Browsing by Subject "Occupational Therapy"
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- ItemOpen AccessAdult family members' perspectives on the play of a young disabled child within the family(2007) Davies, Belinda; Ramugondo, Elelwani; Galvaan, RoshanIncludes bibliographical references (leaves 107-118).
- ItemOpen AccessAssessment 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.
- ItemOpen AccessA biographical inquiry into the occupational participation of men who drop out of school(2011) Peters, Liesl; Galvaan, Roshan; Kathard, HarshaThis qualitative interpretive biographical inquiry describes the nature of the occupational participation of men in Lavender Hill who drop out of school. School dropout was constructed as an occupational transition for the purposes of this study and the occupational participation of men who drop out of school was considered in relation to this. Study participants were selected using purposive, maximum variation sampling. Achieving a sense of fidelity in the research process was critically considered, because of its complexities in relation to the use of biography. Ethical principles were rigorously applied...
- ItemOpen AccessCaregiving of adults with acquired brain injury (ABI) a case study of mothers' perspectives(2013) Steinhoff Inge; Sonday, Amshuda; Duncan, MadeleineIncludes abstract. Includes bibliographical references.
- ItemOpen AccessA case study of professional role transition for occupational therapists in specialised education in post-apartheid South Africa : a critical narrative perspective(2016) Sonday, Amshuda; Ramugondo, Elelwani; Kathard, HarshaBackground: This study is a critical description and explanation of the situated nature of the professional role transition process experienced by occupational therapists working in specialised education in post-apartheid South Africa. The study posed the research question: How do occupational therapists experience the process of professional role transition within specialised education in the Western Cape? The study was framed conceptually within critical social theory and occupational science. Aim: The study aimed to describe and analyse a single instrumental case of professional role transition experienced by five occupational therapists currently working at special school resource centres in two education districts in the Western Cape, South Africa Objectives: The objectives of the study were to: Describe and explain the process of professional role transition as experienced by occupational therapists along a trajectory from 1994 to 2013; Provide insights into the occupational therapists' perceptions, thoughts, feelings and attitudes on their professional role transition experience; Determine whether there are any role changes present and the possible impact this might have on the role and scope and development of occupational therapy practice within specialised education; and Outline the influences the socio political context has on the role of occupational therapists working in special school resource centres in the Western Cape.
- ItemOpen AccessChanging mindsets through lived experience : an exploratory study of a partnership in occupational therapy education(2005) Linegar, Margaret; Buchanan, HelenIncludes bibliographical references (leaves 157-165).
- ItemOpen AccessA 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, MadeleineThe 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.
- ItemRestrictedCore Elements of an Activity Analysis in Occupational Therapy(2015-12-21) Ramafikeng, MatumoAn activity analysis is a tool used by Occupational Therapists to assess suitability of an activity for use in treatment to facilitate attainment of therapy outcomes. Knowledge of activity analysis and developing the skill of conducting one is regarded as an important competency in Occupational Therapy. The Occupational Therapy students are introduced to activity analysis in the first year of study and then continue to accumulate more knowledge of the tool through overt instruction and application in an assignment in second year.
- ItemOpen AccessThe costing of an occupational therapy service at the secondary level of healthcare in the metropole of the Western Cape(2003) Whelan, Janet; Buchanan, HelenIn 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.
- ItemOpen AccessCreating supported employment partnerships for people with psychiatric disabilities(2008) Hajwani, Zerina; Van Niekerk, LanaThis 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.
- ItemOpen AccessA critical ethnography of young adolescents' occupational choices in a community in post-apartheid South Africa(2010) Galvaan, Roshan; Amosun, Seyi L; Van Niekerk, LanaThis 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.
