Scielo RSS <![CDATA[South African Journal of Occupational Therapy]]> vol. 45 num. 2 lang. es <![CDATA[SciELO Logo]]> <![CDATA[<b>Editorial Comment</b>]]> <![CDATA[<b>The reliability of the Motor-Free Visual Perceptual Test (MVPT-3) when translated into Afrikaans, on a first language Afrikaans urban population aged 8 years 0 months to 8 years 11 months</b>]]> Occupational therapists and other professionals in South Africa are faced with the task of assessing and providing intervention for children from a range of cultural and language groups. The possibility of cultural variation in different cultural groups can produce confounding and inaccurate results and biased conclusions when the test is used with different groups and the results are interpreted using the norms and criteria provided by the authors. The aim of this study was to investigate the reliability of the Motor-Free Visual Perceptual Test 3rd Edition (MPVT-3) when instructions were translated into Afrikaans. A descriptive split-half comparative research design was used to determine the internal consistency of the items on the MVPT-3 after the instructions had been translated into Afrikaans. 80 learners between the ages of 8 years 0 months and 8 years 11 months were selected from nine schools to participate and the translated MVPT-3 was administered once during school time. Data was analysed using Cronbach's alpha and split-half reliability statistics. Results indicated that although overall reliability was adequate, the split-half reliability revealed that the reliability scores were not adequate for half of the test, with the second half of the test showing poor reliability. There were also significant differences between boys' and girls' performance on the test, with reliability scores for boys being well below the accepted level. Thus the reliability of the MVPT-3 both within the South African population as well as when translated is questionable and the test should be interpreted with caution. <![CDATA[<b>Clients' perceptions of an occupational therapy intervention at a substance use rehabilitation centre in the Western Cape</b>]]> Substance use among adolescents is a significant health and social problem and affects occupational performance. While occupational therapy interventions are available at substance use rehabilitation centres in the Western Cape, little is known about clients' perceptions of the usefulness of these interventions. A qualitative study was conducted to address this gap, specifically exploring clients' perceptions of the usefulness of the intervention on their occupations post discharge. The occupational therapist at a particular centre was interviewed as a key informant. Eight participants who attended the aftercare programme at the centre took part in three focus groups. Four themes emerged from the analysis of data: "We taking the drugs away, but we need to give them something back in that place"; "I don't want to be that person I was in the past"; "Keeping me clean"; "Take us out into the life". Participants perceived skills development, work training, life skills and leisure exploration to be useful. However, team members' roles and treatment objectives should be clarified to the clients to ensure that clients understand why they are participating in therapy. Finally, there should be more community-based, out-patient support programmes for adolescents so that the appropriate services are more easily accessible. <![CDATA[<b>Developing a vocational rehabilitation report writing protocol - a collaborative action research process</b>]]> A vocational rehabilitation interest group of occupational therapists in the public healthcare sector of Gauteng, South Africa, identified the writing of reports as a practice problem. Supported by a PhD candidate, they developed a report writing protocol with report templates, using action research as methodology. Collaborative steps, as part of an action research inquiry were taken to compile a concept report writing protocol and report templates. The concept protocol and templates were implemented in public healthcare vocational rehabilitation services. Critical reflection and feedback on the trial applications took place to refine the protocol. The protocol consisted of a cover letter, background information, legal and ethical considerations for reports, a step by step report writing guide including handy tips, report writing templates, and a guiding checklist. It concluded with a request for feedback from users, an undertaking for annual revision and suggested readings and skills training. Selected experts reviewed and critically appraised the final version. Dissemination of the final report writing protocol and templates was done through public healthcare forums and the annual vocational rehabilitation orientation workshop for occupational therapists entering public healthcare. <![CDATA[<b>Preparation for an uncertain world: Professional agency and durability in the practice preparation of mental health in occupational therapy</b>]]> INTRODUCTION: This article presents the findings from a cross contextual pilot study, which investigated how the occupational therapy pre-registration programme prepares occupational therapy graduates for contemporary mental health practice. In particular occupational therapy graduates in their first post were asked for their perspectives about how the curriculum had equipped them to be visible, agented