Scielo RSS <![CDATA[South African Journal of Occupational Therapy]]> vol. 42 num. 1 lang. es <![CDATA[SciELO Logo]]> <![CDATA[<b>Editorial comment</b>]]> <![CDATA[<b>School-based occupational therapists: An exploration into their role in a Cape Metropole full service school</b>]]> School based occupational therapists within the South African context are faced with the challenge of extending their roles within inclusive education. The following article describes a research study that was conducted by a group of fourth year occupational therapy students in 2006. The purpose of the research was to explore the current role and develop a future perspective for school-based occupational therapists in an inclusive education system in a full service school in the Cape Metropole area. A qualitative phenomenological approach was followed, where semi structured interviews and focus groups were the methods of data collection. Data was transcribed and analysed inductively using content analysis.The article expands on the following two themes, namely the unclear existing role of the occupational therapist in inclusive schools and diverse and evolving attitudes towards inclusive education. The themes highlight the attitudes and perceptions of teachers, parents and an occupational therapist on inclusive education and explores the possibilities of emerging and transforming roles for occupational therapists willing to engage in this inclusive process. <![CDATA[<b>The collaborative relationship between teachers and occupational therapists in junior primary mainstream schools</b>]]> A qualitative research study was conducted to explore collaboration between teachers and occupational therapists in junior primary mainstream schools. A purposive sample of teachers and occupational therapists was selected in the eThekwini district, Kwa-zulu Natal. Two focus groups interviews were conducted - one with teachers and one with occupational therapists. In addition, two in-depth individual interviews with a representative from each profession were conducted. These interviews were audio taped and transcribed and thematic analysis was adopted to identify themes and sub themes. The primary themes were (1) Benefits of collaboration, (2) Methods of collaboration (3) Attitudes (4) Obstacles in the collaborative relationship, and (5) Methods of overcoming obstacles. Factors such as limited knowledge about the role of occupational therapy, attitudes of teachers towards occupational therapists and time were identified as barriers to a collaborative relationship between occupational therapists and teachers. <![CDATA[<b>The achievement of community integration and productive activity outcomes by CVA survivors in the Western Cape Metro Health District</b>]]> INTRODUCTION: According to the South African National Rehabilitation policy, achieving advanced outcomes such as community integration and productive activity, should be the focus of the rehabilitation services. However, according to the literature, rehabilitation does not often progress beyond basic outcomes such as mobility and self-care. The aim of this study was to describe the achievement of community integration and productive activity outcomes by a group of CVA survivors in the Western Cape Metro Health District. METHODS: A descriptive study was carried out. Quantitative data were collected from 57 CVA survivors and caregivers. All these CVA survivors had received in-patient rehabilitation at the Western Cape Rehabilitation Centre (WCRC). Data were collected by means of a medical and demographic questionnaire, the Barthel Index and the Outcome Levels according to Landrum et al. RESULTS: On discharge from in-patient rehabilitation seven (12%) stroke survivors were at level II ie they had achieved only the basic rehabilitation outcomes necessary to preserve long term physiological health, whereas 37 (65%) stroke survivors were discharged at an outcome level III ie ready for residential integration, and 12 (21%) were at level IV ie community integration, and one (2%) at level V (productive activity). Assessment at the time of the study showed a general improvement post discharge, with 21 participants (37%) improving by one or two outcome to achieve community integration and five (9%) achieving the outcome level of productive activity through informal income generating activities. CONCLUSION: Thirty three (58%) stroke survivors achieved community integration, while six (10%) progressed to employment. One would like to see further progress to employment especially for those participants who were employed before the stroke. Clinicians might be able to assist more stroke survivors to achieve this through using the outcome levels and incorporating the interventions to reach productive activity such as performing work and skills assessments, employer education and assistance with reasonable accommodations in rehabilitation goals. <![CDATA[<b>Curriculum transformation: A proposed route to reflect a political consciousness in occupational therapy education</b>]]> INTRODUCTION: Curriculum review is an ongoing, dynamic, long-term process that forms part of occupational therapy education. The Department of Occupational Therapy, University of the Western Cape (UWC) recently responded to the challenge of becoming socially responsive and politically relevant by engaging in curriculum review. The review revealed that political reasoning was not clearly delineated previously in the curriculum. In response to this problem, over a period of several years we engaged in a process of curriculum transformation so that students become politically conscious. METHODS: The process entailed environmental