Scielo RSS <![CDATA[South African Journal of Occupational Therapy]]> vol. 48 num. 1 lang. en <![CDATA[SciELO Logo]]> <link></link> <description/> </item> <item> <title><![CDATA[<b>Developing a socially transformative focus in Occupational Therapy: insights from South African practice</b>]]> Social and political contexts are known to influence people's opportunities to engage in occupations. Occupational therapy in the domain of community development practice addresses the social determinants of health by contributing towards social transformation. Socially IH transformative practice refers to occupational therapy practice that strives to and addresses the social determinants of health and social Π I injustice through drawing on critical perspectives. Educators applied an autobiographical form of study, data were generated firstly through keeping a written reflective journal and audio recorded reflections on practice. Secondly, written comments and feedback to students ~\ during their community development practice placements were also included in the data set. Data were thematically analysed, yielding (/) I a theme and two categories. The theme: Towards socially responsive practice revealed the value of adopting a critical and collaborative approach to practicing occupational therapy in various domains of practice. Working towards social transformation was demonstrated as possible through the categories of being able to See and Feel the invisible and enabled as Equals working for change. The findings suggest that critical reflexivity together with implementation of participatory practices are necessary requirements towards addressing the conditions of people's health and occupational well-being. <![CDATA[<b>Occupational therapists' views and perceptions of functional capacity evaluations of employees suffering from major depressive disorders</b>]]> INTRODUCTION: Major depressive disorders (MDD) cause work disability and work loss, often resulting in unemployment. Employees with MDD are often referred to occupational therapists (OTs) to assist with functional capacity evaluation (FCE). Functional Capacity Evaluation forms a part of the return-to-work decision making process. This study describes the views and perceptions of occupational therapists regarding the requirements needed to conduct reliable FCEs of employees suffering from MDD. METHODS: This study employed a descriptive, qualitative study design. Data were collected in three phases using open-ended questions, focus groups and member checking groups. Thematic content data analysis was used. FINDINGS: In total, 78 occupational therapists were recruited and 39 participated, with response rates of (28) 47%, (11) 61% and (9) 82% respectively across the three phases. Nine participants took part in the focus groups and member checking groups. Three themes emerged, namely: (1) occupational therapists' competencies in performing functional capacity evaluations (2) the process of functional capacity evaluation and (3) comprehensive functional capacity evaluation. CONCLUSION: The views and perceptions of occupational therapists of performing FCEs is to formulate return-to-work decisions. Occupational therapists should be competent in the use of standardised measurement tools, non-standardised assessment and clinical reasoning. <![CDATA[<b>An exploration of the roles and the effect of role expectations on the academic performance of first year occupational therapy students: a University of the Free State case study</b>]]> First-year students in occupational therapy enter higher education and take on different roles while engaging in occupations such as academics, instrumental activities of daily living (IADL) and social participation. Some of the roles are new and pose challenges to students which in turn influence their academic performance. A qualitative research approach was applied by making use of a case study research design to explore possible factors that influence the students' academic performance. Eighteen first-year occupational therapy students from the University of the Free State were randomly selected to take part in the study. Data were collected from documentation and Nominal Group Technique discussions. The aim of this article is to report on some of the significant findings from the initial study, namely the roles students adopt to meet the challenges during their first year at university. Four roles were identified: role of a student, role of an independent young adult, role of a friend and role of a member of a campus residence. The identification of these roles should make educators take note of the need for support to the first-year student on a departmental as well as faculty level. <![CDATA[<b>People-centeredness in health system reform. Public perceptions of private and public hospitals in South Africa</b>]]> INTRODUCTION: South Africa's planned National Health Insurance system seeks to transform and integrate public and private healthcare services, as part of wider efforts to realise universal health coverage. Ensuring quality, acceptable care is crucial for public buy-in to these changes. In this study the public perceptions of the country's private and state hospitals are explored. A better understanding may guide improvements in public sector services, and strengthen confidence and trust in health system reforms. METHODS: Eight qualitative focus group discussions were held with 54 participants delineated by race ('black' and 'white' South Africans) and experience (recent or indirect) of public and private hospital services. The views on quality of care, cleanliness, satisfaction, staff attitudes, origins of perceptions, and suggestions for improving state hospitals were explored. FINDINGS/RESULTS: Thematic content analysis revealed an almost-automatic initial perception that private hospitals are "good" and state hospitals "bad". However, on further exploration, a more nuanced understanding surfaced around the costs and affordability of private and public hospitals, and trust in and acceptability of health services. CONCLUSION: Health systems are also human systems, with personal encounters at their heart. In order to acceptably serve people and society, policy emphasis is needed to build a culture of person-centred care in the public sector. <![CDATA[<b>Women's experiences of informal street trading and well-being in Cape Town, South Africa</b>]]> BACKGROUND: Street trading is one of the largest sub-categories in South Africa's booming informal economy. RESEARCH PROBLEM: The scarcity of occupational science/therapy literature around informal economy occupations limits the profession from understanding their implications for well-being and development. RESEARCH PURPOSE: Contextually relevant conceptions of survivalist occupations such as street trade will inform occupational therapy practice for social change and