and influential therapists, fit for practice for contemporary mental health METHOD: Using case study methodology, 11 graduates from a South African and a UK university were interviewed and the data thematically analysed and interpreted FINDINGS / RESULTS: Four key themes are presented, namely: 'identity and relationship to the profession'; 'informing personal attributes and characteristics'; 'professional knowledge and knowing'; and 'capacity, desire and durability to be, do, and act in practice' CONCLUSION: The findings revealed that the challenge for professional education in occupational therapy mental health lies in developing graduates as agented therapists with a strong professional identity and ability to creatively implement occupation-focused practice. Moreover, graduates need to be durable therapists, equipped in promoting professional perspectives amidst complex multi-agency organisational dynamics in the changing environment of practice <![CDATA[<b>Rehabilitation outcomes following autologous human stem cell transplantation in a chronic complete C4 tetraplegic - the first 12 months: A case report</b>]]> Autologous Human Stem Cell Transplantation (AHESC) is emerging as one of several promising new cell-based treatments for chronic spinal cord injury (SCI). Since chronic SCI is generally deemed irreversible, treatment paradigms for post-intervention rehabilitation after many years of disability are limited, and a description of the impact of such intervention on the patients is hard to find. Here we describe, for the first time, the multi-disciplinary post-operative rehabilitation and outcome of a patient with chronic cervical SCI after autologous human embryonic stem cell transplant. We include the anatomical, physiological, functional and quality of life outcomes. METHODS: A 33 year old male, American Spinal cord Injury Association (ASIA) Grade A, C4 chronic SCI patient received glial scar resection and Autologous Human Embryonic Stem Cell (AHESC) transplant, 6 years after injury, and thereafter had intensive interdisciplinary rehabilitation comprising occupational, biokinetic and physiotherapy, for an average of 17 hours per week over the course of 12 months. Outcomes were measured with standardised outcome measures of physiological improvement, increased independence, and a questionnaire was designed to gain understanding of the changes in quality of life and well-being of the patient, from his perspective RESULTS: The patient progressed from ASIA Grade A to ASIA Grade C, over the first 12 post-operative months. Sensory recovery comprised awareness of deep pressure and light touch in all dermatomes, with accurate localisation to L1. Motor activation was restored to all major muscle groups of the right upper limb, and to a lesser extent in the left upper limb, with some recovery in thoracic, abdominal and spinal muscles. Gains have been made in areas of motor, sensory and vascular function, self-care, wheelchair use and safety, and leisure participation. The patient has found these changes meaningful in terms of quality of life CONCLUSION: Regenerative medicine approaches may create rehabilitation potential where none formerly existed, presenting unprecedented challenges to rehabilitation therapists. Our experience demonstrates the value of intensive multi-disciplinary rehabilitation programmes in this setting, and provides a template for functional restoration and retraining after many years of chronic disability. It also emphasises the need to debate the ethical questions surrounding the application of such interventions and highlights the impact that participation in rehabilitation can have on a patient's perception of quality of life and health status. <![CDATA[<b>Occupational therapy hand assessment practices: Cause for concern?</b>]]> INTRODUCTION: Assessment is critical for measuring improvement, or lack thereof, and demonstrating the outcome of intervention. In response to the lack of research in this area, this study aimed to determine the assessment practices of occupational therapists working with clients with hand conditions METHODS: A quantitative cross sectional survey design was used. A convenience sample of occupational therapists was recruited from five provinces. Respondents completed a questionnaire developed for the study that comprised demographic information, assessments used, frequency of use and factors influencing assessment choice. Data were analysed with Statistica version 11 RESULTS: Eighty-one respondents (n=114) completed questionnaires representing a 71% response rate. Goniometry (84.0%), manual muscle testing (76.5%) and testing for flexor tendon function (76.3%) were used most frequently. The most common reasons for not using assessments were lack of availability and unfamiliarity CONCLUSION: It is of concern that the assessment practices of participants in this study focussed primarily on the assessment of body function and structure with few therapists using activity and participation measures. This could seriously limit the evidence needed to verify the outcomes achieved through occupational therapy intervention in the treatment of hand conditions. <![CDATA[<b>Students' fieldwork experiences of using community entry skills within community development</b>]]> BACKGROUND: Community development has been identified as an approach that occupational therapists can use to make a unique contribution to the health