Scielo RSS <![CDATA[South African Journal of Occupational Therapy]]> vol. 42 num. 3 lang. es <![CDATA[SciELO Logo]]> <![CDATA[<b>Editorial comment</b>]]> <![CDATA[<b>The effect of a repeated course of Constraint-Induced Movement Therapy, implemented in the home environment, on the functional skills of a young child with cerebral palsy</b>]]> The lack of research in South Africa related to the use of Constraint-Induced Movement Therapy (CIMT) motivated this single-system (A-B-A-B-A) study The aim was to investigate whether a repeated course of CIMT would improve self-care, play and functional skills of a young boy with asymmetrical cerebral palsy (CP). The subject's less affected arm was placed in a sling for a period of six hours during the intervention phases. The duration of the CIMT was 10 working days, followed by a two-week withdrawal phase. This sequence was repeated once. The subject was engaged in play and self-care activities in his home environment during the intervention phases. The Pediatric Evaluation of Disability Inventory (PEDI) was used to assess the subject six times: at the start; before and after interventions; and after the last withdrawal phase. The minimal clinically important difference (MCID) was calculated between the first and last assessments to determine the effectiveness of the CIMT. The critical 11 points difference was reached in the PEDI self-care domain for functional skills (such as dressing and washing) and in the social functioning domain for caregiver assistance (indicating that the caregivers were giving less assistance with regards to participation in household chores, communication and play ability). <![CDATA[<b>The experiences of parents with tactile defensive children</b>]]> AIM: Tactile defensiveness is a phenomenon that infringes on the daily lives of many young children and their parents. This study explored the experiences of parents of children with tactile defensiveness. As primary caregivers, parents' experiences of the condition can give valuable insight into the possible considerations regarding intervention approaches used by professionals. Relatively little research has been done on the topic. METHOD: A phenomenological framework was used, gathering the data via a thematic content analysis of interviews held with seven participants concerning their experiences of the condition. RESULTS: It became evident that many different areas of the parents' daily living were affected. Parents reported feelings of emotional turmoil in relation to their children, including frustration, exhaustion, incompetency and not having their own needs met. They experienced that having a child with tactile defensiveness influenced the parent-child relationship. Tactile defensiveness also impacted on siblings and the relationship between the parents. However, parents also reported that they found their own unique ways of dealing with the condition which enhanced their coping abilities. The important role of psychologists and occupational therapists in providing parents with information regarding tactile defensiveness were highlighted. The findings of this study aim to guide parents and professionals alike in the process of dealing with a child diagnosed with tactile defensiveness. <![CDATA[<b>The use of the Sensory Integration and Praxis Tests with South African children</b>]]> BACKROUND: The Sensory Integration and Praxis Tests (SIPT) developed by A. Jean Ayres, are currently one of the best researched and scientifically sound measuring instruments available for detecting developmental problems based on sensory integration functions2,3. There is currently no instrument of the stature of the SIPT, available that is standardised on the South African (SA) population. The question that needed to be answered was whether the use of the SIPT on SA children was fair and just, since the SIPT is standardised on a sample of children from the United States (US). METHODOLOGY: A quantitative, descriptive research design was used to investigate equivalency between the US normative data and a sample of typically developing SA children. FINDINGS: This research indicated that 12 of the 17 test items of the SIPT can be scored against the normative sample of US children. There are however five tests within the older age bands (6y 0m - 8y 11m) on which the SA sample of children performed moderately to significantly better. This can cause SA children who do have sensory integration dysfunctions to go unidentified by the SIPT. CONCLUSION AND RECOMMENDATION: The scores of five of the tests of children in the older age bands must each be adapted with ½ a standard deviation unit to the negative side before clinical interpretation and reasoning are done by the occupational therapist. <![CDATA[<b>The sources of professional confidence in occupational therapy students</b>]]> INTRODUCTION: While undergraduate training in South Africa places an emphasis on ensuring the competence of occupational therapy graduates, very little attention has