Scielo RSS <![CDATA[South African Journal of Occupational Therapy]]> http://www.scielo.org.za/rss.php?pid=2310-383320170004&lang=en vol. 47 num. 3 lang. en <![CDATA[SciELO Logo]]> http://www.scielo.org.za/img/en/fbpelogp.gif http://www.scielo.org.za <![CDATA[<b>Rehabilitation - strengthening advocacy for change. It's time to act</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2310-38332017000400001&lng=en&nrm=iso&tlng=en <![CDATA[<b>The effect of neoprene thumb abduction splints on upper limb function in children with cerebral palsy</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2310-38332017000400002&lng=en&nrm=iso&tlng=en INTRODUCTION: Children with cerebral palsy (CP) have limitations in hand function due to weakness and spasticity, with long term effects causing shortening and stiffness of muscles in the hand and arm. The soft neoprene thumb abductor splint is prescribed by occupational therapists to correct these impairments. There is insufficient evidence for the effectiveness of this splint on upper limb function in children with CP with a thumb-in-palm deformity within the South African public health context. METHODS: A non-blinded randomised intervention study was carried out in a CP clinic at a tertiary level public hospital. Twenty-eight CP children between the age of 18 and 68 months, presenting with thumb-in-palm deformity, functioning on a Level II to IV on the Gross Motor Function Classification Scale (GMFCS) participated in the study. The Quality of Upper Extremity Skills Test (QUEST) was used to assess upper limb function in terms of dissociated movement, grasps, weight bearing and protective extension to obtain baseline information. Both the intervention and control groups received monthly individual occupational therapy and a home programme over a three month period. The intervention group additionally received a soft neoprene thumb abduction splint. RESULTS: No statistically significant differences between the intervention and control groups were found. Clinically relevant between group differences indicated by effect sizes were found however with large effect sizes the for the total QUEST score and weight bearing. The effect size for improvement within the intervention group was large for dissociated movement and weight bearing with and without the splint on as well as for grasps with the splint on. Only dissociated movement showed a clinically relevant medium effect size for change within the control group. Protective extension decreased within both groups except for the intervention group with the splint on. The caregivers/parents perceived the home programme as easy to follow, and those who were prescribed the splint mostly reported that it was easy to use. CONCLUSION: Soft neoprene thumb abduction splints have a positive effect on weight bearing and upper limb function in children with thumb-in-palm deformity, particularly with the splint on. Further research is recommended in the area of splinting in CP. <![CDATA[<b>"The pen is a powerful weapon; it can make you change": The value of using reflective writing with adolescents</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2310-38332017000400003&lng=en&nrm=iso&tlng=en INTRODUCTION: Adolescent programmes have been criticised for implementing activities but not allowing opportunities for reflection. One way that reflection can be facilitated is through writing. This paper describes the use of reflective writing with adolescents as part of a health promoting schools project in Cape Town, South Africa. METHOD: The project included an annual leadership camp for adolescent learners. A descriptive, qualitative study was conducted to describe how the learners responded to writing as a means to express their feelings about, and experiences of, the camp. Thirty learners participated in two writing sessions resulting in 53 written reflections that were analysed thematically. FINDINGS: Three themes emerged: (1) Reflections on self; (2) Reflections on self in relation to others; and (3) Reflections on writing. Participants reflected on connecting with complex, positive and negative feelings, and felt that reflective writing had enabled them to express themselves with courage and honesty, connect with themselves, identify weaknesses and let go of negative emotions and feelings. Furthermore, writing was perceived as being non-judgmental, providing a sense of relief and release, and evoking emotions. CONCLUSION: Reflective writing enabled the participants to acknowledge personal changes and development, and provided insight into their feelings and experiences. This study shows the value of reflective writing for use by health professionals such as occupational therapists, as a tool for empowerment in the pursuit of health and wellbeing. <![CDATA[<b>"We all need employment" - An exploration of the factors which influence the return-to-work after a severe traumatic brain injury</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2310-38332017000400004&lng=en&nrm=iso&tlng=en INTRODUCTION: While individuals with mild and moderate traumatic brain injury (TBI) manage to achieve some degree of successful return-to-work, individuals with