Scielo RSS <![CDATA[South African Journal of Occupational Therapy]]> vol. 50 num. 1 lang. en <![CDATA[SciELO Logo]]> <link></link> <description/> </item> <item> <title><![CDATA[<b>Patient characteristics, therapy service delivery and patient outcomes following pyrocarbon proximal interphalangeal joint arthroplasty</b>]]> BACKGROUND/AIM: Studies on likely sociodemographic and pre-surgical determinants of hand function and satisfaction following pyrocarbon proximal interphalangeal joint arthroplasty (PPIJA) are scarce. The primary aim of this study was to explore the association between pre-surgical sociodemographic and clinical characteristics and post-surgical hand function and satisfaction of patients who underwent PPIJA. A secondary aim was to evaluate the effects of the procedure on pain and active range of movement (AROM) using retrospective data and on-site follow-up assessment. METHODS: A panel survey of 48 patients (male = 13; female = 35) with median age of 64 years, who had PPIJA between 2001 and 2012, with a total of6l arthroplasties, was conducted. During follow-up, participants' pain and satisfaction, AROM, and hand disability were assessed using the Pain and Satisfaction Questionnaire (PSQ), goniometer, and the Disability of the Shoulder, Hand and Elbow (DASH) Questionnaire respectively. RESULTS: The main reason for surgery amongst participants was joint stiffness (68%) while 33.3% of the participants had a repeat surgery. Participants' median satisfaction and DASH scores at final assessment were 3 and 22.55 respectively. Patients who underwent arthroplasty once had significantly higher median PSQ scores (p = 0.011) than those who had their surgery repeated. Pain significantly reduced (p < 0.001) while AROM significantly increased (p = 0.001) from pre-operative assessment to final follow-up assessment CONCLUSIONS: Pyrocarbon arthroplasty improved treatment outcomes regarding pain and joint motion; post-operative satisfaction may be associated with patients having a repeat surgery. <![CDATA[<b>The use of appreciative inquiry with mental health service consumers -towards responsive occupational therapy programmes</b>]]> BACKGROUND: Common ways of planning and evaluating occupational therapy services include the clinical judgement of therapists and cause-effect interpretation of statistics. Patient-informed methods of planning occupational therapy services are yet to be explored within occupational therapy, and more specifically within the provision of in- and out-patient mental health services in South Africa. An Appreciative Inquiry was conducted to explore the views of a group of out-patients on a craft group at a tertiary mental health hospital in the Western Cape, South Africa. OBJECTIVES: To highlight the use of Appreciative Inquiry to explore the perspectives of out-patient mental health consumers. To identify the enabling elements contained in an Occupational Therapy out-patient craft group. METHODOLOGY: A social constructivist paradigm framed the research process. The 4-D model of Appreciative Inquiry was used. Six participants selected via purposive sampling were recruited as co-researchers. Five data collection sessions of 90 minutes each were conducted. Inductive analysis was used. FINDINGS: The research participants come from differing ethnic and social backgrounds which contributed to the richness and transferability of the findings. Participants identified ten elements that enabled them to improve their mental health and enhanced their sense of belonging to the group. These included non-judgement, being able to redo the craft activity at home, no pressure, the stimulating effect of the group, being able to talk to the therapist about anything, feeling like a family, socialising nicely, a calm environment, feeling safe at the group and a quiet environment. It may be unrealistic for an occupational therapist to have the time available to evaluate their clinical services using the Appreciative Inquiry model. However, it may be beneficial for occupational therapists to apply the principles of Appreciative Inquiry in the evaluation of their groups. CONCLUSION: Appreciative Inquiry is a valuable method for exploring patient views of useful aspects of occupational therapy outpatient art groups. <![CDATA[<b>Dynamic Seating in Learners with Down's Syndrome in South Africa</b>]]> INTRODUCTION: The study aimed to investigate whether the classroom behaviour and task performance of learners with Down syndrome improved with the use of a stability ball as a classroom chair METHOD: A single-subject withdrawal design was utilised. There were three participants, aged ten to twelve, with Down syndrome in a special education classroom. Five phases of three weeks each were implemented alternately. Two phases incorporated usual classroom chairs and the other three phases made use of stability balls as chairs. Momentary time sampling was used to record learners' classroom behaviours in relation to their in-seat and on-task performance RESULTS: A substantial positive change was found in the learners' on-task performance when seated on stability balls instead of chairs. Results differed across participants; with some demonstrating a definite difference in the usual daily average on-task performance, while others showed steadier patterns of on-task behaviour in comparison with their usual fluctuating levels of attention CONCLUSION: Stability ball seating is a non-invasive intervention strategy that can be effectively utilised in classrooms and occupational therapy clinical settings, to improve on-task behaviour in learners with Down syndrome <![CDATA[<b>Parents and caregivers knowledge of school readiness for children admitted to Grade R and Grade 1</b>]]> INTRODUCTION: Children with scholastic difficulties, including failure to adapt to or thrive in formal schooling, are frequently referred to occupational therapists. Assessment of these children indicates that many of them have not attained the essential school-readiness skills. Concerns have been raised that parents/caregivers often only consider school-readiness with respect to age rather than other developmental milestones. Research has found that the parents' or caregivers' understanding and ability to determine their children's development in relation to school-readiness is important if the child is to succeed academically. The purpose of this study was to explore parents' or caregivers' knowledge of school-readiness as per the expectations for formal schooling as defined by the current National Curriculum and Assessment Policy Statement (CAPS) and the Independent Schools Association of Southern Africa, (ISASA METHOD: This study used a quantitative, descriptive, cross sectional survey research design. Stratified sampling was used to select a sample of parents or caregivers of children admitted to Grade R and Grade 1 level at schools in the