South African Journal of Occupational Therapy

A new publication model for SAJOT

Current practice used by therapists to screen and assess cerebral visual impairment in children with cerebral palsy in the South African setting

BACKGROUND AND PURPOSE: Cerebral visual impairment (CVI) is a common comorbidity in children with cerebral palsy and has a significant impact on their functional capabilities. The lack of obvious deficits related to the eyes means awareness of CVI is poor. However, early diagnosis of CVI in children with cerebral palsy supports intervention which may improve the child's functioning in everyday activities. Occupational therapists and physiotherapists are able to identify children at risk for CVI, but there is a lack of research on the screening procedures they use to identify this deficit. This study therefore aimed at determining the current awareness of and clinical screening procedures used by occupational therapists and physiotherapists to detect CVI in children with cerebral palsy in South AfricaMETHOD: A quantitative descriptive survey was distributed nationally to occupational therapists and physiotherapists treating children with cerebral palsyRESULTS: The majority (81%) of the participants could define and explain CVI but a formal diagnosis of CVI is not commonly seen in practice (15.3%). The difficulty in getting a formal diagnosis of CVI was reported as being due to a lack of testing for functional vision by medical professionals. Less than half of the participants (45.7%) reported that they would always screen for a CVI in children with cerebral palsy and 42.9% of participants reported that they used informal screening procedures. Most of the participants reported that they would alter their intervention if they were aware that a child with cerebral palsy presented with CVICONCLUSION: This study shows that although therapists are aware of CVI, there is limited screening for this deficit and little or no formal screening of CVI in children with cerebral palsy in the South African context

Exploring the implementation of the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) in Namibia. Perspectives of policymakers and implementers

INTRODUCTION: Namibia signed the UNCRPD in 2007 without any reservation. The country uses a monist system prescribed in its constitution. Therefore, the UNCRPD became part of the national binding document related to disability. This paper explores the perspectives of disability stakeholders on the implementation of the UNCRPD in NamibiaMETHODS: An exploratory qualitative study using in-depth interviews was conducted in Omusati and Khomas regions, Namibia. Key stakeholders in disability policy formulation and implementation were included in the study. Policymakers (n=4), implementers (n=7) and representatives from Non-Government Organisations (n=3) were recruited via purposive sampling. Data were thematically analysedRESULTS: The findings revealed evidence of fundamental national disability rights-enabling strategies. These include disability rights-enabling environment, national disability policy and legislative framework, and disability rights enforcement strategies. However, there are setbacks in implementing the UNCRPD in Namibia, such as the challenges created due to insufficient collaborative and technical capacity, limited aggregated disability data and lack of expertise and experience to apply UNCRPD concepts to advance disability rightsCONCLUSION: The disability sector may utilise policy and legislative framework and disability rights enforcement strategies to develop an Integrated National Disability Strategy to support occupational freedom and justice for persons with disabilities

Health seeking pathways for stroke survivors in a rural setting: Optimising early intervention for stroke rehabilitation in occupational therapy

BACKGROUND: Health seeking behaviour and health seeking pathways are interdependent concepts underpinning access to healthcare. Understanding these concepts is critical for appropriate and time-dependant stroke interventionsMETHOD: An explorative qualitative study design using one-on-one semi-structured interviews were conducted with 16 participants who were either stroke survivors or caregivers of stroke survivors. The Socio-Ecological Model (SEM) was used to guide data collection and the discussion of the findings in line with the objectives of this studyFINDINGS: The traditional health practitioners (n=11) were the most preferred first encounter followed by public hospital (n = 2) and private hospital (n=1) while others (n=2) self-medicated. On average, it took 30 days for stroke survivors to navigate the health system. The two themes emerging from this study, were 'health seeking delays', and 'the health seeking behaviour factor'CONCLUSIONS: A combination of factors influenced the health seeking delays at the levels of the SEM. The participants' health seeking behaviours were influenced by their knowledge, attitude, and beliefs at individual and interpersonal levels as well as dissatisfaction with health services at organizational and public policy levels of the SEM. In the South African rural settings, stroke survivors seek medical help from multiple service providers prior to consulting the public healthcare system due to diverse factors that affect them at interpersonal organizational, community and policy levels

Challenges related to worker characteristics in the workplace for people with mental illness, as rated by employees with and without mental illness

INTRODUCTION: Research on the workplace accommodation of people with a mental illness, considering their needs, abilities, and the required work competencies, is limited. Perceptions of which worker characteristics limit the abilities of those with mental illness in the workplace may influence both the understanding of accommodations required in terms of the work as well as the capabilities of these employees. This study, conducted in South Africa, aimed to determine how employees with and without a mental illness, employed in different work sectors, rated the likelihood that worker characteristics present a challenge in the workplace for people with mental illnessMETHOD: A quantitative, descriptive, cross-sectional design was used. An online questionnaire was completed by 271 participants with a mental illness and 455 without a mental illness. Participants were employed in the public, business, retail, manufacturing, and construction sectors. The impacts of work sector, gender and age were examinedRESULTS: There was a significant difference (p<0.05) for all 38 worker characteristics in the ratings between participants with and without mental illness. Work sector, age and gender contributed to this difference: Ratings only differed significantly in the construction sector on 19 characteristics, for the age group 35-46 years on 16 characteristics, and for males on 5 characteristicsCONCLUSION: People who do not have a mental illness rate the challenge presented by worker characteristics in those with mental illness differently from people who do have a mental illness. This may impact perceptions of work accommodations required

