Scielo RSS <![CDATA[South African Journal of Occupational Therapy]]> vol. 46 num. 1 lang. en <![CDATA[SciELO Logo]]> <![CDATA[<b>Occupational therapy past, present and future: Crafting our relevance with intent and foresight</b>]]> <![CDATA[<b>Job satisfaction among occupational therapists</b>]]> <![CDATA[<b>The value of a rural service learning experience for final year undergraduate occupational therapy students</b>]]> INTRODUCTION: Service learning is a form of practice learning employed by occupational therapy training programmes in South Africa, through which the call for universities to engage with communities is also heeded. Rural areas of South Africa have limited access to occupational therapy services, thus service learning engagements with rural communities is a pertinent consideration for occupational therapy training programmes. However, given the high resource demands of rural service learning engagements it was necessary to ascertain the value that such a rural service learning experience has for occupational therapy students. METHOD: A qualitative, descriptive enquiry design was utilised to describe the value of a rural service learning experience for final year undergraduate occupational therapy students. A purposive sample of twelve students who participated in a rural service learning placement in one year was drawn. A nominal group was conducted with nine of these students who were available for participation, and deductive qualitative content analysis of all twelve students' written journals submitted throughout the year was performed. RESULTS: Findings highlighted various ways in which this experience enhanced students' understanding of the dynamics of working in a rural community setting, and provided them with opportunities for personal and professional growth. CONCLUSION: The rural service learning experience was a valuable and transformative learning opportunity for students. Future considerations should include expanding these opportunities and establishing a service learning model based on the insights gained. <![CDATA[<b>The developmental status and prevalence of sensory integration difficulties in premature infants in a tertiary hospital in Bloemfontein, South Africa</b>]]> INTRODUCTION AND AIM: Research indicates that premature infants are at risk of neurological abnormalities and developmental and functional delays during infancy and early childhood. Annually, in South Africa, approximately 15% of infants are born prematurely, the majority being from low socio-economic homes. Basic needs and survival of the infant take priority over developmental progress of infants. Since developmental progress is dependent on sensory integration, the aim of this study was to determine the occurrence of developmental and sensory integration difficulties in premature infants in South Africa. METHODS: A descriptive, observational study was conducted. Relevant information on medical history and environmental factors were obtained through parent questionnaires. Three standardised assessments, the Bayley III Scales of Infant and Toddler Development, the Test of Sensory Function in Infants and the Infant/Toddler Sensory Profile, were used. RESULTS: Infants presented with low average to average performance in all developmental subtests. The majority (67.7%) of infants presented with typical sensory seeking behaviour. Sensory processing difficulties were identified in terms of high neurological thresholds resulting in low registration behaviour as well as low neurological thresholds, resulting in sensory sensitivity and sensory avoiding behaviour. This influenced their adaptive motor functions and normal development. CONCLUSION: Premature infants participating in this research presented with challenges regarding developmental and sensory integration. <![CDATA[<b>Occupational therapy and the use of music tempo in the treatment of the mental health care user with psychosis</b>]]> The mental health care user (MHCU) with psychosis has restrictions in occupational performance components and occupational performance areas, causing impaired activity participation, compromising the achievement of Occupational Therapy (OT) goals with this population. The effect of slow versus fast tempo music during OT treatment of the MHCU with psychosis was investigated by means of a quantitative, experimental study. One hundred and sixty MHCUs with either inhibited or agitated symptoms of psychosis were included. The activity participation of the MHCUs, in terms of attention, following of instructions, directedness towards activity and willingness to participate were evaluated by three assessors through a pre- and post-test. The study indicated that music tempo, together with activity, has the ability to improve attention, following of instructions and directedness towards activity in the inhibited MHCU and attention and following of instructions in the agitated MHCU. Occupational therapy with music elements might be useful when working with the MHCU with psychosis. <![CDATA[<b>Time and space dimensions of