, emotional, social, and mental health, even though these are subjective ratings. The general health perception is key to the model since they are a prediction of the use of mental health services and general medical services (Wilson & Cleary, 1995). The authors observed that the general health perception and the functional status are closely connected. Again, even though the general perceptions are also connected to the physiological and biological factors, there is a wide range of factors impacting health perceptions; hence they vary depending on the patient or clinical setting. Perhaps the most important part of the model to the project is the overall quality of life. In most cases, the individual’s subjective well-being is assessed through various measures such as how satisfied or happy the persons are with their life. Subjective well-being has been widely used as a measure of the overall quality of life.

Figure 1: The diagrammatic representation of the quality of life conceptual framework.

The logical connections between the framework presented and the nature of my study include the alignment and concepts within the framework in the quality of life conceptual framework. The research question is aligned in the essence that the concepts within the model can be used to effectively unveil the daily lived experience of the Makonde immigrants during the Covid-19 Pandemic and therefore formulate various strategies that can help improve their quality of life. Abal et al. (2021) explained that quality of life gives individuals provisions and opportunities in the society in which they live to thrive in happiness, well-being, and satisfaction in their daily endeavors. Therefore, this model is key in understanding the impacts of Covid-19 on various life aspects of the Makonde immigrants. This model can effectively be applied by healthcare professionals concerned offering care to patients impacted by pandemics and various outbreaks such as Covid-19. The implication is that the healthcare professionals would have a better understanding of the real impacts of the condition and formulate better interventions, methods, or strategies that can be used in addressing the problem.

According to Carlson et al. 2014, the quality of life conceptual model can effectively be applied in studying ethnicity/race, gender, and age as predictors of the overall perceived health. This research was conducted on heart failure as a chronic condition to determine the overall perceived health predictors. According to this study, the model was key in studying various factors connected to the overall perceived health. Race, particularly being white or black, symptom stability, comorbid burden, social functioning, and perceived income sufficiency were found to be independent predictors of the overall perceived health.

The role of nursing practice is to integrate all these models in the process to promote definitive copying mechanisms for Makonde immigrants to adapt to challenges caused by the Covid-19 Pandemic to improve their quality of life. Castillo et al. (2019) explained that factors that affect the quality of life include social and physical determination like language, culture, access to healthcare services, and schools. Quality of life is also affected by psychosocial, political, economic, and environmental factors. In nursing practice, to give high-quality care, nurses and other healthcare givers often have to inquire about daily life experiences in their assessment and whether the patient can access medication, healthcare, and if the patient’s physical, social, psychological, emotional, and spiritual dimensions are stable. These factors strengthen and improve quality of life (Kim & Hocking, 2016).

Chapter 3

Research methodologies are central to research as it helps in explaining and exploring what methods are to be applied or were applied during the research process (Nieswiadomy & Bailey, 2018). Therefore, this section focuses on the justification of the proposed research design and methodology. As such various aspects will be discussed, for example, the procedure to be followed while performing the research, description of the methodology and design for the dissertation, the data sources to be used in answering the research question, and alignment in research design. In addition, other aspects that will be covered include research questions, a sample of participants, instrumentation, data sources, data collection, and a plan for data analysis.

The Research Methodology and Design

The plan for the study is to integrate various subjective and objective indicators and methodologies to study the perceived quality of life among the Makonde immigrants during the Covid-19 Pandemic. This study will use a qualitative study design that will focus on exploring the various themes arising from the Makonde immigrants and analyzing the themes to find out the perceived quality of life among the Makonde immigrants during the Covid-19 Pandemic.

Qualitative research with a phenomenological design where participants will be purposefully be selected. The selection of the participants will be voluntary. About 10-15, both men and women aged 18 years and above participants will be sought for this study from among Makonde immigrants from Kwale and Kilifi counties in the coastal town of Kenya. Data will be collected via in-depth interviews with open-ended questions and through observation. Data collected from participants will be analyzed using Colizzi’s phenomenological approach, where themes and categories will be widely and extensively be scrutinized analyzed to bring forth the essence of the phenomena (Jesmi et al., 2021). Upon accepting to be part of this study. The consent form will contain my contact and school information in case they have further questions that need to be answered. (Patton, 2015)

The targeted research design is a phenomenology design. A phenomenology research design in qualitative research entails a kind of design that explores a commonality of some experience among a particular group of individuals (Nieswiadomy & Bailey, 2018). The implication is that the design allows the researcher to come to a description of the nature of a specific phenomenon. Therefore, this study design will be key in helping to achieve the aim of describing the perceived quality of life among the Makonde immigrants in Kenya during the Pandemic. It is important to note that even before the outbreak of the COVID-19 Pandemic, the Makonde immigrants in Kenya were already experiencing various problems that were impacting their quality of life. Therefore, by using the phenomenology research design, the experiences and perceived quality of life among the Makonde immigrants will be described in relation to the COVID-19 pandemic outbreak.

