Scielo RSS <![CDATA[South African Journal of Occupational Therapy]]> vol. 51 num. 2 lang. en <![CDATA[SciELO Logo]]> <![CDATA[<b>The Protection of Personal Information Act: Its effect on Clinical Practice and Health Research</b>]]> <![CDATA[<b>Promotion of Access to Information Act: Key issues for occupational therapists</b>]]> INTRODUCTION: Increasingly, healthcare practice, including occupational therapy, is influenced by non-medical legislation, such as the Promotion of Access to Information Act (PAIA), which regulates the right to access information held by others. While the PAIA does not intend to limit existing access to information rights, such as a patient's right to access their health information in terms of the National Health Act, the PAIA does provide better clarity regarding access to patients' information than health-related legislation and policies, including those of the Health Professions Council of South AfricaMETHOD: Using normative analysis of a desktop review of relevant legislation, case law and literature, this paper aims to provide guidance to occupational therapists about patients' right to access their information in terms of five themes: Theme 1: What is the difference between a public and a private body? Theme 2: Who may request access to information? Theme 3: Is there a prescribed process to be followed when requesting access to information? Theme 4: What is the nature of information to which access is granted? Theme 5: Are there any circumstances under which access may reasonably be refused?CONCLUSION: The paper concludes that, while existing health-related legislation and policies already provide the right to access to information, application of specific guidance from the PAIA e.g., using prescribed forms to request access, could serve to better protect patients' and practitioners' interests alike <![CDATA[<b>Assessment of in-hand manipulation by occupational therapists in paediatric practices in South Africa</b>]]> INTRODUCTION: Assessment of in-hand manipulation is fundamental to guide treatment for children with fine motor delays. Limited literature is available on how South African occupational therapists assess in-hand manipulation. This study aimed to describe which current in-hand manipulation assessment methods are used and what the preferences of occupational therapists in all areas of paediatric practices are regarding a suitable instrumentMETHODS: Quantitative cross-sectional study design with a non-probability purposive sampling method was used. Participants completed an EvaSys survey system online questionnaireRESULTS: Two-hundred-and-ninety-two (n=292) occupational therapists registered with the HPCSA participated. Limited familiarity (n=50; 17.1 %) with the formal assessment instruments described in literature was reported. The informal assessment methods most commonly used were subjective observation of tasks (n=287; 98.3%) of scholastic tasks (n=261; 89.4%) and play tasks (n=255; 87.3%) for children between the ages of five to six years (n=273; 93.5%). Preferences supported a descriptive instrument accompanied by a user manual that is administered under 15 minutes, in multiple languages, and with attention to the quality of movements and compensatory techniques used by the childCONCLUSION: Results showed that the current and preferred assessment methods used by occupational therapists might provide guidance for the future development of a contextual, relevant in-hand manipulation instrument for paediatric practices in South Africa <![CDATA[<b>Clinical utility of three sensory modulation measures for the child with ASD in South Africa: A practitioner's perspective</b>]]> BACKGROUND: There is need for the assessment of sensory modulation in children with Autism Spectrum Disorder (ASD) to be culturally, environmentally, economically and language sensitive to the South African population. It is assumed that the measures in current use are not appropriate, acceptable, practical or accessible for the South African child with ASDAIM: This study sought the practitioners' perspective on the clinical utility of three sensory modulation measures for children diagnosed with ASD in South AfricaMETHODS: A quantitative survey method was used to collect data from a purposive sample of 31 SAISI Occupational Therapy members nationwideRESULTS: Urban participants accounted for 83% of the sample, 80% were in private practice and 67% from English-speaking practices. All three measures demonstrated some level of clinical utility. The Sensory Processing Measure (SPM) was found to be more appropriate than the Sensory Profile (SP) (p<0.007), although the SP was more accessible than the SPM (p<0.002). Amongst non- English speakers the Sensory Experiences Questionnaire (SEQ) was more acceptable than the SPM (p<0.045RECOMMENDATIONS: The SPM should be used in an interview format, with recommended changes and translation into the caregivers' home language, until a South African specific sensory screening measure, which can be readily reproducible in several local languages, is developed <![CDATA[<b>Coping Styles and Sources of Stress of Undergraduate Health Science Students: An Integrative Review</b>]]> METHOD: Background and aim: Tertiary education provides many personal and social benefits. However, students, particularly those from professional and health science disciplines are known to face significantly greater stress throughout their undergraduate degrees. In this integrative review sources of stress for students and the strategies they use to cope with the stress are explored. : Various databases were searched using common