- ItemOpen AccessDeterminants of positive functional outcomes at 16 weeks after flexor tendon repair at a teritiary hospital in South Africa. A descriptive, analytical study(2019) Menegaldo, Amy; Buchanan, HelenTitle: Determinants of positive functional outcomes at 16 weeks after flexor tendon repair at a tertiary hospital in the Eastern Cape of South Africa: A descriptive, analytical study. Introduction: Flexor tendon injuries account for a substantial number of hand injuries presenting to health care facilities, yet rehabilitation following flexor tendon repair remains a challenge. There is limited research pertaining to flexor tendon rehabilitation in middle economic income countries like South Africa. Objectives: The aim was to identify determinants of positive functional outcomes sixteen weeks after flexor tendon repair at a tertiary hospital in South Africa. The objectives were: 1) to describe the functional outcomes at four, eight, twelve and sixteen weeks post flexor tendon repair using total active motion (TAM), muscle strength and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, 2) to ascertain the demographic profile for patients presenting to the hospital with a flexor tendon injury, 3) to describe the rate of recovery between the four assessment intervals, and 4) to cross-culturally translate the DASH questionnaire into isiXhosa. Method: Ethical approval was obtained through the University of Cape Town’s Human Research Ethics Committee. A quantitative, descriptive, analytical design was used. The DASH was translated as per the guidelines for cross-cultural translation by the Institute for Work and Health. All patients presenting to the target institution with a flexor tendon injury between February and August 2017 formed the sample. Twenty-two participants were recruited. Participants were assessed at four, eight, twelve and sixteen weeks post operatively using TAM, muscle strength and the DASH questionnaire. Demographic and treatment factors for each participant were compared to 16-week DASH scores using Mann-Whitney U and Kruskal-Wallis ANOVA tests. The rate of recovery was analysed using Spearman’s Rank Correlation Coefficient, Friedman’s ANOVA and Wilcoxon Matched Pairs for TAM, DASH score and muscle strength respectively. Results: Time to repair was the only factor to have statistical significance at 16-weeks post operatively (H(df=9)=15.3; p=0.05). Rate of recovery when compared to DASH (F(df=3)=12.98; p=0.005) and muscle strength (Z=3.076; p=0.002) scores showed statistical significance, though TAM did not (rs(df=2)=0.06; p=0.78). The epidemiological profile was similar to those documented elsewhere in South Africa and globally. Conclusion: The outcomes achieved in the present study were poorer than those described in the vast body of literature in the field, but similar to those described in a similar cohort elsewhere in the country. The demographic profile was similar to those previously documented in South Africa and across the globe, but with different environmental and institutional barriers. Rate of recovery appears greatest between four and eight weeks, as well as between weeks twelve and sixteen. Time to repair showed that it is not harmful to delay primary flexor tendon repair up to six days post injury. Recommendations for future policy, education, practice and research were made.
- ItemOpen AccessDeveloping appropriate Fetal Alchohol Spectrum Disorder (FASD) prevention initiatives within a rural community in South Africa(2012) Cloete, Lizahn; London, Leslie; Van Niekerk, LanaThis 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.
- ItemOpen AccessDevelopment 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, ReinieThe 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.
- ItemOpen AccessDisability and violence : a narrative inquiry into the journey of healing.(2013) Motiimele, Mapheyeledi; Ramugondo, ElelwaniIncludes abstract. Includes bibliographical references.
- ItemOpen AccessEducators' perspectives of the implementation of a classroom based, educator led occupational therapy intervention for fine motor skills(2021) Damonse, Shireen; Gretschel, Pamela; Ebrahim, AdeleBackground Children attending South African low quintile schools are faced with various barriers to learning which impacts academic performance, with handwriting being an aspect with which they experience difficulty. Provision of on-site occupational therapy services to address handwriting at such schools is limited by human resource constraints. To address this, final year occupational therapy students attending University of Cape Town placed in a low quintile school were tasked to collaborate with Grade R educators to train them to implement a classroom-based fine motor programme. Aim This study describes the educators' experiences of the factors impacting on the implementation of a fine motor programme in a low quintile school. Methodology A qualitative, descriptive study was conducted to explore their experiences relating to the programme, which is an emerging area of research in the South African context. Using sampling, three Grade R educators were purposively trained in implementing a fine motor skills programme. They participated in two focus groups to describe their experiences of the training and the implementation of the programme. Data was audio-recorded and transcribed verbatim. Inductive approach to analysis led to the generation of themes and categories focussing on their experiences, of the hindrances and factors supporting the implementation. Ethical principles were upheld throughout the research process. Findings and Discussion The theme “Them and us” was highlighted throughout the discussion as there was a divide between the educators and the students. The lack of communication and role clarification resulted in both the educators and students missing out on opportunities for collaboration and teamwork, and in turn the learners lost out on intervention albeit on a population basis that could impact learning and development. The process, fraught with challenges, resulted in a difficult partnership and a programme which was not implemented and subsequently not sustained. Conclusion The South African Educational Policy encourages therapists working in schools to integrate their services into the classrooms as well as the homes of learners by means of contextual interventions implemented in partnership with educators and parents. Lack of understanding of how to invest in the initiation of partnerships and consistent attention to grasping roles and responsibilities is a vital component of the collaborative partnership. Power dynamics within the relationship, commitment and spontaneous communication are aspects that stakeholders need to be conscious of to bring about change for positive occupational engagement of learners.
