Masters Degrees (Occupational Therapy)

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Open Access
Kritiese faktore vir ontwikkeling en groei by Parkinson-ondersteuningsgroepe
(University of the Free State, 2004-05) De Villiers, Danette Esther; Van Heerden, S. M.
English: The curative advantages of support groups are lauded in the literature and offer every individual to grow in self-knowledge (Nichois & Jenkinson 1991:16). Despite the physical, psychological and cognitive limitations of Parkinsons disease and old age, support groups offer positive outcome in many ways (Manicorn & Viljoen 1992:37): Groups are time-effective and economical. Support groups enable multidisciplinary teams to become involved in consulting and rehabilitating roles. Every member becomes a potential helper and thus each person's status and self-worth is increased. Each member has own unique experience that makes belonging to a group worthwhile (Haberman-Little 1991:165). Family, friends, life partners and caregivers are included in a supportive environment where processes, which are to everyone's advantage, can take place. Despite the advantages, the researcher found that Parkinsons support groups in South Africa are stagnating or disappearing. The aim of this study was to identify critical factors, which could initiate the growth and development of Parkinsons support groups. The information would enable the Parkinsons Association to initiate successful support groups in the community. A descriptive study design was used. Individual questionnaires were sent to 400 patients and caregivers who were drawn systematically from the Parkinsons Association's alphabetical address list. All group leaders, identified by the association, and who could be found, also received the questionnaire. Eventually, 312 completed questionnaires were returned (171 patients, 126 caregivers and 15 group leaders). The literature and empirical study identified both socialising and increasing knowledge of pathology, as the respondents' most important needs. Parkinsons support groups fulfil both these needs. Additional factors are needed to ensure the continued growth and development of Parkinsons support groups. The following critical factors that hamper development were found: - The lack of community awareness and involvement concerning Parkinsons support groups. The new health laws may possibly improve the situation by creating the relevant resources in the community. - All three groups are not aware of a support group's potential and what the Parkinsons Association is able to offer. - Communication is lacking between support groups and with the Parkinsons association, especially for the group leaders. - There are no specific group structure and aims (the internal mechanisms which develop and sustain a group). Program planning according to each individual group's needs and effective evaluation methods are lacking. - Basic skills training and development of Parkinsons support group leaders, in presentation and group management, should be done. - Patients are unsure of their own specific needs and which needs to choose for group subjects. Thus, the democratic compilation of the year program is affected. - The acknowledgement of the caregiver's role and needs in Parkinsons support groups is lacking. A multidisciplinary team involvement with groups is needed. - Rehabilitation and maintenance programs are not emphasized.
Open Access
Die voorkoms van visuele persepsieprobleme en die effektiwiteit van arbeidsterapie groepbehandeling onder Graad 1 kleurling leerders
(University of the Free State, 2006-11) Van Romburgh, Jacomina Adriana; Van Jaarsveld, A.