severe TBI have a reduced chance of returning to work. This study aimed at investigating how personal factors, workplace environment and vocational rehabilitation influenced the return-to-work and assumption of the worker role of individuals with severe TBI. METHOD: A phenomenographic study design with purposive sampling was used to select 11 participants. Data were collected through semi-structured interviews using the Worker Role Interview as a guide. Data were thematically analysed using Clarke and Braun's six phases of thematic analysis. RESULTS: Two themes emerged: It's all about me, which addressed the internal aspects of the role of a worker and The support for me which focused the external factors of personal, work and rehabilitative support. CONCLUSION: Results showed that rehabilitation, personal factors and work support were critical for successful return-to-work for survivors of severe TBI. Results indicated that participation in work was as important in developing self-worth as participation in any other area of daily living. With regard to personal factors, rehabilitation and support were vital in maintaining self-worth after an injury. This could be enhanced through vocational rehabilitation. <![CDATA[<b>Occupation-based practice in a tertiary hospital setting: occupational therapists' perceptions and experiences</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2310-38332017000400005&lng=en&nrm=iso&tlng=en Occupation-based practice is an important feature of occupational therapy. There is however limited research regarding occupational therapists' experiences with occupation-based practice. This study aimed to explore occupational therapists' perceptions and experiences regarding occupation-based practice in a tertiary hospital setting in the Western Cape, South Africa. An explorative and descriptive research design within a qualitative research approach was utilised. Purposive sampling allowed the selection of four participants with a minimum of 2 years practice experience. Semi-structured interviews were conducted to gain an understanding of how they perceived and implemented occupation-based practice. Data were analysed using thematic analysis. Four themes emerged: occupation-based practice expresses professional identity; occupation-based practice necessitates relevance; constraints to occupation-based practice; and facilitators of occupation-based practice. The findings revealed that the participants' perceived the implementation of occupation-based practice as an expression of their professional identity and that in adopting an occupation-based approach they perceived their roles as being diverse and transformational. It was however highlighted that the nature of the service context posed several constraints that influenced the implementation of occupation-based practice. Thus, occupational therapists may need to generate practice-based evidence to advocate for the service conditions necessary to implement occupation-based practice and deliver relevant occupational therapy services. <![CDATA[<b>The effects of rehabilitation education for village health volunteers on walking speed and upper extremity function in stroke survivors in Thailand</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2310-38332017000400006&lng=en&nrm=iso&tlng=en INTRODUCTION: Stroke can cause long-term disabilities to survivors. Rehabilitation is an on-going process and should, ideally, be provided to these people in their homes. This study aimed to investigate the effect that rehabilitation education provided to village health volunteers (VHVs) would have on walking speed and upper extremity (UE) function in stroke survivors who stay at home in Thailand. METHODS: Participants were recruited by purposive sampling, which included 27 stroke survivors from four municipalities in Chiang Mai and Lamphun provinces. The measuring instruments used were the Ten-Meter Walk Test and the UE motor domain of the Fugl-Meyer Assessment. Researchers presented a 7-hour rehabilitation education programme to VHVs, who then made weekly1-hour visits to the homes of stroke survivors to implement the rehabilitation programme over eight weeks. Data were collected within seven days before and again after the 8-week programme. RESULTS: Descriptive statistics and the paired t-test were applied to analyse the data. Results showed that the participants used significantly less walking time from pre-test ( X =34.73 ±8.48) to post-test ( X =32.18±9.32) (p<0.05). However, the score of UE function at pre-test (X=36.81±9.59) was not significantly different from that at post-test (X =37.26±9.67). CONCLUSION: The findings suggest that trained VHVs can be part of the rehabilitation team and contribute to improved functional performance for disabled stroke survivors, particularly in developing countries. <![CDATA[<b>Occupational therapy graduates' reflections on their ability to cope with primary healthcare and rural practice during community service</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2310-38332017000400007&lng=en&nrm=iso&tlng=en BACKGROUND: Occupational therapy graduates are expected to deliver service in public health facilities using