key phrases such as "stressors among undergraduate health science students" and "coping mechanisms utilised by undergraduate health science students". Thirty-three articles were selected based on predetermined inclusion and exclusion criteria. The content in the articles were analysed to identify themesRESULTS: Academic stress was the primary source of stress for health science students. Other sources of stress included interpersonal interactions and clinical training. Students primarily used problem-focused strategies to cope with stress. Other strategies included avoidance and the use of social support networksCONCLUSION: Health science students experience stress from academic tasks, interpersonal stress and stresses emanating from clinical training. They utilize problem-focused coping strategies, as well as avoidance and seeking social support when faced with stressful situations. Students would benefit from regular screening for stress-related conditions, and interventions to teach them more adaptive ways to deal with stress <![CDATA[<b>Learning styles in Physiotherapy and Occupational Therapy students: an exploratory study</b>]]> BACKGROUND: Learning styles of health care professionals are unique and tend to be profession- specific. This study aimed to compare the learning styles of undergraduate occupational therapy and physiotherapy students and to determine the relationship between preferred learning styles, demographic factors, and academic performanceMETHOD: The study design was a cross-sectional, descriptive study. Undergraduate occupational therapy and physiotherapy students completed a self-developed questionnaire and the Grasha-Reichmann Learning Style InventoryRESULTS: A total of 313 students with a mean age of 19.6±1.58 years participated in this study. The results showed that students preferred the collaborative (75%) learning style, with the first-year students scoring significantly higher in the collaborative style (3.97±0.48; p<0.001). The male students (2.67±0.65) scored higher in the competitive learning style than female students (2.20±0.62; p=0.001, d=0.757). The competitive learning style, when controlling for sociodemographic variables, is a significant predictor of an increase in academic performance in English language (B=2.28, [0.60-3.96]), physics (B=3.62, [0.22-7.02]) and overall academic performance (B=2.12, [0.34-3.90CONCLUSION: The predominant preferred learning styles are the collaborative and participant styles. The application in the teaching space should be carefully considered for the selection of teaching approaches and activities. This study points to the Physiotherapy and Occupational Therapy programmes need to align to the collaborative style and respond with a variety of teaching methods. The associations shown between preferred learning styles and demographic variables point to the need to pay attention to diversity when selecting teaching approaches and activities <![CDATA[<b>Shaping professional identity: a descriptive qualitative study on Health and Rehabilitation final year students in higher education</b>]]> BACKGROUND: Professional identity represents a person's philosophy of their profession. This identity defines what it means to be and act as a professionalAIM: This paper will describe the factors that shaped the professional identity of students in Occupational Therapy, Physiotherapy and Communication Sciences Disorders during their four years (2015 - 2018) of studies in the Faculty of Health Sciences in a higher education institutionMETHODOLOGY: A descriptive qualitative design was used to describe the factors that emerged. Seven participants were purposively selected from the Faculty of Health Sciences. Individual interviews and a focus group with participants were conducted. Data were analysed inductivelyFINDINGS: The results generated the theme 'The curriculum and experiences within practice and professional environments shape professional identity'. The findings highlighted how critical events in higher education may have influenced the participants to develop a professional identityCONCLUSION: The curriculum played an integral role in defining how the narrative for each participant was played out and how professional and practice environments greatly shaped the students' developing professional self <![CDATA[<b>Challenges impacting functional recovery experienced by Mental Health Care Users with Major Depressive Disorder after a short-term admission to hospital</b>]]> INTRODUCTION: Major Depressive Disorder often has a chronic course. Mental Health Care Users (MHCUs) with this diagnosis report experiencing challenges with the transition to their home and in resuming their previous activities of daily living or their functional recovery after a short-term admission to hospital. This research aimed to explore these challenges which these MHCUs perceived had contributed to their re-admission within a six-month periodMETHODS: A qualitative descriptive design was used to explore these challenges. Data were gathered through semi-structured interviews with eleven participants and analysed thematicallyRESULTS: Data analysis generated two themes: 'Inability to fully benefit from the therapeutic programme' and Life was not what I expected it to be after discharge'. Participants reported struggling to participate fully in the occupational therapy programme during admission and with the abrupt transition from hospital to home. They reported challenges in implementing changes that they had committed to in hospital and a lack of support from significant others. The greatest challenge reported by participants