South African nursing students' awareness and knowledge of the occupational therapy profession

BACKGROUND: Interprofessional education is a growing field of knowledge that promotes collaborative competencies among healthcare professionals within a South African context. Occupational therapists and nurses work together to enhance patient care. However, little is known about nursing students' awareness of occupational therapyAIM: The study assessed the level of awareness and general knowledge of nursing students regarding the occupational therapy profession as part of interprofessional collaborative practiceMETHODS: A quantitative, descriptive cross-sectional survey design was conducted using a paper-based self-administered questionnaire with nursing students recruited from the Western Cape, Gauteng, and Mpumalanga provinces. The Statistical Package Social Sciences was used for quantitative analysis and content analysis was used for the qualitative commentsRESULTS: A response rate of 90.60% (n=299) was achieved. Of the respondents, 87.5% (n=262) were aware of occupational therapy, while more than half 57.5% (n=172) indicated that they know an occupational therapist. The findings showed that interprofessional education provided the respondents with opportunities to learn and collaborate with other students. Two-thirds of the respondents, 66.9% (n=200) indicated that they never engaged in an interprofessional module during their trainingCONCLUSION: Nursing students who had been exposed to interprofessional education had substantial general knowledge that occupational therapists collaborate with other professionals to improve the quality of life using activities as part of the interventions

Rediscovering identity through leisure travel: Lived experiences of persons with disabilities

INTRODUCTION: Travelogues for non-disabled travellers state that travelling offers an opportunity for constructing new identities. This meaning ascribed to travelling led the researcher to pose the question: What is the lived experience of travelling for people with disabilities? The objectives of this study were to describe and explore the experiences of travelling for people with disabilities, how they make sense of their experiences of travelling, and the meaning that travelling holds for them. The theoretical framework for the study is the Person-Environment-Occupation Model and the Model of Human OccupationMETHOD: A qualitative, hermeneutical phenomenological research design was utilised. Through purposive sampling, six participants were selected and then interviewed using a semi-structured interview guide. Interpretative phenomenological analysis was applied to analyse dataRESULTS: Three themes emerged, namely: A Double-edged sword, which highlights the contradictory effects of travelling, followed by People are part of the package, which emphasises the participants' interpretations of the role that society plays in disability, and lastly the Pilgrimage to self-discovery, as travelling offers the means to rediscovery of selfCONCLUSION: The study provides insight into how travelling, as a leisure occupation, facilitated discovery of a new identity for people with disabilities

Wheelchair prescription after spinal cord injury: satisfaction and functional mobility

INTRODUCTION: Globally, rehabilitation services aim to address activity limitations and participation restrictions for those with mobility issues. Therefore, the prescription of wheelchairs is integral to the work of rehabilitation professionals, particularly occupational therapists. The dearth of research in South Africa necessitated this study into wheelchair prescription, satisfaction with and the functional mobility in the prescribed wheelchairs for individuals with spinal cord injuryMETHOD: A cross sectional, descriptive, non-experimental research design was used to collect data from 40 participants using a demographic questionnaire, the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) 2.0 and Wheelchair Users Functional Assessment (WUFA). The data were analysed descriptively to determine the satisfaction with and the functional mobility in the wheelchair as well as the association between these variables. The influence of involvement in the prescription of the wheelchair, the type of wheelchair prescribed on satisfaction and the functional mobility in the wheelchair were also consideredRESULTS: Of the 40 participants, 34 (85%) were prescribed rigid-frame wheelchairs and only six participants (15%) received folding frame wheelchairs. Over 87.98% of the participants had a high level of satisfaction with their prescribed wheelchair and 84.82% reported being functionally mobile in their wheelchairs. High involvement in the prescription of the wheelchair resulted in higher scores for both satisfaction and functional mobilityCONCLUSION: This study concluded that a rigid-frame wheelchair facilitated functional mobility in individuals with SCI in the South African context. The greater the involvement of participants in the wheelchair prescription process, the higher their satisfaction with their wheelchair and functional mobility, indicating the importance of client-centeredness in wheelchair prescription in occupational therapy

Factors to consider in planning a tailored undergraduate interprofessional education and collaborative practice curriculum: A scoping review

BACKGROUND: Heath care students need to be practice-ready at qualification. Increased interest in and drive towards more collaborative practice necessitate consideration of teaching and learning factors unique to learning settings, to plan a tailored interprofessional education and collaborative practice curriculum, based on empirical findingsMETHOD: The Joanna Briggs Institute's scoping review methodology guided this study. Eight online databases were searched, with 72 articles included for full review. Charted data, analysed quantitatively, included year, context, study design and population. The four-dimensional curriculum framework model, consisting of future health care needs, interprofessional competencies, methods of teaching and institutional support, directed the deductive analysisRESULTS: Interprofessional education is best presented as a tailored curriculum, i.e. fitting the specific institution's needs, based on formal rather than a voluntary participation and presented longitudinally. Buy-in from institutional management assists in overcoming barriers related to resourcing and staff participationCONCLUSION: Successful interprofessional education and collaborative practice curricula are dependent on an interplay of various factors such as specific professions involved, future healthcare needs of the country, expected capabilities and competencies of graduates, content and teaching methods, and available resources. Facilitators, as well as policymakers of academic and clinical institutions, could benefit from the synthesized evidence

Madness. Stories of Uncertainty and Hope