OpenUCT :: Browsing by Department "Division of Occupational Therapy"

Browsing by Department "Division of Occupational Therapy"

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Open Access
A descriptive qualitative study exploring youth with intellectual disabilities participation in the community of Moshi
(2024) Ephraim, Anthony; Galvaan, Roshan
Introduction: Youth with intellectual disability (YID) in Tanzania are at an impasse, as they face potential exclusion from accessing services and participation in their community. This is due to existing negative cultural beliefs, lack of awareness of the needs and abilities, and limited government services. For youth attending the Gabriella Children's Rehabilitation Centre (GCRC) occupational therapy services, little is known about how they engage in occupations in the community following occupational therapy intervention nor has research been conducted to date in this regard. Such insight would be important in recognizing factors that enable or hinder youth with intellectual disability participating within their communities after rehabilitation services. Research question: How do youth with intellectual disabilities engage in occupations in the community of Moshi Kilimanjaro and what enables their participation? Aim: The study aimed to describe how youth with intellectual disabilities participate in occupations in the Moshi community, Kilimanjaro Region, Tanzania. Method: A descriptive qualitative research approach with semi-structured interviews was used to collect data from eight participants and analyzed using a thematic analysis. The ethical principles of ensuring autonomy, non-maleficence, beneficence and justice guided the research. Findings: Two major themes were identified. The first theme; ''Becoming who I can be through what I can do” with two sub-themes, namely, “Opportunities at Gabriella Centre” and “Changes and development;” and the second theme; “Connecting and earning community trust through valued occupation and routines” with three sub-themes, being; “Valued occupational routines at home and in the community”; “Trusted, given responsibility and making choices”, and “Community acceptance and support”. Discussion: The occupational based intervention for YID offered by GCRC provided considerable practical skills that facilitated YID's participation in community life. The youth became confident, and their abilities were recognized, bringing about more community acceptance. YID contributed to alleviating poverty through their engagement in the valued family and community routines. The person-centered approach was used to guide youth to make informed occupational choices. Various facets of the environment were identified as enablers and barriers to community participation. Conclusion: A well-designed program that uses a person-centered approach and reflects valued community occupations, such as the GCRC, is necessary for YID to learn skills and use their ability to participate and contribute to the community. However, it is essential to consider holistically the needs of YID. Existing policies and laws coupled with supportive families and communities can contribute to successful community participation for YID. Abstract Word Count: 396 Keywords: Youth with intellectual disability; community participation; vocational skills; household chores; valued occupations
Open Access
A prospective cohort study of school-going children investigating reproductive and neurobehavioral health effects due to environmental pesticide exposure in the Western Cape, South Africa: study protocol
(BioMed Central, 2018-07-11) Chetty-Mhlanga, Shala; Basera, Wisdom; Fuhrimann, Samuel; Probst-Hensch, Nicole; Delport, Steven; Mugari, Mufaro; Van Wyk, Jennifer; Röösli, Martin; Dalvie, Mohamed A
Abstract Background Research on reproductive health effects on children from low-level, long-term exposure to pesticides currently used in the agricultural industry is limited and those on neurobehavioral effects have produced conflicting evidence. We aim at investigating the association between pesticide exposure on the reproductive health and neurobehavior of children in South Africa, by including potential relevant co-exposures from the use of electronic media and maternal alcohol consumption. Methods The design entails a prospective cohort study with a follow-up duration of 2 years starting in 2017, including 1000 school going children between the ages of 9 to 16 years old. Children are enrolled with equal distribution in sex and residence on farms and non-farms in three different agricultural areas (mainly apple, table grapes and wheat farming systems) in the Western Cape, South Africa. The neurobehavior primary health outcome of cognitive functioning was measured through the iPad-based CAmbridge Neuropsychological Test Automated Battery (CANTAB) including domains for attention, memory, and processing speed. The reproductive health outcomes include testicular size in boys and breast size in girls assessed in a physical examination, and blood samples to detect hormone levels and anthropometric measurements. Information on pesticide exposure, co-exposures and relevant confounders are obtained through structured questionnaire interviews with the children and their guardians. Environmental occurrence of pesticides will be determined while using a structured interview with farm owners and review of spraying records and collection of passive water and air samples in all three areas. Pesticide metabolites will be analysed in urine and hair samples collected from the study subjects every 4 months starting at baseline. Discussion The inclusion of three different agricultural areas will yield a wide range of pesticide exposure situations. The prospective longitudinal design is a further strength of this study to evaluate the reproductive and neurobehavioural effects of different pesticides on children. This research will inform relevant policies and regulatory bodies to improve the health, safety and learning environments for children and families in agricultural settings.