Visueel-perseptuele vaardighede speel 'n belangrike rol in 'n kind se suksesvolle vordering op skool. Graad 1-leerders word gekonfronteer met belangrike ontwikkelingstake, soos skoolaanpassing, sosiale aktiwiteite en akademiese verwagtings ten einde hulle voor te berei om 'n bydrae te lewer tot die gemeenskap waarin hulle woon. Visueel-perseptuele vaardighede lê die fondament vir daaropvolgende ontwikkeling ten opsigte van hoër kognitiewe vaardighede. Agterstande ten opsigte van visuele persepsie kan lei tot probleme met skooltake soos lees, spelling, handskrif, visueel-motoriese koërdinasie en wiskunde. Deur doeltreffende terapie kan funksionele probleme in 'n kind se lewe voorkom word. Vroeë intervensie kan 'n kind help om basiese vaardighede te ontwikkel wat die fondament vorm waarop formele onderrig of funksionele vaardighede gebou kan word. Arbeidsterapie-intervensie onder kinders het ten doelom hul funksionaliteit te verbeter en te kompenseer vir beperkte deelname deur middel van terapeutiese, doelgerigte en ouderdomsrelevante aktiwiteite of omgewingsaanpassings. Suksesvolle terapie kan 'n kind help om aan daaglikse aktiwiteite deel te neem wat vir hom doelgerig en betekenisvol is. Arbeidsterapeute wat met skoolgaande kinders werk, is gemoeid met 'n kind se vermoë om take en aktiwiteite, wat 'n invloed op sy skoolfunksionering het, so funksioneel moontlik uit te voer. 'n Kind maak staat op sy vaardighede om volgens sy potensiaal te funksioneer. Kinders het nie gelyke geleenthede vir die ontwikkeling van visuele persepsie nie. Perseptuele probleme kom by kinders van verskillende ouderdomme voor en kan verskeie oorsake hê. Kinders met emosionele probleme asook ontwikkelingsagterstande toon dikwels perseptuele probleme. Dit hang gewoonlik nou saam met die soort stimulasie waaraan hulle blootgestel is. Die aantal kinders wat remediëring of hulp in die grondslagfase benodig, vermeerder toenemend en neem kommerwekkende afmetings aan. Dit word vererger deur 'n leemte in bestaande dienslewering in die gemeenskap om ontwikkelingsagterstande aan te spreek. Buiten dat privaatterapie kostes inhou, is daar nie 'n privaat arbeidsterapie-diens in die Heidedalof omliggende woonbuurtes beskikbaar nie. As gevolg van lae sosio-ekonomiese omstandighede en maatskaplike probleme in 'n gemeenskap, kan 'n gebrek aan stimulasie noodsaak dat 'n kind hulp moet ontvang om sy visueel-perseptuele vaardighede te ontwikkel. Kinders met visueel-perseptuele agterstande moet die geleentheid kry om deel te neem aan terapie ten einde hul skolastiese vermoë te verbeter en hul potensiaal te bereik. Die behandeling van kinders met persepsieprobleme in privaatpraktyk en by hospitale geskied hoofsaaklik individueel. Die studie het aangetoon dat daar In baie hoë voorkoms van visueel-perseptuele probleme onder graad 1 Kleurlingkinders in Heidedal, Mangaung is. Die studie het verder getoon dat arbeidsterapie-intervensie by beide individuele- en groepterapie In positiewe invloed op die kinders se visueel-perseptuele vaardighede gehad het. Geen statisties beduidende verskille tussen individuele- en groepterapie vir die behandeling van visueel-perseptuele probleme het voorgekom nie. Dit blyk egter dat die kinders wat in groepe terapie ontvang het, neig om meer te verbeter ten opsigte van hul algemene visuele persepsie en visueel-motoriese integrasie vaardighede. Behandeling in groepe lei tot meer effektiewe benutting van mannekrag, tyd en finansiële bronne. Deur kinders in groepe te behandel kan In groter aantal kinders bereik word in die arbeidsterapeut se hantering van kinders met visueel perseptuele agterstande.
Open Access
Substansmisbruikers se sensoriese prosessering, woede-ervaringe en -gedrag
(University of the Free State, 2009-11) Crous, Denisé; Van Heerden, S. M.; Van Jaarsveld, A.
