On-line version ISSN 2310-3833
Print version ISSN 0038-2337
S. Afr. j. occup. ther. vol.43 n.2 Pretoria Aug. 2013
The Scientific letter published in this edition of the South African Journal of Occupational Therapy (SAJOT) on the need for person-centred care for people with advanced dementia1 describes research in a much neglected area of occupational therapy practice i.e. intervention with the elderly and in particular those with dementia. It points out the activities that "...would most likely promote engagement and diminish isolation, monotony and helplessness..."1:3. The activities suggested can be used and adapted to create a more home-like atmosphere, something that is missing from many dementia care units and indeed from many residences for the aged. The letter serves to remind occupational therapists of the important aspects of treating people with dementia.
The first scientific article in this edition examines the multidimensional factors that influence the research orientation and attitudes of South African occupational therapists to engaging in and applying the results of research2. The author found that the SA occupational therapists who responded to her questionnaire valued research and the contribution that it can make to improving treatment. She pointed out that there is a lack of local evidence on best practices in occupational therapy in this country as indicated by the small numbers of articles published in journals such as this one. This statement stimulated me to have a cursory look at the past editions of SAJOT in my possession. I was very excited to find in this collection, which unfortunately is not complete, the very first edition of SAJOT in 1953 (Voll No 1, Aug 1953). This current edition of SAJOT therefore, marks the 60th birthday of SAJOT!
The first edition was a very tiny publication and contained 12 pages and 12 articles. The print was very small and the articles described various aspects of occupational therapy (OT). The trend of publishing descriptions of aspects of OT continued up until the late nineteen eighties and many very helpful articles on treatment methods, splints and assistive devices were published. SAJOT only obtained an ISSN number from Vol. 30 No 3 in November 2000. Up until approximately 2007, SAJOT only published two to four scientific articles in each edition. SAJOT can now publish six or more scientific articles per edition. This is still not enough to turn SAJOT into a well recognised publication in the occupational therapy world for its excellence. If SAJOT is to produce the local evidence on which best practice can be based there needs to be many more articles that prove the worth of occupational therapy intervention per edition. The daft report from the Academy for Science in South Africa, which recently carried out an assessment of the quality of SAJOT, suggested that SAJOT should publish more articles based on quantitative research and on randomised control trials - the gold standard in research. The SAJOT team is therefore appealing to all those occupational therapitsts embarking on research to consider using this type of methodology.
The second scientific article discusses the current practices of a group of clinicians including occupational therapists, physiotherapists and paediatricians in the assessment of hypotonia in children3. The assessment of hypotonia is an important part of the physical assessment of the child as it leads to the correct treatment method being used. The authors found however that there was confusion regarding the best method to use and agreed along with the respondents that there was a need to obtain an objective method to measure hypotonia in children.
The article on the experiences of four mothers who have children with severe brain injury and who live in a disadvantaged community in the Cape flats4, provides some insight into the difficulties that these mothers have in caring for their children. This article highlights the need for support groups in the various communities as well as for respite intervention for the mothers.
Adolescents with a physical disability are prone to experience a lowered self esteem and it has been found that the type of social activities that adolescents participate in, influence their self esteem, control aggression and improve the ability to socialise5. The paper describing wheelchair dancing as a means of improving self esteem and the ability to socialise is described in the next article5. This study compared the results of a research group who participated in wheelchair dancing with that of a control group who did not. A scale measuring feelings of inadequacy was the tool used to measure the effectiveness in reaching the study aims. Although the authors experienced difficulty in finding an adequate measure of self esteem to monitor the effectiveness of their intervention, they still found that there was an observed change in the behaviour of the experimental group when compared to the control group. This paper highlights, along with the importance of relevant and exciting social activities for adolescents, the need for tools to measure change if we are to carry out quantitative research as mentioned above.
An Opinion Piece and a Commentary follow the publication of the research articles. It is the policy of the journal to emphasise the publication of scientific articles as mentioned above and normally either an opinion piece or a commentary would be published as usually this type of article is not research based. However for this journal it was decided to make an exception to this rule as both articles offer the opportunity for the readers of SAJOT to comment in the form of "letters to the Editor".
The Opinion Piece - "Occupational Therapists in Medico-Legal work - South African experiences and opinions6 offers the opportunity for debate and comment on this field of practice. The article highlights the possible need for a formalised training in Medico-Legal work. It also, interestingly, highlights the therapists feeling of frustration when they have no means of determining whether their therapeutic recommendations have been implemented and therefore the related ethical issues.
The commentary which follows describes using the Occupational Therapy Practice Framework II (OTPF-II) to help occupational therapists in the treatment of patients diagnosed with a brain abscess and empyema7, a fairly rare condition which is not often seen by therapists. Although the process of assessment and indeed the treatment of the various symptoms such as hemiplegia, poor concentration and some perceptual problems are similar to other conditions, this paper highlights how the OTPF - II can be used to helping the treatment of fairly unknown conditions and indeed could be used for any condition. The authors have requested comments from practitioners who try out the guidelines provided.
1. du Toit S and van der Merwe R, Promoting person-centred care for people with advanced dementia through environmental adaptations. South African Journal of Occupational Therapy, 2013 vol43:2. In this edition. [ Links ]
2. Pitout, H. Research Orientation of South African Occupational Therapists. South African Journal of Occupational Therapy, 2013 vol43:2. In this edition. [ Links ]
3. Naidoo, P. Current practices in the assessment of hypotonia in children. South African Journal of Occupational Therapy, 2013 vol43:2. In this edition. [ Links ]
4. du Toit C, Coetzee Z, Beeton, H. Mother's experiences of caring for a child with sever brain injury in a disadvantaged community in the Cape flats. South African Journal of Occupational Therapy, 2013 vol43:2. In this edition. [ Links ]
5. de Villiers D, van Rooyen FC, Beck V Calitz Y, Engelbrecht C, Odendaal, E, Roothman L and van Eeden L. Wheelchair dancing and self esteem in adolescents with physical disabilities. South African Journal of Occupational Therapy, 2013 vol43:2. In this edition. [ Links ]
6. van Biljon H. Occupational Therapists in Medico-Legal work - South African experiences and opinions. South African Journal of Occupational Therapy, 2013 vol43:2. In this edition. [ Links ]
7. Gradidge K, Casteleijn, Franzsen D. Using the Occupational Therapy Practice Framework - II to treat a rare condition - brain abscess and empyema. South African Journal of Occupational Therapy, 2013 vol43:2. In this edition. [ Links ]