of communities. There is however limited research that addresses the practical application that occupational therapists need to use when engaged in community development. This includes community development's most important phase of community entry which is defined as a prelude to any action that will take place in true partnership with the community PURPOSE: This paper explores the experiences offinal year occupational therapy students using community entry skills during community fieldwork practice METHODS: An auto-ethnographic approach was used to explore students' experiences of the use of community entry skills within community development. Data collected included the use of the students' reflective fieldwork journals, a narrative and a focus group. All data collected was critically analysed through a process of thematic analysis in order to explore the students' experiences of the use of community entry skills during community fieldwork practice FINDINGS: The findings of this study highlight that the process of community entry is a subjective experience that requires mindfulness and awareness in becoming a part of the community. This allows professionals to interact with the community and its members and it gives rise to the understanding that one receives when working in a community IMPLICATIONS: Recommendations are made regarding the support of and preparation of Occupational Therapists in the field of community development. <![CDATA[<b>Fostering evidence-based practice in community-based rehabilitation: Strategies for implementation</b>]]> Occupational therapists around the world are taking up the challenge to implement an evidence-based practice approach to the development of occupational therapy services. The emphasis in applying evidence-based practice within occupational therapy has been strongly biomedical in focus. In South Africa, many occupational therapists work in communities where their work is largely community-based rehabilitation. With no examples of how evidence-based practice can be applied in such settings, therapists have struggled with how it may be used to inform their practice. This paper explores the concepts of evidence-based practice and community-based rehabilitation, and illustrates how evidence-based practice can be applied within community-based rehabilitation. Examples are provided to show how evidence-based practice can realistically be applied in community-based rehabilitation programmes with the intention of empowering therapists to begin using evidence as a basis for their practice. It further explores how evidence-based practice can be used by occupational therapists to inform decision-making related to the development of community-based rehabilitation programmes and services. <![CDATA[<b>An historical overview of the development of occupational therapy educational institutions in Brazil</b>]]> INTRODUCTION: The first occupational therapy (OT) undergraduate programme in Brazil opened in 1956 in Rio de Janeiro by the "Associagao Brasileira Beneficente de Reabilitagao", as a technical educational course. It became a university undergraduate programme only in 1969. The aim of this article is to provide a comprehensive overview of the development of OT undergraduate programmes in Brazil. In addition, a mapping of the distribution of existing educational courses in Brazil will be reported through an historical overview. From 1958 until 1986, 15 undergraduate programmes were identified. Between 1987 and 1999, this number increased to 24 and finally between 2000 and 2011 this number was raised to 75 across the whole country. There are some significant differences between the OT courses, depending on the region of the country. The lecturing laboratory spaces that drew the most attention were the Assistive Technology Laboratories, which only began to appear in the middle of the 2000s CONCLUSION: There was a marked increase throughout the last decade in the number and the quality of OT undergraduate programmes in Brazil, which consequently enhanced the number of occupational therapists in the country, improved standards within the profession and brought advances in the field of practice. In order to understand the role of the practitioners in the contemporary world a dialogue between different countries and continents plays an important role when reflecting on the OT undergraduate programmes. <![CDATA[<b>The use of Danielson's Framework in developing a new fieldwork training setting for 3<sup>rd</sup> year occupational therapy students from the University of the Western Cape</b>]]> Charlotte Danielson developed a framework for teaching to assist novice educators. Her framework considers four domains, namely Planning and Preparation, The Classroom Environment, Instruction and finally Professional Responsibilities. This article describes the adaptation of Danielson's Framework in the development of a new fieldwork setting for third year occupational therapy students. The description of the process that was followed illustrates how the four domains were used to guide the development of a new fieldwork setting, which would meet the requirements of the university as well as the needs of a group of six third year occupational therapy students who were doing their first fieldwork practice in this new setting. The conclusion shows that this Framework proved to be a suitable one to guide the process of developing a fieldwork setting.