- ItemOpen AccessThe effect of sensory processing on the work performance of call centre agents in a South African context(2012) Lombard, Annemarie; Watson, Ruth; Duncan, MadeleineBackground: Call centres are thriving and expanding commercial enterprises providing cost-effective ways for organisations to connect with new and existing clients through telecommunication channels. Call centre agents perform this function telephonically for 75% of the day in large open-plan office environments characterised by workloads that are demanding, repetitive and highly scripted. Verbal abuse by clients is prevalent adding to a work experience that is potentially emotionally draining and stressful. Agents are under constant surveillance and monitoring to abide with commercial regulations but also to ensure high call volume and quality engagement with clients, these being the most important performance indicators. High staff absenteeism and attrition levels account for large financial losses in the industry. To date no studies have been found considering the impact of sensory processing of call centre agents on their performance, absenteeism and attrition. Sensory processing considers the neuro-physiological and behavioural components of individuals in the interactions with their daily work occupations and life environments. Although predominantly applied in paediatric clinical populations in occupational therapy, sensory processing provides universal truths about human behaviour which can add value to promoting wellness amongst healthy adults in work environments. Design: A quantitative, non-experimental and correlational study design was used to measure and compare demographic, sensory processing and performance data from 459 call centre staff within four fully operational call centres, which varied in type of operation, employer and geographical area in South Africa. The standardised and validated 60-item Adolescent/Adult Sensory Profile (Brown, Tollefson, Dunn, Cromwell & Fillion, 2001) was used to measure sensory processing as neurological thresholds and potential propensity for individuals to cope with high sensory stimulating work environments. Agent performance data in each of the four centres were recorded daily, in real time, using sophisticated information technology systems, and included details about absenteeism. Attrition data were collected after the initial data intake to reflect true attrition. Results: Data were analysed using statistical methods to obtain locality (e.g. means, medians), dispersion (e.g. standard deviations and interquartile ranges) and associations (e.g. Spearman Rank correlations). Results showed strong, consistent and significant correlations between agents who displayed sensation avoiding processing and poor performance. Agents who exhibited sensation seeking processing had higher performance ratings. To a lesser, yet still significant, degree agents with low registration and sensory sensitivity also had lower performance ratings. Sensory sensitive agents were absent less often than other workers and sensation seeking agents showed a tendency for higher attrition. Results differed between service inbound call centres to sales and collections outbound ones. Team leaders, who are high performing agents promoted into these positions, had less sensory sensitive and sensation avoiding processing styles. A novel subset structure was designed to account for the multidimensional capacity of the AASP, and this was correlated with all the performance data. It provided a preliminary method for use in further research studies. The study strengths were the innovative sample in measuring sensory processing of healthy populations at work and the compilation of performance data through sophisticated computerised systems, which minimised the margin of error. Study limitations were the use of a self-questionnaire format for profile data collection and small sample sizes in subsequent data collection stages. Recommendations: The AASP has the potential to be used by call centre human resource practitioners for recruitment and performance management. Improved sensory environmental considerations and adaptations supportive of a more successful and healthier agent-job-environment fit are provided. The study findings support knowledge transfer into other general human resource management, education and training, occupational health management and occupational therapy practises. It expands the application of sensory processing theories and informs future research.