been paid to exploring their professional confidence, despite the fact that this has been highlighted as an issue for students. The foundation for professional confidence is laid during student years, and is influenced by a number of determinants, which this study aimed to identify. METHODS AND MATERIAL: Qualitative methodology was used with a purposive sample of nineteen final year occupational therapy students. Students were invited to participate voluntarily in focus group interviews and/or submit their reflective journal. Five lecturers and six clinical supervisors at the University concerned also participated in focus group interviews. Deductive thematic analysis of the data was undertaken. RESULTS: Two broad themes emerged. The first theme, external determinants, included clinical experience, relationships with peers, staff and patients, and the changing environment in which they worked. The second theme, internal determinants, included certain identified personal characteristics and influencers. The external and internal sources of professional confidence beliefs were either within the control of the student, or the lecturer/clinical supervisor or the profession. DISCUSSION: A number of recommendations ranging from re-thinking clinical practicals and supervision are made. These findings have implications for student selection, teaching methodology and experiences, and the professional identity of the profession. Greater formal emphasis needs to be placed on confidence building during the undergraduate experience. <![CDATA[<b>Measuring percieved social support in stroke survivors: Linguistic validation of the Multidimensional Scale of Percieved Social Support (MSPSS) in Hausa (Nigerian) language</b>]]> BACKGROUND AND AIMS: In stroke survivors, social support is believed to affect the quality of patient care and the disease outcome, as well as patients' physical and psychosocial well-being. Assessment is therefore essential for the development and evaluation of interventions designed to improve social support for those deprived of this resource. The aim of the linguistic validation of the Multidimensional Scale of Perceived Social Support (MSPSS) was to produce a translated version in Hausa language with "conceptual, semantic and operational equivalence" to the original U.S. English version for use in clinical practice and research in Nigeria. METHODS: A multiprofessional committee that consisted of five experts carried out the translation process in accordance with the Mapi Research Institute format and guidelines for cultural adaptation of questionnaires. This included the steps of forward translations, synthesis, back translation, expert committee review, pre-testing (with 10 hemiplegic subjects) and finalisation. RESULTS: During the translation processes of the MSPSS into Hausa, concerns were raised pertaining to some linguistic and semantic issues including the appropriateness of certain terms used. The literal translation of some of the items and expressions used was not viable in Hausa language; hence, researchers had to find culturally agreeable linguistic equivalents. Pilot testing revealed the MSPSS to be easily understandable, simple, clear and appropriate for the evaluation of social support among these stroke survivors. CONCLUSION AND RECOMMENDATION: The processes involved in the translation served to ensure that the Hausa-MSPSS was measuring the same circumstances as the original scale, thereby enabling comparisons between different cultures. Nevertheless, further in-depth psychometric testing on a larger sample is proposed to be carried out among Hausa speakers. <![CDATA[<b>The potential of Dementia Care Mapping as a practice development tool for occupational therapists in South Africa</b>]]> The quality of care for persons living with dementia in institutional care settings is of global concern. The provision of person-centred care (PCC) for people with dementia is internationally recognised as best practice, which promotes possibilities for people with dementia to experience well-being. However, there remains a lack of evidence of approaches that can help to support delivery of PCC for older people with dementia in long-term care, in South Africa. Dementia Care Mapping (DCM) is a successful practice development tool, originating in the UK, used for supporting the implementation of PCC. However, to date it has not been considered for use by South African occupational therapists working in residential care facilities. This article defines the components of the DCM tool, its process of use and potential outcomes for care practice. In an attempt to scrutinise the value of findings from an occupational therapy perspective, the Kawa Model is drawn upon to explain how the data from DCM can be interpreted. The Kawa Model provides a strong focus on how a sense of being is promoted by a person's context, and is an established vehicle to aid understanding of the potential for application of PCC in South African care facilities.