computer laptop use amongst third year students of the University of the Free State</b>]]> To broaden the knowledge base of occupation, therapists should understand how spaces, objects and time components support, shape and inhibit occupational performance. The aim of this study was to describe the spatial and temporal dimensions of laptop use amongst students at the University of the Free State in 2013. A descriptive study design was used with a sample of 216 third year students who make use of a laptop computer for academic and/or recreational purposes. Data were collected by means of an anonymous self-administered questionnaire in which the spatial and temporal dimensions were investigated. Student's postural configurations were identified and prioritised according to frequency of preference. The three most preferred positions during the academic year were sitting at a table on a chair with backrest (39.8%), sitting with one's back against a vertical surface (17.6%) and lying on one's back (11.1%). The median time spent on a laptop was 38.5 hours per week, which occurred in a variety of spatial contexts. Specific postural configurations and time components relative to the occupation of laptop use are conceptualised in this study. Recommendations call for a study to investigate the association between the preferred postural configurations and postural risks with the use of laptop computers. <![CDATA[<b>The impact of the "Developmental Resource Stimulation Programme" (DRSP) on children with Down syndrome</b>]]> BACKGROUND: This study investigated the impact of an intensive early-intervention programme, the Developmental Resource Stimulation Programme (DRSP), on Down syndrome (DS) children younger than 42 months in the South African context. The DRSP is a unique, child-parent specific, one-on-one, integrated developmental programme for children with Down syndrome from birth to 42 months. AIM: The aim of this study was to investigate the impact of the DRSP on Down syndrome children younger than 42 months in the South African context. METHODOLOGY: A non-randomised control group pre-test-post-test design was followed. The Bayley Scales of Infant and Toddler Development, 3rd edition was used. Thirty children with the general characteristics of DS, specifically Trisomy 21, were included in the study. There were two groups, namely the intervention group (n = 16) and the control group (n = 14) which were studied over a period of six months. RESULTS: This study showed that a specifically designed programme, with participation of a parent, has a positive impact on the development of the child with Down syndrome. CONCLUSION: Contrary to the existing literature, there were positive changes in the fine-motor development and language of the intervention group overall and in the gross-motor development of children older than 9-months with Down syndrome. <![CDATA[<b>Time management guidelines for the intervention of a child with Down syndrome using the Developmental "Resource Stimulation Programme" (DRSP)</b>]]> BACKGROUND: The duration of an intervention session for an intensive early-intervention programme, the Developmental Resource Stimulation Programme (DRSP), for Down syndrome (DS) children younger than 42 months, was investigated as part of a larger research study. The DRSP is a unique, child-parent specific, one-on-one integrated developmental programme for children with Down syndrome from birth to 42 months. AIM: The aim of this programme was to determine the required number of sessions per activity and optimal session length that enables a child younger than 42 months with DS to master the DRSP activities. METHODOLOGY: A descriptive study design was used to organise and summarise data from the DRSP checklist score-sheets. Sixteen children with common characteristics of DS, specifically Trisomy 21, and their parents formed part of the investigation. RESULTS: The research established a time management guideline including the specific duration and frequency of executing an occupational performance activity by a child with DS in order for the child to master the activity. CONCLUSION: The recommendation is that individual sessions should occur fortnightly to implement the DRSP for children with DS from birth, with the suggested length of a session being 12-15 minutes for children younger than 18 months and 15-40 minutes for children older than 18 months and should be undertaken over a six month period. <![CDATA[<b>Opinions of occupational therapists on the positioning of vocational rehabilitation services in Gauteng Public Healthcare</b>]]> INTRODUCTION: A collaborative effort to transform occupational therapist's vocational rehabilitation services in Gauteng's public healthcare was hampered by the fact that role players were unclear as to what the scope of the service should be within the various sectors and staffing levels of public healthcare. This article reports on the opinions of occupational therapists on the positioning of vocational rehabilitation services in the Gauteng Province. METHOD: A