was in the social participation category of occupation and their experiencing extreme loneliness and isolation after dischargeCONCLUSION: The unresolved challenges experienced by participants during hospitalisation and after discharge were perceived to be detrimental to their functional recovery <![CDATA[<b>Postural control in children receiving intervention using the Astronaut Training Protocol</b>]]> INTRODUCTION: The vestibular system plays an important role in postural control and an upright posture when seated at a table. Some children have difficulty with their in-seat posture resulting in increased in-seat movement. This research investigated the effect of the Astronaut Training Protocol on a child's vestibular processing and postural control, and by extension their in-seat behaviourMETHOD: A case study research design with multiple data sources was used with four participants identified presenting with dysfunction in in-seat posture and in-seat movement. Data were collected over three phases: Pre-Astronaut Training (Baseline), Post-Astronaut Training (Intervention) and Withdrawal. The Pre-Astronaut Training and Withdrawal phases consisted of four sessions of sensory-based occupational therapy while the intervention phase included eight Astronaut Training sessions in addition to regular sensory-based occupational therapy. Four assessments were used to determine vestibular and postural control changes at each phase: Movement ABC one-leg balance, Post-rotary Nystagmus (PRN) test, in-seat posture assessment (designed for the purpose of this study), and in-seat movement through the collection of data using an accelerometerRESULTS: Participants' scores differed, depending on their initial ability to tolerate rotary input. This research showed that change in vestibular function and postural control differed for participants who could tolerate rotary input and those who were over-reactive to rotary input at the start of the study. Generally, the participants who were over-reactive to rotary input showed greater improvement Post-Astronaut Training with continued smaller improvements into the Withdrawal phase. Participants who could tolerate rotary input showed improvement in in-seat posture and in-seat movement during the Post-Astronaut training phase and deteriorated during the Withdrawal phaseCONCLUSION: The Astronaut Training Protocol can improve vestibular function and postural control in children with poor in-seat posture and in-seat movement, although the frequency and intensity of the programme still need to be confirmed <![CDATA[<b>The application of the Vona du Toit Model of Creative Ability to self-employment in South African informal microenterprises</b>]]> INTRODUCTION: Persons with disabilities experience difficulties entering the formal South African labour market despite progressive legislation to enhance their economic participation. Consequently, self-employment becomes a work placement consideration for occupational therapy clients. However, self-employment requires certain volitional attributes, and the identification of such attributes would greatly enhance the outcome of vocational rehabilitation efforts. The aim of the study was to describe the level of creative ability of self-employed business owners in informal microenterprisesMETHOD: A descriptive, quantitative non-experimental research design was used. Sixteen self-employed business owners of informal microenterprises were interviewed and observed completing work tasks using the eight domains of the Activity Participation Outcome Measure (ApOM) based on the Vona du Toit Model of Creative Ability (VdTMoCARESULTS: Participants were between 27 and 50 years of age. Their education levels ranged from no-education (6%) to tertiary education (19%) with the majority (38%) having a high school education. Based on the APOM scores, participants functioned on three levels of creative ability namely: Passive Participation, Imitative Participation and Active Participation. Most participants functioned at the Imitative patient-directed level with the highest APOM domain scores for all participants being Communication Skills, Affect and Role PerformanceCONCLUSION: To be successfully self-employed in an informal microenterprise, the required level of creative ability ranging from Passive to Active Participation, was identified. This provides occupational therapists with an understanding of these requirements when considering self-employment as work placement option <![CDATA[<b>A review of South African Public Healthcare policies addressing Service Delivery for wheelchairs through a Primary Health Care lens</b>]]> INTRODUCTION: In some areas of South Africa, people with impaired mobility are known to have difficulty accessing wheelchairs. This study aimed to critically appraise public healthcare policies addressing service delivery in terms of assistive devices in general, and more specifically wheelchairs within primary health careMETHOD: South African public healthcare policies that address assistive device service delivery were identified and thematically analysed using retrospective deductive document analysis. The themes used correspond to the WHO guidelines for the provision of wheelchairs within the context of the guiding principles of primary health care i.e., accessibly, affordability, acceptability, appropriateness, and availability. An analysis was undertaken on how the provision of assistive devices under these principles was addressedRESULTS: Three policies were identified addressing assistive device service delivery i.e. The National Rehabilitation Policy, The Policy Framework