SciELO - Scientific Electronic Library Online

vol.39 número3 índice de autoresíndice de assuntospesquisa de artigos
Home Pagelista alfabética de periódicos  

Serviços Personalizados



Links relacionados

  • Em processo de indexaçãoCitado por Google
  • Em processo de indexaçãoSimilares em Google


South African Journal of Occupational Therapy

versão On-line ISSN 2310-3833
versão impressa ISSN 0038-2337

S. Afr. j. occup. ther. vol.39 no.3 Pretoria Dez. 2009




Applying the Model of Creative Ability to patients with diabetic foot problems



Marjolein JansenI; Daleen CasteleijnII

IBSc(OT), University of the Witwatersrand, DHT, University of Pretoria; Occupational therapist at the Rehabilitation and Functional Assessment, Joint Venture between AngloGold Ashanti and Anglo Platinum
IIMOcc Ther, University of Pretoria; Senior Lecturer, University of the Witwatersrand





Motivation is recognised as an important factor in the treatment of any patient12. There has been an increase in the number of people diagnosed with diabetes, and, thus an increase in the number of people with foot complications as a result of diabetes. Motivation has been identified as a factor contributing to the treatment outcomes of a person with this type of problem3,4,5,6,7, and an assessment into the level of motivation is recommended in the context of this condition. Currently, an assessment of motivation has not been sufficiently investigated.
The Model of Creative Ability (MCA) provides a framework within which to assess intrinsic motivation and principles with which to treat a patient, based on the determined level of motivation, also referred to as levels of creative ability1,2,8. The purpose of this study was to investigate whether occupational therapy, tailored to the level of motivation, for patients with diabetic foot complications, has more positive treatment outcomes than occupational therapy that is not.
A programme was therefore carried out in which two groups of patients were treated, an experimental group receiving intervention according to level of motivation and a control group.
In spite of a small sample size, the results of the research indicated a more positive outcome when occupational therapy was tailored using the MCA, for patients suffering from diabetic foot complications.

Key words/phrases: Motivation, Model of Creative Ability, diabetes, diabetic foot, quality of life, occupational therapy



“Full text available only in PDF format”




1. Casteleijn JMF The measurement properties of an instrument to assess the level of creative participation.         [ Links ] [dissertation] Pretoria: University of Pretoria; 2001.

2. Casteleijn D, de Vos H. The model of creative ability in vocational rehabilitation. Work. 2007;29:55-61.         [ Links ]

3. Reiber GE. Epidemiology of the diabetic foot. In: Levin ME, O'Neal LW, Bowler JH. The diabetic doot 5th ed. St Louis: Mosby Year Book; 1993 p1-15.         [ Links ]

4. McDermott JE, editor. The diabetic foot. Rosemont Il: American Academy of Orthopaedic Surgeons; 1995.         [ Links ]

5. Edmonds ME, Van Acker K, Foster AVM. Education and the diabetic foot. Diabetic Med. 1996; 13: Suppl 1: S61-64.         [ Links ]

6. Faris I. Prevention of major lesions. In: Faris I. The management of the diabetic foot. Edinburgh: Churchill Livingstone; 1982. p. 58-70.         [ Links ]

7. Viswanathan V The diabetic foot: perspectives from Chennai, India. International Journal of Lower Extremity Wounds. 2007;6(1):34-36.         [ Links ]

8. Casteleijn D, Smit C. The psychometric properties of the creative participation assessment. South African Journal of Occupational Therapy 2002 May;32(1):6-11.         [ Links ]

9. Faris I. A brief history of diabetes and its complications. In: Faris I. The management of the diabetic foot. Edinburgh: Churchill Livingstone; 1982. p. 1-4.         [ Links ]

10. Scheehan P Introduction to diabetes principles of care in the surgical patient with diabetes. In: Veves A, Giurini JM, LoGerfo FW, editors. The diabetic foot: medical and surgical management. New Jersey: Humana Press Inc; 2002. p. 1-34.         [ Links ]

11. Yetzer EA. Causes and prevention of diabetic foot skin breakdown. Rehabil Nurs. 2002 March/April; 27(2):41-58.         [ Links ]

12. Ponchillia SV Complications of diabetes and their implication for service providers. Journal of Visual Impairment and Blindness. 1993 Nov;87(9):354-359.         [ Links ]

13. Lipsky BA, Berendt AR, Deery HG, Embil JM, Joseph WS, Karchmer AW, et al. Diagnosis and treatment of diabetic foot infections. Clin Infect Dis. 2004 Oct;39:885-910.         [ Links ]

14. Meijer JWG, Trip J, Jaegers SMHJ, Links TP Smits AJ, Groothof JW, et al. Quality of life in patients with diabetic foot ulcers. Disabil Rehabil. 2001;23(8):336-340.         [ Links ]

15. Tennvall GR, Apelqvist J. Health-related quality of life in patients with diabetes mellitus and foot ulcers. J Diabet Complications. 2000;14:235-241.         [ Links ]

16. Evans AR, Pinzur MS. Health-related quality of life of patients with diabetes with foot ulcers. Foot and Ankle Int. 2005 Jan;26(1):32-37.         [ Links ]

17. American Diabetes association. Preventative foot care in diabetes. Diabetes Care. 2004;27: Suppl S63-S64.         [ Links ]

18. Price P. The diabetic foot: quality of life. Clin Infect Dis. 2004;39 Suppl 2: s129-s131.         [ Links ]

19. Rijken PM; Dekker J. Clinical experience of rehabilitation therapists with chronic diseases: a quantitative approach. Clin Rehabili. 1998;12:143-150.         [ Links ]