Open Access
A scoping review of post-school young adults with mild-moderate intellectual disabilities employment retention within the open labour market in low- and middle income countries
(2025) Danster, Dylan; Galvaan, Roshan
Background: Employment is a critical milestone for adults with intellectual disabilities, yet young adults with intellectual disabilities in low- and middle-income countries (LMICs) face significant challenges in entering and retaining employment in the open labour market. Extensive research in high-income countries highlights the opportunities and ability of individuals with intellectual disabilities to secure employment in the open labour market. Further research focused on the retention of such employment in LMICs is needed. Objectives: This scoping review aims to explore existing research on how young adults with intellectual disabilities retain employment in LMICs, identifying key factors, barriers, and facilitators influencing retention. Method: The review uses the methodological framework of Arksey and O'Malley, along with updates by Levac and colleagues and the PRISMA-ScR guidelines (Arksey and O'Malley, 2005; Levac, Colquhoun & O' Brien, 2010). The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines are premised on the framework devised by Arksey and O'Malley (2005) for specifically conducting scoping reviews. The framework outlines a five-stage methodological approach, which is listed as: 1) identifying the research question, 2) identifying relevant studies, 3) study selection, 4) Charting the data and 5) collating, summarising and reporting results. A comprehensive search of electronic databases from 1996-2024 yielded relevant primary studies in accordance with the inclusion criteria of the scoping review. The inclusion criteria identified studies conducted in low and middle-income countries (as defined by the World Bank); and involved a focus on post school young adults (aged 18-35) with mild to moderate intellectual disabilities. The relevant primary studies addressing employment retention within mainstream workplaces were considered and independently screened through a structured two-level screening process against the inclusion and exclusion criteria by two qualified occupational therapists using the Rayyan web App. The Rayyan web-based application is designed to streamline a collaborative review process by assisting researchers in screening and selecting the studies for systematic and scoping reviews (Ouzzani et al., 2016). During the first-level screening, titles and abstracts were independently reviewed by the two reviewers to identify studies meeting the predefined inclusion criteria, with Rayyan's blinding feature minimising bias. Irrelevant studies were excluded, and potentially relevant or unclear studies were transitioned to the next stage. In the second-level screening, full-text articles of studies identified in the first level were retrieved and thoroughly reviewed to confirm eligibility. Discrepancies between 2 reviewers were resolved through an iterative discussion process with a third reviewer. The web app's tools for labelling and categorising studies ensured a systematic decision-making and transparent documentation throughout the reviewing process. Results: The analyses of the four included studies highlighted key practices which were grouped under two major themes. The themes were: The critical facilitatory role of the occupational therapist and the contribution of disability related legislation and policy. These themes described how work preparation programmes, disability awareness training, advocacy for inclusive laws, and employment incentives contributed to the retention of young adults with mild-moderate intellectual impairment in open labour market employment. Gaps in research, particularly around unique stressors faced by individuals in LMICs, were noted. Conclusion: This review underscores the need for targeted interventions, including the expansion of inclusive legislative frameworks, to improve employment retention for persons with intellectual disabilities in LMICs. Ultimately, this holds the potential for people with intellectual disabilities (PWID), as a vulnerable group to improve their employment outcomes, particularly in retaining their open labour market employment.