- ItemOpen AccessThe efficacy of an adapted Roland-Morris disability questionnaire in measuring functional status of Patients with low back pain(2001) Buchanan, Helen; Coetzer, TheaThe purpose of this study was to determine whether an adapted Roland Morris Disability Questionnaire (ARMDQ) could be used to determine functional status in subjects with chronic mechanical low back pain, and thereby assist the surgeon in deciding on the appropriateness of spinal fusion surgery for individual patients. The study aimed to detem1ine whether the Roland-Morris Disability Questionnaire (RMDQ) improved its ability to measure function and different aspects of function through the addition of a 26-item scale (AddS). The study design was retrospective and descriptive. A convenience sample of 42 subjects who consulted one Orthopaedic surgeon working in a private practice in the South Peninsula Municipal area of Cape Town, South Africa, was drawn. All subjects were diagnosed with chronic mechanical low back pain and no other known pathology. Subjects consulted the surgeon between August 2000 and July 200 I. All subjects had completed the adapted RMDQ (ARMDQ). A series of analyses were performed in which the items in the AddS scale were compared with those of the RMDQ to assess the degree to which they enhanced the performance of the RMDQ. Although there was a high correlation between the two scales (R=. 72; P<.00), Cronbach's alpha showed the reliability of the RMDQ to be higher than the AddS and the ARMDQ. This finding was supported in a number of subsequent analyses. There was a low correlation between the rating for surgery and total RMDQ scores (r=.40; P<.01). Despite deficiencies in the RMDQ, it is recommended as the basis for comparison in future studies within a variety of South African contexts.
- ItemOpen AccessEnabling factors in the open labour market and strategies used by individuals with rheumatoid arthritis to maintain their employment(2002) Prinsloo, Ancil; Kalla, A AThe objective of this research was to determine the enabling factors that employed individuals with rheumatoid arthritis encounter in the open labour market, and strategies they use to keep their jobs. One hundred individuals with rheumatoid arthritis between the ages of 18 and 65 years and employed in the South African open labour market participated in the study. Participants were recruited from two tertiary hospitals and two private practices in the Western Cape. Participants completed a questionnaire and afterwards six volunteers were selected for a one-hour semi-structured interview.
- ItemOpen AccessETD: The Impact of covid-19 on occupational therapy students in mental health practice learning placements(2023) Cassim, Feroza; Abbas, Iesrafeel; Sonday AmshudaIntroduction: Practice learning (PL) is a core feature of occupational therapy (OT) students' curriculum and professional development during their undergraduate training. It promotes students' clinical reasoning abilities and enhances their reflective skills as emerging clinicians, enabling them to graduate as competent healthcare practitioners. However, the covid-19 pandemic interrupted curriculum delivery and forced blended teaching and learning methods. Globally this was recognized to have a significant impact on the training of undergraduate health science students who relied on face-to-face teaching and learning methods. This study aimed to explore the opportunities and barriers that influenced undergraduate OT students' learning experiences within mental health (MH) PL placements during the covid-19 pandemic. Methods: A qualitative descriptive research design was utilized to explore the barriers and opportunities occupational therapy students faced during the covid-19 pandemic in MH PL. Eight undergraduate students were purposively sampled, each participating in a 60-minute individual face-to-face interview which was transcribed verbatim and analyzed inductively using thematic analysis. Findings: Three key themes emerged from the study: 1) Acknowledging ME in the pandemic, describing the need for acknowledgement of what the participants were experiencing during the pandemic, 2) Setup for failure, describing the elements that participants identified as barriers to their ability to thrive in PL and 3) Stuck between a rock and a hard pandemic, demonstrating the opportunities and the barriers for learning which were present in PL placements, and which became more distinct because of the pandemic. Discussion: Complexities of PL in MH PL placements within higher education highlighted the opportunities and barriers which were present in participants' learning experiences, shaping their development as emerging healthcare practitioners. The complexities highlighted the need for additional emotional support structures in the PL learning experience. Social identity constructs, such as language, gender, and culture emerged as critical elements in the consideration of curriculum transformation work impacting PL in South Africa (SA). The context of the pandemic created space for considering how professional identity development is formed and impacted in undergraduate OT students who emerged from the pandemic. Barriers which were present because of the pandemic included feeling underprepared by the pandemic curriculum for PL. Whilst opportunities for learning were positively influenced by peer learning from fellow students. Recommendations included further development of the practice education curriculum in the current PL placements drawing on lessons learnt from the pandemic. Suggested future research is recommended to deepen the understanding on the long-lasting effects of the pandemic on emerging health professionals in a longitudinal study.