collaborative action research team launched a non-experimental descriptive inquiry within the planning phase of a larger transformative project. Data were generated through an opinion survey to capture the perspectives of occupational therapists on the potential positioning of vocational rehabilitation services in the province. The opinions of three groups of occupational therapists were collected, i.e. clinicians working in Gauteng public healthcare, experienced vocational rehabilitation practitioners from all fields of service delivery who acted as critical friends and occupational therapy academia. RESULTS: The purposive sample was composed of 307 potential respondents. A low response rate of 31% was achieved. There was a lack of consensus as to which vocational rehabilitation services occupational therapists should render in public health care. The results reflected the need to address the scope and position of vocational rehabilitation services in public health care. CONCLUSION: Positioning of vocational rehabilitation services in public health care remains a point of contention. However, the process of asking occupational therapists their opinion created awareness and directed continuous efforts to address the issues within the field of practice. <![CDATA[<b>Meaning and purpose in the occupations of gang-involved young men in Cape Town</b>]]> INTRODUCTION: Involvement in gangs negatively influences the lives of many young men living in Cape Town, South Africa. There is a need to better understand young men's motives and reasons for belonging to gangs as efforts to reduce gang involvement have shown little success. METHODOLOGY: A descriptive qualitative study was conducted to explore the meaning and purpose of engaging in occupations related to being a gang member, and the influence on other occupations. In-depth, semi-structured interviews were conducted with four participants who were purposively selected from a Special Youth Care Centre in Cape Town. FINDINGS: Five themes emerged: Why am I where I am?; To strengthen the camp; Attraction to gangs; It's difficult but it's life; and Threshold to manhood. The participants' involvement in gangs meant social support, material resources including drugs and money, independence, thrills and excitement. The purpose of engaging in gang-related occupations was to strengthen the gang, gain belonging, prove manhood and for survival. However, gang-involvement deprived participants from engaging in other occupations and roles including schooling, leisure activities and relationships with mothers and girlfriends. CONCLUSIONS: Understanding gang-related occupations assists occupational therapists to plan relevant programmes to support young men's disengagement from gangs and reintegration into the community in pro-social ways. <![CDATA[<b>Clients' subjective experience of their participation in rehabilitation at an out-patient community rehabilitation center</b>]]> INTRODUCTION: Rehabilitation services in South Africa are governed by various policies. It is important to evaluate these services to assess if the services are achieving their aims as set out in these policies. The evaluation should include the outcomes that clients achieve by participating in rehabilitation services. METHOD: The findings presented were obtained as part of a larger mixed methods descriptive study and this paper will focus on clients' subjective experience of participating in rehabilitation. Convenience sampling was used to select 78 clients from the five most prevalent diagnostic groups seen at the center. Semi-structured interviews were conducted, transcribed and analysed by means of basic content analysis. RESULTS: Clients commented on the emotional impact that participating in rehabilitation had had on them and on the physical changes it had brought about. Clients experienced a high level of satisfaction with the service and enjoyed participating in rehabilitation. The knowledge, skills and confidence that they gained enabled them to be more independent in Daily life activities and to share this knowledge with others in their community. CONCLUSIONS: The results emphasise the importance of providing rehabilitation services for persons with disabilities that are based in their community. It will be useful in further service and policy planning for persons with disabilities. <![CDATA[<b>Practice-based evidence: Evaluating the quality of occupational therapy patient records as evidence for practice</b>]]> BACKGROUND: Occupational therapy patient records are required for legal purposes, but may also be used to produce evidence for practice. Our aim was to establish how comprehensively occupational therapists documented patient records. METHODOLOGY: We conducted a descriptive cross-sectional study of occupational therapists at public health facilities in a South African province. Trained raters audited five randomly-drawn records per participant using a checklist developed for the study. The maximum possible score was nine and the lowest was zero. Audits were checked for consistency. RESULTS: Forty-nine occupational therapists participated and 240 records were audited. Records contained information on intervention (96%) and changes occurring at impairment (82%) and activity and participation levels (64%). Documentation of baseline assessment (impairment level: 20%; activity and participation level: 10.4%) and re-assessment (impairment level: 7%; activity and participation level: 0.0%) was limited. Audit scores were significantly better in the work practice area (H=16.10, p=0.003) and among therapists in urban areas (U=24.50, p<0.001).There was a significant negative correlation between audit score and number of clients seen per month (r s=-0.46, p<0.001). CONCLUSION: The low audit scores suggest that the records did not contain sufficient information to produce robust evidence. Manageable ways of documenting occupational therapy practice need to be devised. <![CDATA[<b>An exploratory factor analysis into the applicability of the Spirituality Care-Giving Scale, the Spirituality and Spiritual Care Rating Scale and the Spirituality in Occupational Therapy Scale to the South African context</b>]]> Spirituality and spiritual care are both considered as important elements of health sciences education; however, limited research has been conducted with occupational therapy students using spirituality scales. Therefore, this study assessed the internal consistency component of reliability and carried out factor analyses of three spirituality scales which examined the perceptions and attitudes of South African undergraduate occupational therapy students regarding spirituality and spiritual care. This study used a cross-sectional survey design using convenience sampling to recruit 100 participants. The internal consistency of the instruments evaluated showed satisfactory reliability: i.e. the Spiritual Care-Giving Scale (α=0.946), the Spirituality and Spiritual Care Rating Scale (α= 0.764) and the Spirituality in Occupational Therapy scale (α=0.868). The Kaiser-Meyer-Olkin measure of Sampling Adequacy values was 0.862, 0.883, and 0.868 respectively, indicating the appropriateness of the factor analysis. Factor analysis from varimax rotated results was also performed to identify the patterns of spirituality and spiritual care within the instruments. The total variances of the instruments were acceptable at 59.1, 67.6 and 69.8% respectively. An implication of these findings is the possibility that exposing occupational therapy students to spirituality and spiritual care could be useful for them to gain insight into and be sensitive to the clients' spiritual needs. Further research should be undertaken in other institutions of higher learning that offer occupational therapy programmes. <![CDATA[<b>Family caregivers' perceptions and experiences regarding caring for older adults with chronic diseases</b>]]> Family caregivers of older adults with chronic diseases are faced with challenges and health risks regarding their occupational role which influences their health, well-being and quality of life. However, there is limited research about family caregivers regarding their caregiving occupation. This study, thus aimed to explore the perceptions and experiences of family caregivers regarding caring for older adults with chronic diseases in the Western Cape, South Africa. A qualitative exploratory-descriptive research design within an interpretive approach was used for the study. Family caregivers aged 21 - 79 years were purposively recruited for the study. Semi-structured interviews were conducted with six participants to gain understanding about caregiving and analysed using thematic analysis. Three themes emerged: "God gives his hardest battles to his strongest soldiers", "Keeping ones head above water", and "It's not what it seems". These findings highlighted the importance of occupational balance among family caregivers as they experienced difficulties while caring for older adults with chronic diseases. Therefore, this study contributes to the knowledge for occupational therapists who provide interventions to older adults and family to consider their health needs. Thus, occupational therapists may need to develop programmes that focus on family caregivers' strategies to enhance their occupational balance. <![CDATA[<b>Mixing-up research methods: A recipe for success or disaster?</b>]]> The increase in the number of occupational therapists training and doing research at undergraduate and post-graduate degree level has led to an exciting growth in research capacity within our profession. My experiences of doing research and in supervising students have raised questions about which methodologies students should be able to apply at the beginning of their research careers. In this opinion piece I argue that concurrent mixed-methods research designs across more than one research paradigm are inappropriate for undergraduate and Masters-level research, because of issues with integration, transparency, and the time taken to develop the sufficient research expertise required for this methodology.