Open Access
Absenteeism : the influence of potentially controllable factors on absence behaviour
(1991) Winfield, Melinda Jane
Open Access
Active Play: perceived and actual motor performance among Ghanaian children
(2021) Doe-Asinyo, Rosemary Xorlanyo; Gretschel, Pamela
Background: There is limited data on active play both in terms of perceived competence and actual motor performance in children living in low- and middle-income countries. Promotion of active play in children is crucial for enhancing participation in physical activity and reducing the burden of obesity. Regular engagement in active play is important for promoting optimal development and increasing physical activity levels in children. Despite the increased interest in active play and physical fitness worldwide, many children in low-resource settings are thought to be physically inactive due to the lack of physical activity-promoting resources and programmes. The 2018 Ghana Report Card on physical activity reports that a high proportion of Ghanaian children do not achieve recommended physical activity levels and a high percentage of these children have poor motor skills. To date, no published study has examined active play among school-aged children in Ghana. Investigating the nature of active play by assessing perceived and actual motor performance among Ghanaian children can serve to increase our understanding of activity deficits, movement difficulties and associated factors in this population. Aim: The aim of this study was to investigate the nature of active play in children aged 6-12 years in Ghana. Specific Objectives: 1. To determine children and caregivers' perceptions of children's motor performance in active play using the Motor Coordination Questionnaire (MCQ). 2. To determine children and caregivers' perceptions of the importance of active play. 3. To identify additional forms of active play and games (which are not listed on the MCQ) that children and caregivers perceive to be important and meaningful. 4. To determine the relationship between MCQ ratings by caregivers and children. 5. To determine the relationship between children's MCQ and actual motor performance. 6. To determine the relationship between caregivers' MCQ and actual motor performance. Methodology: A cross-sectional descriptive and analytical design was used. Three primary schools were purposively selected for this study. The study recruited 406 children and their caregivers for this study. Ethical approval was sought from the Ethics Review Committee of the Ghana Health Service (GHS-ERC 052/05/19) and the University of Cape Town Faculty of Health Sciences Human Research Ethics Committee (HREC REF: 112/2020). Data was collected from both caregivers and children (aged 6-12 years) using questionnaires and the Performance and Fitness (PERF-FIT) test battery. The MCQ-caregivers and MCQ-children were used to assess perceived motor performance, and the PERF-FIT test was used to measure children's actual motor performance. In using the Statistical Package for Social Sciences (SPSS) version 24.0 (SPSS Inc, IBM Company, Armonk, NY), Pearson or Spearman's correlation coefficient was calculated to determine the relationship between children and caregivers' perceptions as well as the relationship between the perceptions and the actual motor performance of the children. Results: Both children (75.6%-94.2%) and their caregivers (69.3%-95.4%) perceived good motor performance of the children during active play. Children (82.8%-96%) and their caregivers (83.2%-94.4%) also regarded active play as very important. Twenty-four additional games were found to be of importance to Ghanaian children and their caregivers. Weak negative, weak positive and sometimes moderate positive correlation between MCQ items and the PERF-FIT items were found. Conclusions: This study shows that we can't rely solely on perceptions, but need actual motor performance, to accurately measure motor performance during active play. We found that parents and children do not accurately estimate the actual level of motor performance. Further studies should be done to understand confounding variables that may have caused poor relationship between perceived and actual motor performance. There is a need for a valid tool like the PERF-FIT to help in accurate measurement of motor performance.
Open Access
Adult family members' perspectives on the play of a young disabled child within the family
(2007) Davies, Belinda; Ramugondo, Elelwani; Galvaan, Roshan
Includes bibliographical references (leaves 107-118).