Sources of Data to Answer the Research Questions

Research questions are an important aspect of the research process, and one of the major focuses of any research process is to answer the research questions (Nieswiadomy & Bailey, 2018). One of the strategies for answering such questions include data sources. As earlier indicated, this is relatively a new area, and therefore not a lot of data sources exist. One of the major sources of data to be used in answering the research questions is to obtain the primary data from the Makonde immigrants living in Kenya through various data collection methods, to be discussed later in this document. To support the research questions and the problem statement, various existing data will also be key. For example, a comprehensive literature review is key and reveals relevant data regarding the experiences and perceived quality of life among various immigrants under different circumstances.

Alignment in Research Design

As earlier indicated, the major purpose of this research is to explore the experiences related to the quality of life among the Makonde immigrants during the Covid-19 Pandemic. Therefore, it is important to align the research design to help to sufficient answering of the research design. This research purposes of using a qualitative research method. This method is aligned in that it will be the most effective method to help in describing various themes arising from the perceived quality of life among the Makonde immigrants during the Covid-19 Pandemic. Therefore, the methodology will be exploratory and will be key in revealing the feelings, thoughts, and opinions of the participants, which will hopefully inform new theories and concepts (Nieswiadomy & Bailey, 2018).

The research design; phenomenology study design is also well-aligned as it will be key in describing experiences and perceived quality of life in relation to a specific phenomenon which is the Covid-19 Pandemic. This design is also key as it will enable the performance of interviews with a specific group of individuals (Makonde immigrants) who have first-hand experience of what they perceive to be their quality of life during the COVID-19 Pandemic. Therefore, in unearthing the perceived quality of life, basic inquires will be important such as the experience of the individuals in terms of the COVID-19 Pandemic and how the situation has impacted their experience. Besides, this design allows a rereading and culling for like themes and phrases, which will then be grouped to create meaning clusters (Nieswiadomy & Bailey, 2018).

Research Questions Justification

Research questions are an integral part of a research process as they act as the guiding light and let a researcher stay on course to fulfill or achieve the research aim and objectives (Nieswiadomy & Bailey, 2018). Therefore, this section focuses on the research questions and the justification for using them. From the earlier discussions, two research questions were formatted:

What is the perceived effect of Covid-19 on the quality of life among Makonde Kenyan Immigrants?
What are the lived experiences related to the quality of life among Makonde

Immigrants?

These research questions were formulated to help in achieving the major purpose of the study, which is to explore the perceived quality of life among the Makonde immigrants. Therefore, the keywords for the research purpose were included as part of the research questions to help in addressing the research.

The Sample or Participants

This research aims to use focus groups. The participants of this research are the Makonde immigrants living in Kenya. The study is targeting to recruit individuals who are at least 18 years of age. The participants will be both men and women. Participation in the study will be out of a free will, and no one will be coerced. However, ethical approval will be sought and informed consent obtained from the participants. The participants will be the Makonde immigrants since this is the specific group of people on which the study is focusing on. The focus groups will also be used since this is a qualitative study that is seeking to gain an insight into an issue, which is the perceived quality of life among the Makonde immigrants during the COVID-19 Pandemic. Therefore, the data will be obtained from a purposely selected group of persons.

The ongoing cases of Covid-19 pandemic infections are expected to complicate matters of recruiting participants in the study. The plan is to travel to where the Makonde immigrants are currently living, in the Kwale and Kilifi counties in Kenya, and convince various individuals from the community to participate in the research and therefore recruit them as part of the research subjects. However, to make the process more successful, the strategy will be integrated with the use of phone calls to help in recruiting the targeted number of participants.

Instrumentation

Instruments form an integral part of a research study and, therefore, will be included in this section as part of the plan (LoBiondo-Wood & Haber, 2021). Therefore, various instruments such as data collection and analysis instruments will be explored. One of the instruments that will be used includes questionnaires for interviewing the purposively recruited individuals. The questionnaires will be formulated and specifically worded to ensure that all the required data is appropriately collected. As part of the questionnaire, aspects such as how the Makonde people perceived their quality of life during the Covid-19 Pandemic will be explored.

The other instrument that will be used for this research is the Perceived Quality of Life Scale (PQoL). This is a measure based on a model that defines the quality of life as an evaluation of the main categories of basic life needs. The current version of the Perceived Quality of Life Scale is composed of nineteen items, and every item has an eleven-point response scale. This instrument is scored based on the median and mean of the nineteen scores. In addition, various subscales scores of cognitive, social, and physical health satisfactions are also used in cases of a need for further analysis.

Data Collection

A data collection plan is important since it fosters an accurate and complete collection of the necessary data to be used in answering the research (LoBiondo-Wood & Haber, 2021). Various data points are targeted. For example, a demographic data point that includes the experience related to the Covid-19 Pandemic and the perception of quality of life of Makonde Immigrants will be targeted. Various methods will be used for collecting the needed data. For example, emails will be used as some of the questionnaires will be sent to participants who cannot make it to a physical or one-one interview on their experiences and perceived quality of life during the Pandemic.