development. RESEARCH AIM AND OBJECTIVES: The study aimed to describe women street traders' experiences of street trading and well-being. The objectives were to identify the positive and negative well-being outcomes of engagement in street trading and to identify the social, economic and political factors that influence the well-being of women street traders. RESEARCH DESIGN: An ethnographic inquiry was carried out with four women survivalist street traders identified through purposive sampling. RESEARCH METHODS: Participant observation and in-depth one-on-one ethnographic and photo elicitation interviews were carried out with each participant. DATA ANALYSIS: Audio recordings were transcribed for inductive and thematic cross case analysis. FINDINGS: The qualitative essence of street traders' experiences of navigating a livelihood in the fluid and unstable context of the informal economy was captured in one theme, 'Togetherness: steering against the current towards a better life'. The theme comprised three categories: 'Taking the helm', 'Facing tough conditions' and 'We're in the same boat'. DISCUSSION: Street trading is a valued means for taking action towards economic survival and well-being. The contextually situated nature of this occupation translated to both adverse and advantageous experiences, resulting in a nuanced sense of well-being as thriving while surviving. CONCLUSION: Women's well-being as street traders is primarily determined by the quality of their collective camaraderie, social connectedness and personal drive. <![CDATA[<b>Occupational therapy students' experiences and perceptions of culture during fieldwork education</b>]]> BACKGROUND: Understanding a client's culture allows practitioners to consider the planning of intervention and allows for a client centred approach to be provided. During fieldwork education occupational therapy students can face the challenge of other cultural practices, standards, morals and ways of life coming into conflict with their own. PURPOSE: There is minimal South African literature discussing the challenges and supporting factors that assist students in becoming culturally competent across cross-cultural settings. This article explored occupational therapy students' experiences of culture, and their perceptions of the barriers and enablers that culture presents during fieldwork education. METHODS: A qualitative study was conducted with undergraduate occupational therapy students from a university in Cape Town, South Africa. Data were collected using focus groups with each group of students from first to fourth year and were analysed using thematic analysis. FINDINGS: The two main themes that emerged from the analysis, were: 1) "Culture is easily defined but not easily described", which focuses on the students own understandings and interpretations of culture, and 2) "Is there no 'me' in OT?" which specifically describes students' experiences of culture during fieldwork practice. IMPLICATIONS: The findings of this study questioned whether cultural competence is static but determined that exposure to, positive attitudes towards and self-reflection on culturally diverse experiences are the factors that contribute towards developing cultural competence in culturally diverse situations. <![CDATA[<b>Psychometric evaluation of the Quick Screening Procedure for referral to Occupational Therapy (QSPOT) for five year olds with and without barriers to learning</b>]]> INTRODUCTION: Adjustments made to the Quick Screening Procedure for Referral to Occupational Therapy (QSPOT) required further validation of the test. This test which was developed in South Africa, is used to screen motor, praxis and sensory-perceptual performance skills related to intrinsic barriers to learning in 4 to 6 year old children. METHOD: The aim of this study was to determine the known group discriminant validity and internal consistency of the QSPOT in identifying intrinsic barriers to learning in 5 year olds. The concurrent criterion validity of the QSPOT compared to the Movement ABC - 2nd Edition (MABC-2), and the Developmental Test of Visual-Motor Integration - 6th Edition (DtVMI-6) (Visual Motor Integration and Visual Perception subtests) as well as the accuracy of these tests were established. Seventy seven learners in mainstream schools and Learners with Special Education Needs (LSEN) schools were assessed with all three tests. RESULTS/FINDINGS: In terms of accuracy acceptable specificity was found for the QSPOT; however, sensitivity was not at an adequate level and lower than for the MABC-2 and the DTVMI-VMI. Adequate concurrent criterion validity was found between the QSPOT Total Score and the MABC-2 Total Score, as well as between the QSPOT and the DTVMI-VMI for Age-band 1 (5 years 0 months to 5 years 5 months), but not for Age-band 2 (5 years 6 months to 5 years 11 months. CONCLUSION: The QSPOT accurately identifies learners without barriers to learning, but may under-identify those with barriers to learning. Concurrent criterion validity of the QSPOT to the DTVMI-VMI and MABC-2 indicate that similar motor, praxis and sensory-perceptual performance skills deficits are identified within Age-band 1 but not for Age-band 2. In light of these findings revision of scoring and cut off criteria should be reviewed for certain items. <![CDATA[<b>Considerations when assessing urban South African children with the Developmental Test of Visual Perception 2</b><b><sup>nd</sup> edition (DTVP-2)</b>]]> INTRODUCTION: The Developmental Test of Visual Perception second Edition (DTVP-2) is frequently used by South African (SA) occupational therapists, despite the suitability of its US-based norms for SA children being questioned, and the 2014 release of the updated DTVP-3. This study investigated the suitability of the DTVP-2 norms for SA English-speaking children aged 5y 6mo-5y 11mo. SA sample scores were compared to American norms. Motor-reduced subtest scores were compared with and without the stop rule. Gender differences were tested. METHODS: A quantitative, descriptive study used 134 English speaking children. Motor-enhanced subtests were administered as prescribed, but motor-reduced subtests were administered without the prescribed stop rule, allowing prescribed and adapted scores to be computed. RESULTS: Scores of SA children varied from American norms, especially in visual closure, visual-motor speed and form constancy. Better visual closure scores were obtained when the stop rule was excluded. Boys and girls differed only on figure-ground, where girls scored higher. CONCLUSION: The DTVP-2 is valuable, but caution is recommended when measuring visual perceptual skills for this age band. Alternative instruments should be used, or local norms, or even more contextually relevant instruments, must be developed locally. At least, occupational therapists should apply US norms with care.