Scielo RSS <![CDATA[South African Journal of Occupational Therapy]]> vol. 43 num. 1 lang. pt <![CDATA[SciELO Logo]]> <![CDATA[<b>Editorial Comment</b>]]> <![CDATA[<b>The 22<sup>nd</sup> Vona du Toit Memorial Lecture</b>: <b>Stepping Stones from Input to Outcomes: An Occupational Perspective</b>]]> Occupational therapists in South Africa do not seem to have, as yet, adopted routine outcome measurement in daily practice. Although there is an abundance of valuable clinical contributions by occupational therapists, there is little evidence of recorded change in clients' activity participation or functional ability. This Vona du Toit Memorial Lecture addresses this apparent shortcoming in practice. The value of the work of Vona du Toit was highlighted as well as two other pioneers in the health care arena: Mary Reilly and Georg Rash. Seven stepping stones to consider when implementing routine outcome measurement were presented. The importance of having an occupational therapy mainstay was argued and that this mainstay should be occupational performance. Routine outcome measurement was presented as a viable strategy for basic evidence indicators of occupational performance at any time, any place and without much effort. The basic science underpinning development of such measures was clarified and presented as a way for occupational therapy to get a foot in the door to enhance its recognition as a powerful profession whilst proving the invaluable change that meaningful occupational performance can bring about. <![CDATA[<b>Development of a task-based bilateral fine motor skill assessment for grade 0 children in South Africa</b>]]> The need for an assessment for Grade 0 children, to establish their school readiness in the area of fine motor skills, resulted in the development of the Task Based Assessment (TBA). The aim of the assessment was to include task-based items based on every day activities required at school and for personal management. Aspects of fine motor skills in terms of efficiency, accuracy, motor skill and time were considered. The development of the items and the psychometric testing for aspects validity and reliability are reported. Testing included the focus groups and pilot studies to field test the TBA and align the items with fine motor skills appropriate for Grade 0 children. Construct and convergent validity and test-retest reliability were found to be at acceptable levels. Field testing on 130 participants from different socioeconomic backgrounds was completed to assess the sensitivity to change over time. <![CDATA[<b>Intra-rater reliability of the posture analysis tool kit</b>]]> BACKGROUND: Health care professionals mainly assess posture through qualitative observation of the relationship between a plumb line and specified anatomical landmarks. However, quantitative assessments of spinal alignment are mostly done by biophotogrammetry and are limited to laboratory environments. The Posture Analysis Toolkit (PAT), a photogrammetric measurement instrument was developed in 2009 to assess standing posture. AIM: The aim of this study was to test the intra-rater reliability of the Posture Analysis Toolkit. METHODOLOGY: A prospective, cross-sectional study design was conducted. Fourteen participants were required to do three measurements of the posture of a single subject using the PAT. Photographs of the anterior and left lateral upright standing posture were taken once, and imported three times for computerised analysis. Reliability was determined using descriptive statistics per session, confidence interval for the median difference between sessions, 95% limits of agreement and Spearman correlations. RESULTS: In this study the intra-rater reliability of PAT between sessions was good. CONCLUSION: The Posture Analysis Toolkit was tested and proved to be reliable for use as an instrument for the assessment of standing postural alignment. Recommendations are suggested for the development of the PAT. <![CDATA[<b>Matriculation scores as an indicator of academic success in an occupational therapy education programme</b>]]> Over the past two decades there has been little change in the entry requirements for undergraduate studies at the South African universities. A particular difficulty in the selection of health sciences students by the universities in South Africa is the ability to predict success, as a substantial amount of knowledge, abilities, and skills are required by the health sciences professions of their graduates. Notwithstanding this, there is evidence to both support and refute pre-admission academic grades as reliable predictors of academic success. The aim of this study was to investigate whether matriculation points (grade point average) could be used as a predictor to determine successful completion of the Bachelor of Occupational Therapy (BOccTh) degree at the University of KwaZulu Natal. A retrospective review of the records of 103 BOccTh student who entered the course between 2005 and 2010 was conducted. Analysis of the year of entry, year of graduation, matriculation point average, number of years taken to complete the degree and degree averages was carried out. It was found that graduates with lower matriculation scores took longer to complete their degrees than those with higher matriculation scores. Graduates with higher matriculation scores had a higher degree average. The results suggest that matriculation scores may be used as a predictor of degree averages; however the authors view this finding with caution due to various confounding factors. <![CDATA[<b>Substance abusers' anger behaviour and sensory processing patterns</b>: <b>An occupational therapy investigation</b>]]> BACKGROUND: Persons with a high tendency towards anger often abuse substances. When problematic anger interferes with substance abusers' ability to cope, the occupational therapist plays a vital role in providing opportunities for substance abusers to experience and practice effective ways to deal with their anger. Many substance abusers seem to also have atypical sensory processing patterns. In Occupational Therapy atypical sensory processing is recognised as a domain of concern not only in children, but adults as well. It is against this background that the question was asked whether relations exist between substance abusers' anger behaviour and their sensory processing. METHODS: A quantitative, cross-sectional study was conducted to describe adult substance abusers' anger behaviour and sensory processing patterns. Adults with substance abuse difficulties admitted to two institutions in Pretoria between 1 October 2008 and 29 May 2009 represented the study population. The one institution specialises in substance abuse rehabilitation, while the other is an inpatient treatment facility for clients with mental health problems. A total of 84 participants met the inclusion criteria, of which 54 participants were in-patients at one institution and 30 in-patients at the other institution. Participants reported on the following anger behaviours: verbal expression, physical expression, escape, substance use, suppression, non-verbal expression, and calming strategies. Participants' sensory processing patterns were determined by completing the Adolescent/Adult Sensory Profile. RESULTS: Anger behaviour in the majority of participants with low registration patterns more than the typical norm, was related to a style of directly expressing anger (65.5% regularly expressed anger physically and 61.5% regularly expressed anger verbally). Anger behaviour in the majority of participants with sensory-avoidance patterns more than the typical norm, was related to a style of avoiding anger (62.5% seldom expressed anger verbally, 60.8% regularly escaped from anger situations and 58.9% regularly suppressed their anger). CONCLUSIONS: Occupational therapists should consider evaluating and if necessary address the sensory processing of their adult clients with problematic anger and/or substance abuse difficulties. Further research on the above associations is indicated in clinical and non-clinical populations. For future studies the use of a qualitative research approach and purposive or representative sampling are recommended. This will provide deeper understanding of relations found and support generalisation of results. <![CDATA[<b>A population approach to occupational therapy</b>]]> Structural and chronic poverty, adverse incorporation, a decline in employment opportunities and the neglect of rural development needs have combined to further destabilise the lives of people who have inhabited the margins of South African society for decades. While many adults struggle to cope with the demands of daily living, children are not thriving or coping well academically. People who receive some form of social grant are relatively better off than many of their neighbours, but in a communitarian society this regular income is shared with the whole household. A community-based rehabilitation approach with a strong occupational perspective could be used to mobilise rural residents (all ages, including disabled people, their households and neighbours) to self-help action, leading to better health, wellbeing and fruitful life course development. This would require conscientisation, effective teamwork and long term commitment from services and the community alike to an evolving process of development across many different sectors. The possibility poses an opportunity for occupational therapists that catch this vision to adopt a population approach to change, and to simultaneously promote people-centred development through occupation.