and Strategy for Disability and Rehabilitation Services in South Africa 2015 - 2020, and the National Health Insurance Policy. The National Rehabilitation Policy addressed the majority of the WHO guiding principles on wheelchair provision. Guidelines for non-discriminatory and evidence-based service delivery and the availability of assistive devices were identified in all the documents. Scant attention was paid to service delivery of assistive devices for people residing in urban or peri-urban areas. There was a paucity of guidance on service delivery to people with impaired mobility who were unable to access health services, those unaware of the services available and those who were not aware of the benefits of an assistive deviceCONCLUSION: The policies, viewed together, addressed all the WHO guiding principles, although some gaps were observed in each policy. A proposal emanating from this review was that an update of the National Rehabilitation Policy would address these deficiencies <![CDATA[<b>The meaning that undergraduate Occupational Therapy students at the University of KwaZulu-Natal attach to the Occupation of dance</b>]]> INTRODUCTION: Occupational Engagement is an inextricable component of life and is considered essential to human survival. Doing an occupation that is positively perceived (such as dance) can lead to the experience and expression of meaning which then enhances quality of life. This study aimed to explore the meaning that undergraduate Occupational Therapy students studying at the University of KwaZulu-Natal attach to dance as an occupationMETHOD: The study followed an exploratory qualitative research design with purposive sampling. Focus groups and semi-structured interviews were utilized to collect data which were analysed thematicallyRESULTS: Five themes emerged: Centre stage (an exploration of factors motivating engagement); On Pointe (beneficial effects of dance); My Solo Dance Experience (the individual's journey whilst engaging); It Takes 2 to Tango (exploring the role of relationships) & Dancing to the Beat (exploring time available for engagement). The hidden complexities of 'meanings' attached to the occupation of dance emerged which were experienced as subjective and multi-dimensionalCONCLUSION: The study revealed that the meanings attached to dance were based on individual experiences with the occupation, others and the environment. Engagement in the occupation of dance (doing) enhances personal growth (becoming) and becomes a part of the individual (being <![CDATA[<b>Re-orienting occupational therapy: Embracing generative disruption and revisiting a posture that acknowledges human dignity</b>]]> BACKGROUND: Amidst the Covid-19 lockdown that commenced in March 2020, while the profession and service-users were coming to terms with its vast implications, the Occupational Therapy Association of South Africa initiated a Webinar series that stimulated provocative discussions and difficult dialogues. The authors of this paper deliver a commentary, critically engaging with the challenges of cogently articulating the contribution of occupational therapy services across various sectors of service delivery during the first wave of the Covid-19 pandemic in South Africa. The challenges of on the one hand, negotiating the abrupt cessation of rehabilitation services, especially in the public sector and, on the other, advancing the reasoning for accessible, community-based services, are consideredAIM: The commentary draws from presentations at and reflections on the webinar hosted on 24 June 2020 titled 'Ethical and Moral Challenges for Occupational Therapy'. In this paper, the competing ethical and moral issues arising from being urged to adopt different ways of thinking and doing occupational therapy during the Covid-19 lockdown are outlinedPROPOSITION: It is suggested that experiences emerging from this pandemic are urging the profession to rethink its positionality in the health sector. Two main considerations deserve attention: The first is rethinking how we use occupational therapy knowledge to act from and in relation to local contexts, viewing people who are marginalised as knowledge and action partners through generative disruption. The second is to revisit what it entails to foster a posture that acknowledges human dignityCONCLUSION: Generative disruption includes a continuous and unabashed critical reflection of and on the limits of our practice and knowledge at hand. It means that we need to include service users and community partners in taking necessary steps to render services in local contexts most needed in recalibration toward social and occupational justice. In our knowledge-making partnerships, it is also imperative to revisit the posture of acknowledging human dignity <![CDATA[<b>Community translation in the context of the translation and cross-cultural adaptation of patient reported outcome measures: a South African perspective</b>]]> INTRODUCTION: Occupational Therapists should use relevant patient reported outcome measures as part of providing evidence for occupational therapy intervention. Measures must be responsive, valid and reliable for use in all health sectors. An essential requirement is that the measure be available in the language of the populations it is intended for. As most measures are developed in the English language for use in English speaking countries, we put forward an opinion on the practice of community translation during the translation and cross-cultural adaption of patient reported outcome measures towards increased clinical utility in the public health sector of South Africa