Various patients with mental health disorders display problematic anger experiences and anger behaviour (DiGuiseppe & Tafrate, 2007:9). Many people with high anger tendencies appear to abuse substances on regular basis (Tafrate et al., 2002:1585). It seems as if the sensory processing patterns of substance abusers are clinically significant (Quadling et al., 1999:12). Sensory processing is reflected in people’s moods, temperament and ways in which they organise their lives (Dunn, 2001:609). Relationships between sensory processing, anger experiences and anger behaviour were investigated in substance abusers, using a quantitative cross-sectional research design. The Ethics Committee of the Faculty of Health Sciences, University of the Free State, approved the study. (ETOVS nr. 133/08). Data was collected between 1 October 2008 en 29 May 2009 at Stabilis Treatment Centre and Denmar Specialist Psychiatric Hospital. The study was piloted at both institutions and these results were included into the study’s results. Eighty four in-patients, with a history of substance abuse, voluntarily participated in the study. Convenience sampling was used and the majority of participants spoke Afrikaans (64%), were male (68%) and had abused alcohol (66%). Participants’ average age was 36 years and 6 months. The participants completed three questionnaires. Questionnaire one collected demographic information. Participants’ sensory processing was assessed through completing the Adolescent/Adult Sensory Profile. The anger questionnaire was compiled, based on indicators from literature and assessed the intensity of anger experiences in situations related to sensory processing behaviours and the frequency of anger behaviour. Anger behaviour was investigated with regards to: expressing anger verbally, expressing anger physically, withdrawing from the angering situation, using substances when experiencing anger, suppressing anger, expressing anger non-verbally and applying calming strategies. Department Biostatistics, University of the Free State, analysed the data of the study. According to the results it appeared as if participants’ could experience high intensity levels of anger in situations related to their: • low registration behaviour more than the typical norm, in vestibular, visual and auditory processing, • sensory sensitive behaviour more than the typical norm, in vestibular, touch and auditory processing and • sensory avoiding behaviour more than the typical norm in touch and auditory processing, as well as activities that did not provide for sensory avoiding behaviours. The results further indicated that participants with low registration patterns more than the typical norm of this quadrant, regularly used substances when they were angry and regularly expressed their anger verbally and physically. With regards to participants with sensory avoiding patterns more than the typical norm of this quadrant, results indicated that they regularly withdrew from angering situations, suppressed their anger, expressed their anger non-verbally, applied calming strategies and used substances when experiencing anger. A need for further research was indicated with regards to the relationships between sensory seeking patterns and anger behaviour. Ongoing research with regards to adult clinical populations’ sensory processing appears to be worthwhile. Occupational therapists should consider assessing their adult patients, with problematic anger (like substance abusers), sensory processing and if necessary integrate it into treatment.
Open Access
Arbeidsterpie en die gebruik van musiektempo in behandeling: die effek op die geestesgesondheidsverbruiker met psigose
(University of the Free State, 2010) Strauss, Monique; Van Heerden, S. M.; Van Heerden, A.; Joubert, G.
𝑬𝒏𝒈𝒍𝒊𝒔𝒉 The mental health care user (MHCU) with psychosis presents with various restrictions in his/her occupational performance components (OPC’s) and occupational performance areas (OPA’s). Restricted motivation, inappropriate affect and sensory-motor problems, together with poor cognition, cause inability in directedness towards activity that leads to poor execution of tasks (Reed, 2001:821-823). These restrictions in OPC’s lead to restrictions in OPA’s, and therefore negatively affect the MHCU’s occupation. This negative effect compromises the promotion of Occupational Therapy goals with this population, as well as integration in the community and prognosis (Sue, Sue & Sue, 2006:421). In the field of psychiatry, music is used by music therapists to treat psychiatric illnesses. The effect of slow versus fast tempo music, together with activity, during Occupational Therapy treatment of the MHCU with psychosis was investigated by using a quantitative, experimental study design. The focus was specifically on MHCU’s with agitated symptoms versus MHCU’s with inhibited symptoms during the psychotic phase. The Ethics Committee of the Faculty of Health Sciences, University of the Free State, approved the study (ETOVS 23/9). Data was collected between October 2009 and September 2010 at the Free State Psychiatric Hospital (FSPC). Hundred and sixty (160) MHCU’s with psychosis, admitted in block A and C of FSPC, participated in the study. The median ages of the study population varied between 27.5 and 30.5 years in the four groups and 72.0% of the participants were male. The participants were included in the study after being evaluated by the inclusion criteria checklist. The MHCU’s were divided into two experimental groups by a process of randomisation. The groups did not contain more that four members and agitated, as well as inhibited MHCU’s could be included in one group. The activity participation of the MHCU’s, in terms of attention, following of instructions, directedness towards activity and willingness to participate, as well as behavior was evaluated by three evaluators by means of a pretest, composed by the researcher. Thereafter the two groups were exposed to either fast or slow tempo music, during Occupational Therapy intervention (creative leatherwork activity). The post test, evaluating the same components and behavior, followed and was administered by the same evaluators. The blood pressure and pulse rate of each participant were also measured and noted during the execution of the group. Results were analysed and presented in four groups. Department of Biostatistics, University of the Free State, analysed the data of the study. ___________________________________________________________________
Open Access
Job satisfaction of occupational therapists in the public health sector, Free State Province
(University of the Free State, 2010-11) Swanepoel, Juanita Millicent; Van Heerden, S. M.; Van der Merwe, T.