Open Access
Assessment of spastic patients before and after selective posterior lumbar rhizotomy
(1988) Berman, Barbara; Vaughan, Christopher Leonard (Kit)
For many decades people working with spastic patients have searched for better methods of alleviating spasticity and its debilitating effects. Although many methods have been used, no single method has been completely successful. It was not until the nineteen seventies that Selective Posterior Lumbar Rhizotomy (SPLR) was used successfully with spastic patients. In 1980 Peacock started doing this procedure on a large number of spastic patients in South Africa. I became interested in SPLR after seeing the dramatic reduction in spasticity and the improvement in function in my patients who had undergone the procedure. Since observations of improvement up to this point had been subjective, I decided to measure and document the physical status of patients before and after surgery. Twenty-nine patients who underwent Selective Posterior Lumbar Rhizotomy in 1985 were studied. In order to be as objective as possible, crawling and gait analyses were done in addition. All the patients were assessed clinically two days prior to surgery and then between four and fourteen months after surgery. For both preoperative and postoperative assessments, resistance to passive movement, degree of joint stiffness, ability to initiate and inhibit voluntary movement, and the degree of abnormal function in the developmental positions (rolling, sitting, kneeling, crawling, standing and walking) were graded on rating scales. Analyses of gait and crawling were done using a digital camera system. Results of the study indicated that SPLR produced a statistically significant reduction in muscle tone and in joint stiffness. Improvements in voluntary movement and functional movement (rolling, sitting, kneeling, crawling, standing and walking) were also statistically significant. It was concluded that Selective Posterior Lumbar Rhizotomy is a useful method of reducing spasticity and results in improvement of the quality of life in patients with spastic cerebral palsy.
Open Access
Caregiving of adults with acquired brain injury (ABI) a case study of mothers' perspectives
(2013) Steinhoff Inge; Sonday, Amshuda; Duncan, Madeleine
Includes abstract. Includes bibliographical references.
Open Access
Changing mindsets through lived experience : an exploratory study of a partnership in occupational therapy education
(2005) Linegar, Margaret; Buchanan, Helen
Includes bibliographical references (leaves 157-165).
Open Access
Child's play: Exposure to household pesticide use among children in rural, urban and informal areas of South Africa
(2009) Tolosana, Sandy; Rother, Hanna-Andrea; London, Leslie
Background. As part of a larger dermatological investigation undertaken in 1999 - 2001 involving the Department of Dermatology, Groote Schuur Hospital (Cape Town, South Africa) and Nottingham University (UK), household pesticide use was investigated among Xhosa-speaking families living in three areas in South Africa (a rural area, an urban township and an informal settlement). Objectives. The aim was to characterise pesticide use patterns and potential exposures through skin absorption, ingestion and inhalation for this group of South African children. Methods. A standardised questionnaire, which included a section investigating household pesticide use, was administered by four trained fieldworkers to the parents/ guardians of the 740 children (25%) aged between 3 and 11 years identified as having atopic dermatitis either by clinical examination or according to the UK criteria (rural N=387, urban N=292, informal N=61). Results. Of the children with atopic dermatitis, 539 (73%) had been exposed to household pesticides. Most childhood exposure (89%) occurred in the informal settlements, followed by 78% in the urban area and 63% in the rural area. Conclusions. This research highlighted considerable home environment pesticide exposure of South African children in lower socio-economic groups in rural, urban and informal areas. As children are particularly vulnerable to the short- and long-term health effects of pesticide exposure, further indepth investigation is needed to ascertain and document the health effects associated with such exposure in the home.
Open Access
Children need others: Triggers for playfulness in pre-schoolers with multiple disabilities living within an informal settlement
(2008) Bross, Helen; Ramugondo, Elelwani; Taylor, Claire; Sinclair, Claire
It is undisputed that play is the primary occupation of children 1 and that playfulness is an essential element of play. If more were understood about the circumstances allowing for playfulness, it would be possible for therapists to create optimal conditions to promote it. This paper highlights the findings of an instrumental collective case study describing triggers for playfulness for pre-schoolers with multiple disabilities. The pre-schoolers were observed in a school setting, as well as at home, to determine potential triggers for playfulness. Results from the pre-school show positive and negative conditions both allowing for playful responses. Being included or excluded, experiencing adversity, and noticing others merely nearby were all conditions that saw disabled children respond playfully. Observations at the children's homes revealed only positive conditions as pre-requisites for playful behaviour. These results provide some insight into what inclusive education may offer disabled children.
