Masters Degrees (Occupational Therapy)
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Browsing Masters Degrees (Occupational Therapy) by Author "Carroll, Esna"
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Item Open Access Towards client-centred practice within an occupational therapy group life skill program: an action research journey(University of the Free State, 2015-07) Carroll, Esna; Van Heerden, S. M.; Du Toit, S.English: The aim of this study was to explore how I could gain insight into my current facilitation of a predetermined/structured two-week life skill program in order to continually address client-centred practice for the clients I serve. This study was conducted at a private psychiatric clinic (PC) in the Free State, South Africa. I cultivated personal reflexivity in order to gain a greater understanding/insight of how external indicators and internal indicators influenced the life skill program, and also explored what the effect of the life skill program on clients was; this all took place in collaboration with my clients, making them stakeholders in the study. This study/exploration was undertaken as some clients had returned to the clinic after having attended the occupational therapy life skill program at their previous admittance to the PC, but still experienced problems with life skills. I thus wanted to establish whether I was attaining best practice with the clients I serve while they were admitted and in the life skill groups I facilitated. My understanding of best practice is aptly described by Parker (2011:139) as she states that client-centred care is considered the optimum way to provide health care. In order to explore if I was attaining best-practice, I had to explore if my facilitation of life skill groups were client-centered and also which other factors influenced their experience of the life skill groups. All the above mentioned questions as well as a disparity in terms of relevant research-based findings (as mentioned further in the summary) called for evidence based practice in order to attain client-centred practice for the clients I serve. Thus reflective and reflexive practice provides the support in order to attain client-centred practice. South African literature on occupational therapy group practice in mental health settings are limited, but suggest similar programs for people diagnosed with mood and anxiety disorders, albeit without specific guidelines as to the facilitation of these groups in the context of a sub-acute psychiatric clinic within a South African setting. As I wanted to gain insight into the life skill groups I presented and the stakeholders’ experience thereof, a study with an explorative nature using Action Research (AR) with a multiple-method approach was conducted. I used mainly qualitative elements in daily reflection activities for stakeholders and for myself, as well as some quantitative elements such as checklists as the methods of data collection. In this study, the population (stakeholders) consisted of clients who attended the Afrikaans group program at the psychiatric clinic, after being admitted to the PC by a psychiatrist. The stakeholders included male and female clients older than 18 years, with various differing mental health diagnoses, of which mood- (depressive) and anxiety disorders were most common. The number of potential stakeholders in a group in one cycle would generally range between five to 12 people. A multifaceted thematic analysis was used for the qualitative data. I analysed the data, together with two co-coders. Quantitative data analysis was completed by the Department of Biostatistics, UFS, after I had entered data using Microsoft Excel and had a co-coder verify. A “critical friend” also helped me gain perspective in the study. Findings described the stakeholders’ and my own experience of the life skill groups and highlighted the indicators that had a negative and positive influence on experiences. It also elaborated on the effect the life skill groups had on stakeholders, thus the client-centredness of these groups, and satisfaction of stakeholders. Throughout the AR process, changes were made according to the findings in order to continually address client-centredness and thus best practice for the stakeholders in my groups. The findings as well as the role of the AR process were further integrated and discussed, using the client-centred frame of reference as background for the discussion. In the closing, conclusions and recommendations towards client-centred practice were made comprising internal and external indicators against the framework of client-centredness. These recommendations included acknowledging and discussing suggestions on the limitations of the study, and recommendations for future research were offered.