Telephones calls will also be used as a data collection strategy; the participants who will be comfortable attending to the questions through telephones will be allowed to pick that option. However, the responses will be recorded for the purposes of data analysis and arrival at the required conclusions (LoBiondo-Wood & Haber, 2021). Tape recorders will form an integral part of data collection. During the sessions in the focus groups, tape recorders will be used to record the experiences of the participants. As earlier discussed, questionnaires will be important for the data collection process as they will have specific questions meant to get the needed information for answering the research questions.

Therefore, the following will be needed.

Tape recorders
Computers and computer software like words, spreadsheet

iPhone (optional)

Audio recorders

Data Analysis Plans

Analyzing data is important as it helps to come up with a targeted conclusion regarding a specific phenomenon. From the data collection section, one of the strategies to be applied is the use of interviews. The interviews will be transcribed for the data to be usable. The implication is that there will be repeated listening to the participant’s voices, which is key for an early analysis (LoBiondo-Wood & Haber, 2021). Coding of the transcripts will also be accomplished to enable identification of the themes arising from the participants’ opinions and thoughts on the perceived quality of life among the Makonde immigrants during the COVID-19 Pandemic.

Computer software will be applied in the data analysis. Past research efforts have revealed the importance of using computer software since they allow transparency and a clear purpose as well as logical theme deductions. Therefore, the first step will involve transcriptions which are preceded by data collection. The next step will then be data organization. Data organization entails a careful reading of the datasets or transcripts to understand them (LoBiondo-Wood & Haber, 2021). The major purpose of thematic analysis is to understand the patterns arising from the meanings of the data of the experiences, thoughts, and opinions as shared by the participants through the narratives or the interviews.

Therefore, the analysis phase commences with the data that should be in textual form, but the focus is to organize the meanings arising from the data into the patterns and then into themes. During the analysis, the designs allow the researcher to explore the aspects and details of the meanings that need reflective writing and reading (LoBiondo-Wood & Haber, 2021). For instance, analysis of parts of the textual data requires the researcher understands as a whole while also having to understand some other aspects that are whole as parts. It is worth noting that the analysis process may be complex, hence calling for flexibility from the researcher.

Data will be analyzed using Colaizzi’s descriptive phenomenological method, which Santoso et al. (2019) explained is highly effective in conducting qualitative phenomenological studies. The process involves a researcher to:

Be familiar with the data by reading the information collected from participants
Identify the statements under the investigation
Come with identification of the meanings and relevant information
Clustering themes and categories from the data collected

To write the description of the information and meanings from the phenomena and incorporate the themes verifying the fundamental structures asking if it captures the lived experiences.

Possible Barriers during the Study

In most cases, proposed studies usually have various barriers that have to be overcome if the study is to be a success. This study is to be conducted during unusual times as Covid-19 continues to impact traveling around the globe. Potential barriers include selecting participants for the interview among Makonde immigrant communities due to restrictions and curfews that were enacted to curb the spread of the Covid-19 Pandemic. Another challenge is traveling in the process of selecting participants since many airports have put up screening and restrictions of movement of people in the process of curbing the spread of Covid-19 (Haper et al., 2020). While I have never met the participants before, I can speak Swahili, which is part of their national language in Kenya.

Another barrier anticipated is the transport; I am new to the roads, and much time might be wasted looking for direction. Selecting participants might indeed be an uphill task. It might not be easy to convince the participants that the study is beneficial to them. The fact that I am a stranger in their territory may complicate the ability to recruit participants. I will travel to Kenya and Kilifi and Kwale counties. Start from the local government by visiting a police station and reporting my presence as a researcher and a student. I would request permission then I would start recruiting participants. I contacted the ministry of education about my traveling and carrying research, and they informed me that I am welcome to carry out research according to Walden University’s protocol. Because of these challenges, preparations are on top gear in financial arrangements and transport in the process of recruitment and collecting data. Another alternative method of recruitment and collecting data is a telephone interview in case the original plan proves difficult.

Conclusion

In conclusion, this research aims to explore the perceived quality of life among the Makonde immigrants during the COVID-19 Pandemic. Exploring the perceived quality of life is important. It helps the researchers come up with new knowledge on how to ensure that the quality of life of individuals and groups of individuals remains high even in the face of threatening situations such as pandemics. Therefore, in efforts to achieve the purpose of this study, qualitative research with a phenomenological design will be implemented where the participants will be selected through a purposeful selection. As a target, around ten to fifteen men and women of at least eighteen years of age will be recruited to participate in the study, and data will be obtained from them for analysis. The data will be collected from the participants through interviews, recorded, transcribed, and analyzed to unravel various underlying themes connected to the perceived quality of life among the Makonde immigrants during the Covid-19 Pandemic.

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BUY A CUSTOM- PAPER HERE

I am replacing the Calista Roys adaptive model and instead, using the Quality of Life Conceptual framework in the proposal paper. Please, bear in mind that this is a descriptive qualitative research study and not a phenomenolgy. So i have been infornmed by the chaor

Lived Experiences with Quality of Life Among Makonde Immigrants during Covid-19 Pandemic