Open Access
A comparison of the quality of life between survivors of leprosy living in a leprosarium and those re-integrated in their communities in the southern region of Malawi
(2011) Chinguo, Dorothy; Duncan, Madeleine
The aim of this research was to compare the quality of life being experienced by survivors of leprosy living in the remaining leprosarium and those reintegrated into their communities in the southern region of Malawi.
Open Access
The costing of an occupational therapy service at the secondary level of healthcare in the metropole of the Western Cape
(2003) Whelan, Janet; Buchanan, Helen
In the context of reduced resoursces available for healthcare delivery, costing of services has become an important focus. As occupational therapy services do not fit neatly into the medical model of healthcare, funding of such services is at risk when costs are rationalised. This study aimed to determine the costs of the Somerset Hospital occupational therapy service and thereby assist other occupational therapists to undertake similar studies to inform health service managers of the funding requirements of such services and promote the expansion of occupational therapy services.
Open Access
Creating supported employment partnerships for people with psychiatric disabilities
(2008) Hajwani, Zerina; Van Niekerk, Lana
This study focused on the process of forming partnerships between a supported environment programme and three businesses. A qualitative approach, namely collective case study, was used.
Open Access
A critical ethnography of young adolescents' occupational choices in a community in post-apartheid South Africa
(2010) Galvaan, Roshan; Amosun, Seyi L; Van Niekerk, Lana
This thesis explored the occupational choices of young adolescents in a southern peninsula Cape Town community of Lavender Hill in South Africa. Informed by current research and prior professional and personal experiences with young adolescents in Lavender Hill, the research question asked: 'What informs occupational choice among young adolescents in Lavender Hill?' This complemented the research aim, which was to generate insight into the nature of the occupational choices of a group of young adolescents in Lavender Hill, and the factors that influenced their occupational choices.
Open Access
Developing appropriate Fetal Alchohol Spectrum Disorder (FASD) prevention initiatives within a rural community in South Africa
(2012) Cloete, Lizahn; London, Leslie; Van Niekerk, Lana
This study focused on women who consumed alcohol during pregnancy. The study population was situated in the West Coast/Winelands, a rural area in the Western Cape Province of South Africa. The study was done in a community which is classified as one of the many previously disadvantaged groups in South Africa. This study was done as part of a larger three-year project on Fetal Alcohol Syndrome Prevention in the Western Cape and Gauteng Provinces of South Africa. The phenomenon of drinking during pregnancy was used as a case example of health compromising occupations in the South African context. Prenatal alcohol exposure may result in brain damage that affects behaviors of those affected. The beliefs, norms, values and perceptions of mothers regarding alcohol consumption are also an important aspect in maintaining healthy pregnancies.
Open Access
Development of a play-based intervention to promote play skills of children with HIV/Aids living in a low resourced setting
(2021) Munambah, Nyaradzai; Ramugondo, Elelwani; Cordier, Reinie
The lack of contextually relevant conceptual tools to promote play makes implementing playbased, occupation-centred practice challenging for occupational therapists working with children with HIV/Aids in low resourced settings. This doctoral thesis focussed on reviewing and generating evidence, and further proposed a play-based intervention framework for children with HIV/Aids living in a low resourced setting. Theoretical frameworks used to guide the intervention development process and content of the play-based intervention were the United Kingdom Medical Research Council (UK MRC) framework for development and evaluation of complex interventions and Cooper's Model of children's play. The development of the play-based intervention involved four phases: 1) conducting a systematic review, 2) profiling of the play of children with HIV/Aids, 3) drawing perspectives of caregivers through in-depth interviews, and 4) gaining consensus from experts on components to include in the play-based intervention framework. In phase 1, a systematic review following the PRISMA guidelines was conducted to identify evidence that support the development of play-based interventions. Eighteen studies that focused on play as an outcome and compared the play of children with Special Health Care Needs (SHCN) to that of typically developing children met the eligibility criteria. The Kmet checklist was used to evaluate the methodological quality of the studies included. The systematic review revealed paucity of research on the play of children with SHCN such as those with HIV/Aids. Phase 2 was undertaken to generate more evidence by comparing the play profiles of 44 children with HIV/Aids aged 4-7 years to that of 52, age and gender matched