a primary healthcare approach (PHC) during their community service year. There is limited literature available about their experiences in this context. OBJECTIVE: This study explored the experiences of novice occupational therapy graduates and the extent to which their curriculum had prepared them for practice in PHC settings METHODS: This qualitative exploratory study used purposive sampling to recruit thirty nine novice occupational therapy graduates. Using audio-recorded semi-structured interviews and a focus group discussion data were collected to explore participants' experience of work and the extent to which their undergraduate programme had prepared them for primary healthcare practice. The data was analyzed thematically. FINDINGS: Occupational therapy graduates expressed challenges in applying the PHC approaches for practice in resource-restricted rural settings. They required additional skills to communicate in the local indigenous language, to understand the various beliefs of the local communities and to manage change in these settings. They were well prepared for basic clinical skills as a need for urban-based ethical practice. Relevance to clinical practice: Curriculum planners need to review the teaching of communication skills and introduce students to strategies for change management. More inter-professional collaboration and service-learning in rural primary healthcare settings will prepare them better for rural and PHC settings. <![CDATA[<b>The effect of caregiver training in increasing social interaction and contact time with children living in residential care facilities</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2310-38332017000400008&lng=en&nrm=iso&tlng=en Infants and toddlers living in residential care facilities are at risk of developmental delay. Environmental factors contributing to this risk are the temporal context (how children spend their time) and social context (how and when caregivers interact with the children). This study compared time-use patterns of children living in residential care facilities where caregiver training had previously taken place versus those in facilities where caregiver training had not taken place using a non-experimental, cross sectional static group comparison study design. Spot observations were used to estimate time-use patterns of infants and toddlers living in residential care facilities in Johannesburg. Results show that caregiver training positively changed the quantity of the time that infants spent with their caregivers (temporal context) and the quality of time toddlers spent with their caregivers (social context). Thus caregiver training has the potential to improve the environment in residential care facilities and can be used as an intervention strategy by occupational therapists. <![CDATA[<b>The Analytical Survey Method: A valuable tool for efficient and effective Occupational Therapy service provision for a patient/client population</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2310-38332017000400009&lng=en&nrm=iso&tlng=en This paper describes the effective integration and application of a hybrid analytical survey method in order to obtain a substantive profile and resource information about a patient/client population. Integrating the Vona du Toit Model of Creative Ability, the survey is used as a primary tool for planning intervention, evaluation and planning in occupational therapy practice. The process has been used extensively in action research in practices throughout South Africa and the United Kingdom and results have shown that it allows for a more targeted and efficient provision of intervention and treatment. This paper briefly describes the development of the Analytical Survey Method and details how the procedure is implemented using the example of its application in a UK mental healthcare facility. Its contemporary relevance is highlighted in the context of healthcare challenges and the need to demonstrate efficient and effective occupational therapy provision. <![CDATA[<b>Occupational Therapy Association of South Africa Position Statement on Rehabilitation</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2310-38332017000400010&lng=en&nrm=iso&tlng=en This paper describes the effective integration and application of a hybrid analytical survey method in order to obtain a substantive profile and resource information about a patient/client population. Integrating the Vona du Toit Model of Creative Ability, the survey is used as a primary tool for planning intervention, evaluation and planning in occupational therapy practice. The process has been used extensively in action research in practices throughout South Africa and the United Kingdom and results have shown that it allows for a more targeted and efficient provision of intervention and treatment. This paper briefly describes the development of the Analytical Survey Method and details how the procedure is implemented using the example of its application in a UK mental healthcare facility. Its contemporary relevance is highlighted in the context of healthcare challenges and the need to demonstrate efficient and effective occupational therapy provision.