scanning, feedback from teaching staff and clinicians, students' evaluations, regular curriculum revision meetings, academic development meetings, workshops and seminars. A qualitative study using a cooperative enquiry approach was conducted to analyse the data. FINDINGS: From the analysis the following themes emerged: (1) identifying the essence of occupational therapy education at UWC, (2) understanding political practice on a theoretical and then a personal level, (3) integrating and operationalising political consciousness into the curriculum. We discuss the debates and critical questions raised in our efforts to develop a curriculum that prepares graduates to be politically conscious and socially responsive. Finally, we present key strategies for the way forward. CONCLUSION: Curriculum transformation around a political practice of occupational therapy does not merely mean just a change in curriculum content, but requires the internalisation of a political consciousness by educators individually and collectively. <![CDATA[<b>Fieldwork education: Putting supervisors' interpersonal communication to the test</b>]]> Various factors have an impact on the development of the clinical reasoning skills of occupational therapy students during their training. The aim of this study was to investigate how the interpersonal communication skills of the supervisors impact on their students' ability to learn clinical reasoning skills during their education in the physical field. Thirty final year students at the University of Pretoria and 14 supervisors from six different hospitals formed the study sample. A mixed research design was employed. Data were collected by means of focus groups and one-on-one interviews conducted with fieldwork educators and students on their inter-subjective experience of supervision. It was then analysed by a clinical psychologist using the Interpersonal Pattern Analysis diagnostic instrument, and finally compared with the grades students obtained for their clinical reasoning skills in the final practical exam in the physical field. The findings of this study indicated that the supervisors of students who received good grades, were predominantly linear in their approach, showed limited empathy and confirmation, were rigid in their expectations and solved problems effectively. Supervisors of students who received lower grades were mainly circular in their approach, were flexible and partly empathetic, validated students and also solved problems effectively. Regarding the interpersonal approach to human behaviour there is no one role or pattern of interaction that is more effective in all contexts. A style or a pattern that may be highly effective in one kind of relationship may be ineffective in another. What is emerging here is that a style which is characterised by flexibility and empathy is not necessarily an effective teaching style, whereas one characterised by a linear approach, rigidity and limited empathy may prove to be significantly more effective. <![CDATA[<b>Domains for occupational therapy outcomes in mental health practices</b>]]> Occupational therapists in mental health care settings find it difficult to produce convincing evidence of their unique contribution to health care. This article reports on the initial phase of a larger study where the purpose was to determine domains for an outcome measure for occupational therapists in mental health care settings. A mixed methods exploratory design: Instrument Development Model was used to determine suitable domains. Occupational therapy clinicians participated in focus group discussions, workshops and the nominal group technique to discuss the status quo of outcome measurement and eventually selected domains for the ideal outcome measure for their contexts of practice. Five themes emerged from the thematic content analysis of the focus groups: Understanding the concept of outcomes, Giving examples of outcomes, Factors influencing the measurement of outcomes, Benefits from using an outcomes measure and Characteristics of an outcomes measure. The nominal group technique was employed during workshops on current trends in outcome measurement in occupational therapy. Eight domains emerged which represented the service delivery of the participating clinicians. The domains were Process skills, Motivation, Communication and interaction skills, Self-esteem, Balanced lifestyle, Affect, Life skills and Role performance. <![CDATA[<b>Undergraduate occupational therapy students' engagement in qualitative research: Identifying research problems and questions through reflection while in a community fieldwork setting</b>]]> As part of the occupational therapy undergraduate programme at the University of the Western Cape (UWC), students carry out group research projects while in their fieldwork placements. The purpose of the Research module is to introduce them to basic qualitative research methods. Following the progress of a group of students in a community fieldwork setting as an example, this article is a commentary on how they use the steps of the community process as a guideline to identify possible research questions. The author will highlight the process that students follow to refine their research questions, the support they require to identify priority problems, the barriers that students face while conducting research in fieldwork, and the positive outcomes for students and the community. In conclusion the community process provided the students with a theoretical guideline, specifically the needs assessment and analysis steps of the process in order for them to conceptualise a research question within a community fieldwork setting.