typically developing children. The children were video-recorded while playing with a playmate at school or clinic and home settings. The Test of playfulness was used to score the videos by two independent raters and the scores were subjected to rasch analysis. A comparison of play profiles revealed that children with HIV/Aids were significantly less playful outdoors as compared to typically developing children (t(94) = 3.57, p = 0.001). Children with HIV/Aids also had more challenges with social play skills. In phase 3, contextual understanding of the play of children with HIV/Aids was sought through in-depth interviews with fifteen purposively selected caregivers whose children with HIV/Aids had participated in phase 2 of the study. The interviews were audio-recorded, transcribed verbatim and analysed thematically. The following four themes emerged: ‘Ubuntu is no more'; ‘survival is primary (chikuru kurarama)'; ‘play affirms that my child is still like other children'; and ‘more is required for a child with HIV'. Caregivers also reported on how contextual factors such as HIV/Aids stigma, poverty and cultural beliefs shaped the play of their children. In phase 4, findings from phases 1, 2 and 3 were synthesised and presented to experts in the field of play, HIV/Aids and intervention development during a two-round Delphi study. Experts were asked about their opinions and to rate what should be included in the play-based intervention framework. Consensus agreement was reached when at least 70% of Delphi experts rated each item at 3 or higher on a 5-point Likert Scale. Experts agreed on the application of Cooper's Model of children's play as a theoretical framework, as well as principles and techniques for the play-based intervention. This study is the second in occupational therapy to report on the play of children with HIV/Aids. It is the first one to review and generate evidence to support play-based interventions targeted at children with HIV/Aids. Evidence generated in this study showcased the need for occupation-centred, play-based services for children with HIV/Aids, particularly those living in low resourced settings. The play-based intervention proposed is child-led, allowing for physical and active involvement of the child. To increase social interaction and continuity into the home environment, playmates and caregivers must be included. Unique to this play-based intervention is advocacy for more play opportunities, access to nutrition and inclusion of culturally sensitive practices. Future studies should include feasibility on various aspects of the play-based intervention before implementing randomised controlled trials to test the effectiveness of the intervention are conducted.
Open Access
Disability and social change: a South African agenda
(2011) Watermeyer, Brian; Swartz, Leslie; Lorenzo, Theresa; Schneider, Marguerite; Priestley, Mark
This powerful volume represents the broadest engagement with disability issues in South Africa yet. It covers a wide range of perspectives of disability, from theoretical perspectives on disability, to disability in education, to disability's relationship with and effect on people living in poverty. This text can be used to support students in disability studies especially in the South African context.
Open Access
Disability and violence : a narrative inquiry into the journey of healing.
(2013) Motiimele, Mapheyeledi; Ramugondo, Elelwani
Includes abstract. Includes bibliographical references.
Open Access
Discovering the barriers that stop children with disabilities from being children: the impact of lack of access to mobility devices - a human rights persective
(2008) Gcaza, Siphokazi; Lorenzo , Theresa
In most research projects there is a tendency not to consult young disabled children about their priorities and experiences. Their needs and aspirations are pre-empted through service providers. Furthermore, there is little research about how resilient young disabled children are in dealing with or overcoming the barriers in their daily lives due to inadequate provision of mobility devices. Therefore, this study undertook to explore and describe the perceptions and experiences of a sample of children with mobility impairments from disadvantaged backgrounds with regard to the impact of lack of access to mobility devices on their lives. From 1998-2000 in a qualitative study, a case study design was used as a method of inquiry to explore the experiences and perceptions of disabled children at a special school in a township in Cape Town in the Western Cape Province, South Africa with regard to the impact of inadequate provision of mobility devices on their lives. Analysis of the stories of disabled children revealed that without adequate mobility devices they were deprived of their right to development, education, play and social interaction as well as adequate health and rehabilitation services. The stories told by disabled children, their caregivers and therapists reflected the contradictory messages sent to disabled children about service delivery. Recommendations were related to the urgent need for transformation in the provision of mobility devices, based on the needs of disabled children.

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