20. Yawn BP Who should care for people with chronic diseases? West J Med. 2000 Feb;172:77-78.         [ Links ]

21. Driessen MJ, Dekker J, Lankhorst G, van der Zee J. Occupational therapy for patients with chronic diseases: CVA, rheumatoid arthritis and progressive diseases of the central nervous system. Disabil Rehabil. 1997 May;19(5):198-204.         [ Links ]

22. Australian Resource Centre for Health Care Innovations. Rehabilitation for Chronic Disease Model of Care [homepage on the Internet].         [ Links ] Australia: Australian Resource Centre for Health Care Innovations; [© 2001 -2008; cited 2007 Oct 2]. Rehabilitation for Chronic Disease Model of Care. [about 2 screens]. Available from

23. Cate Y, Baker SS, Gilbert MP Occupational therapy and the person with diabetes and visionl impairment. Am J Occup Ther. 1995 Oct; 49(9):905-911.         [ Links ]

24. Colburn J, Ibbotson V Amputation. In: Turner A, Foster M, Johnson SE, editors. Occupational therapy and physical dysfunction. principles, skills and practice. New York: Churchill Livingstone; 1996. p. 635-666.         [ Links ]

25. White JC, Bell RA, Langefeld CD, Jackson SA. Preventative foot-care practices among adults with diabetes in North Carolina, 1997 to 2001. J Am Podiatric Med Assoc. 2004;94(5):483-491.         [ Links ]

26. Boulton AJM. Why bother educating the multi-disciplinary team and the patient - the example of prevention of lower extremity amputation in diabetes. Patient Education and Counselling. 1995;26:1831188.         [ Links ]

27. Lithner F, Apelqvist J. Preventative treatment reduces the number of major amputations in diabetic patients. Int J Diab Dev Countries. 1994;14:48-52.         [ Links ]

28. Reiber GE. Epidemiology and health care costs of diabetic foot problems. In: Veves A, Giurini JM, LoGerfo FW, editors. The diabetic foot: medical and surgical management. New Jersey: Humana Press Inc; 2002 p. 35-58.         [ Links ]

29. Edmonds M, Foster AVM. Diabetic foot clinic. In: Levin ME, O'Neal LW, Bowker JH. The diabetic foot. 5th ed. St Louis: Mosby Year Book; 1993. p.587-603.         [ Links ]

30. Yetzer EA. Incorporating foot care education into diabetic foot screening. Rehab Nurs. 2004 May/June;29(3):80-84.         [ Links ]

31. Delmas L. Best practice in the assessment and management of diabetic foot ulcers. Rehabil Nurs. 2006 Nov/Dec;31(6):228-234.         [ Links ]

32. De Witt PA. Creative ability - a model for psychiatric occupational therapy. In: Crouch RB, Alers VM, editors. Occupational therapy in psychiatry and mental health. 3rd ed. Cape Town, South Africa: Maskew Miller Longman; 1997. p. 3-45.         [ Links ]

33. Neuman WL. Experimental research. In: Neuman WL. Social research methods qualitative and quantitative approaches. 6th ed. Boston: Pearson A and B; 2003. p. 246-271.         [ Links ]

34. Wood-Dauphinee SL, Williams JI. Reintegration to normal living as a proxy to quality of life. J Chronic Dis. 1987; 40(6):491-499.         [ Links ]

35. Wood-Dauphinee SL, Williams JI. Assessment of global function: the reintegration to normal living index. Arch Phys Med Rehabil. 1988 Aug;69:583-590.         [ Links ]

36. Bailey DM. Choosing a research method. In: Bailey DM. Research for the health professional. A practical guide. 2nd ed. Philadelphia: F. A. Davis Company; 1997. p. 37-59.         [ Links ]

37. Cutler SK, Stein F. Quantitative research methods. In: Cutler SK, Stein F. Clinical research in occupational therapy. 4th ed. Canada: Singular Thomson Learning; 2000. p. 63-132.         [ Links ]

38. Unsworth C. Measuring the outcome of occupational therapy: tools and resources. Aust Occup Therap J. 2000;47:147-158.         [ Links ]

39. Armstrong DG, Jude E, Boulton AJM, Harkless LB. Clinical examination of the diabetic foot and identification of the at-risk patient. In: Veves A, Giurini JM, LoGerfo FW, editors. The diabetic foot medical and surgical management. New Jersey: Humana Press; 2002. p. 163-178.         [ Links ]

40. Huck SW. Reading statistics and research. New York: Pearson; 2008.p. 164.         [ Links ]

41. Custard C. Tracing research methodology in occupational therapy. Am J Occup Ther. 1998 September;52(8):676-683.         [ Links ]

42. Bennett S, Bennett JW. The process of evidence-based practice in occupational therapy: informing clinical decisions. Aust Occup Therap J. 2000;47:171-180.         [ Links ]

43. Ottenbacher K, York J. Strategies for evaluating clinical change: implications for practice and research. Am J Occup Ther. 1984 October;30(10):647-659.         [ Links ]

44. Petersen NJ. Designing a rigorous small sample study. In: Osborne JW, editor. Best practices in quantitative methods. California: Sage Publications Incorporated; 2008. p. 137-146.         [ Links ]



Marjolein Jansen
PO Box 8619
South Africa

Creative Commons License Todo o conteúdo deste periódico, exceto onde está identificado, está licenciado sob uma Licença Creative Commons