Gauteng Province. A self-report questionnaire, specifically designed from the literature was circulated to parents/caregivers by participating schools RESULTS: There was a 41.2% return rate, but only 180 returned questionnaires could be analysed. The results found that that 57.9% of the participants had the correct expectation of school-readiness in ten learning areas within the questionnaire. Participants viewed school-readiness most correctly in the learning areas of Thinking and reasoning (78.9%) and Motor ability (76.8%), while the learning areas of Activities of daily living (ADL) (48.9%), Reading and viewing (48.2%) and Language structure and use (33.7%) were rated with less accuracy, with both under-estimations and over-estimations reported. The mother's level of education was the single demographic factor found to have significance with respect to knowledge of variables related to school-readiness CONCLUSION: The parents/caregivers in this study had a fair understanding of some of the variables included in school-readiness, but their ability to determine others, including ADL, was limited. Occupational therapists should be cognisant of the curriculum criteria for school-readiness and should play a role in raising awareness of school-readiness criteria among parents and caregivers wherever possible, to prevent scholastic under-achievement due to lack of school-readiness <![CDATA[<b>Being a mother of a child with HIV-related Neurodevelopmental Disorders in the Zimbabwean Context</b>]]> BACKGROUND: There is a growing population of mothers caring for their biological children who are infected with Human Immunodeficiency Virus (HIV), in Zimbabwe. Many of these children present with HIV-related Neuro Developmental Delays (NDDs). The occupation of being a mother is a complex and multifaceted role geared towards caring for and nurturing children. The different ways in which mothers negotiate the unique circumstances linked to the occupation of being a mother to a child with diagnosis of HIV-related NDDs warrants exploration. AIM: The aim of the study was to describe the mother's experiences of engaging in daily occupations relating to caring for their child with HIV-related NDDs. METHODOLOGY: A descriptive qualitative study using a hermeneutic phenomenological approach was used to uncover the mothers' lived experiences of caring for their child with HIV-related NDDs. Data generated from phenomenological interviews conducted with five mothers were analysed inductively using a simplified version of the StevickColaizzKeen method FINDINGS: Two major themes, namely 'Ndozvazviri' (Resilient Acceptance) and 'Rekindled hope for the future' emerged from the findings. These themes revealed that caring for a child with HIV-related NDDs is a difficult and demanding role. Despite this, mothers accepted and found meaning in this caring role. Their meaning was expressed through the opportunity to care for their own child and to observe their progress in occupational development and engagement. These interactions created positive experiences for the mothers and rekindled their hope for the future of their child. DISCUSSION AND RECOMMENDATIONS: Despite the huge demands associated with being a mother of a child with HIV-related NDDs, mothers were committed to this role and were reluctant to entrust this role to others. The findings of this study encourage occupational therapists designing interventions for families, to carefully consider how the mothering role positively shapes the identities of mothers caring for children with HIV-related NDDs. <![CDATA[<b>Interventions for Primary Caregivers of Children with Autism Spectrum Disorder: A cross-sectional study of current practices of stakeholders in South Africa</b>]]> BACKGROUND: Primary caregivers of children with autism spectrum disorder (ASD) face many challenges potentially impacting their mental health and well-being. Given their role in childcare, it becomes essential that primary caregivers be recognised as health care users who should receive interventions towards improved health, well-being and quality of life (QOL). The study aimed to describe the content, structure and mechanism of delivery of interventions offered to primary caregivers of children with ASD, with specific reference to QOL, in South Africa METHOD: A cross-sectional survey design was used to establish the interventions provided to primary caregivers as reported by health care and non-health care professionals who deliver interventions to children with ASD and their families, using an online questionnaire. Snowball sampling was implemented to access a sample of 61 respondents. Demographic data were analysed using descriptive statistics. Details of specific content ofinterventions were analysed according to identified intervention goals. Closed questions (binary and intensity scales) were analysed using frequencies and means and open-ended questions were thematically analysed with deductive reasoning using QOL domains as identified in relevant literature RESULTS: Demographics of respondents are presented. Content of intervention included goals towards, awareness about ASD, interventions beneficial for the child with ASD and interventions beneficial for the primary caregiver. The structure and mechanism of delivery of interventions are described. Three QOL domains, development and activity, as well as social and emotional wellbeing, were more commonly targeted in interventions. Physical and material wellbeing were targeted to a lesser extent CONCLUSION: The QOL elements that are embedded in the described interventions described, highlight both strengths and limitations within current practices. Additionally, it is noted that interventions appear to primarily cater for the needs of the child, with gaps in catering directly for the needs of the primary caregiver. The mental health and wellbeing of the primary caregiver is essential for the child with ASD to develop and achieve their optimal potential. Therefore inclusion of the social, emotional and health needs of the primary caregiver need to be overt with specific outcomes towards improved QOL within interventions <![CDATA[<b>Informal caregivers for stroke survivors: what does occupational therapy offer?</b>]]> Informal caregivers play an important role in the continuum of care for survivors of stroke and the caregivers' own well-being may therefore have a significant impact on the survivor of stroke. Yet, caregiver training and support often do not fulfil the needs of caregivers and the consequences are often described in literature as 'burden of care'. In this article, we encourage occupational therapists to consider caregiving from an occupational perspective and we propose strategies for the enabling informal caregivers to maintain optimal well-being and health by means of increased opportunity for balanced occupational participation.