English: The aim of this study was to investigate the job satisfaction status of occupational therapists in the Public Health Sector (PHS) of the Free State (FS). For the purpose of this study, job satisfaction referred to the occupational therapist’s perception of the fulfillment and gratification experienced while doing their work within the context of the PHS. A scientific inquiry was instigated to assess and address the job satisfaction of occupational therapists in the PHS of which the researcher, at the time of the study, was part. Employees of the PHS at that time seemed to suffer from low morale and the frequency with which occupational therapists became disillusioned with either the profession or the PHS was worrisome. The investigation was conducted by making use of multiple research methods namely questionnaires for the quantitative typical descriptive study design and semi-structured interviews for the qualitative phenomenological study design. Electronic self-administrative questionnaires were distributed to all the occupational therapists in the service of the Free State Department of Health in November 2008. Thirty-five (n=35) questionnaires were used for the analysis of quantitative data. In augmentation to this base-line data gathered, semistructured interviews with an opening question and an interview schedule were conducted among fifteen occupational therapists practicing in the PHS of the FS between November and December 2008. The thirty-five respondents in the quantitative investigation, as well as the sixteen participants in the semi-structured interviews, represented a largely homogenous group of white, Afrikaans-speaking females on senior, chief and assistant manager level. Community service occupational therapists who had already completed at least six months’ tenure were also included. Only occupational therapists directly involved in clinical services were eligible to participate in the study. The results of the study showed that the occupational therapists in the PHS of the FS experienced low levels of job satisfaction. This was found to be in contrast with most other studies conducted on the job satisfaction of occupational therapists in other parts of the world. This disparity was clarified when the contextual factors of the PHS such as; inadequate resources, excessive red-tape, poor management and an undesirable working environment were configured. The results and findings showed that the afore-mentioned facets were sources of dissatisfaction for the participants and consequently increased their job dissatisfaction. More so however, the main causes of the occupational therapists dissatisfaction were; the low status of occupational therapy as a profession and poor salary. Inadequate career-paths and disillusionment with the current performance appraisal system of the PHS added to further dissatisfaction for the participants in this study. The main source of the occupational therapists’ satisfaction with the job was that of “working with people, making a difference and experiencing success with clients”. Secondary facets of satisfaction were the relationships colleagues had with each other, inherent characteristics of the profession such as autonomy, creativity, diversity and to a lesser degree some advantages to working in the PHS such as fringe benefits and job/income security. In conclusion it was found that the job satisfaction status of the occupational therapists in the PHS of the FS was low. This was mainly due to the influence of contextual factors and not with regards to profession itself. As was the last objective of the study, extensive recommendations were made to redress the balance between job satisfaction and dissatisfaction for this population.
Open Access
Job satisfaction of occupational therapists in the public health sector, Free State Province
(University of the Free State, 2010-11) Swanepoel, Juanita Millicent; Van Heerden, S. M.; Van der Merwe, T.
English: The aim of this study was to investigate the job satisfaction status of occupational therapists in the Public Health Sector (PHS) of the Free State (FS). For the purpose of this study, job satisfaction referred to the occupational therapist's perception of the fulfillment and gratification experienced while doing their work within the context of the PHS. A scientific inquiry was instigated to assess and address the job satisfaction of occupational therapists in the PHS of which the researcher, at the time of the study, was part. Employees of the PHS at that time seemed to suffer from low morale and the frequency with which occupational therapists became disillusioned with either the profession or the PHS was worrisome. The investigation was conducted by making use of multiple research methods namely questionnaires for the quantitative typical descriptive study design and semi-structured interviews for the qualitative phenomenological study design. Electronic selfadministrative questionnaires were distributed to all the occupational therapists in the service of the Free State Department of Health in November 2008. Thirty-five (n=35) questionnaires were used for the analysis of quantitative data. In augmentation to this base-line data gathered, semi-structured interviews with an opening question and an interview schedule were conducted among fifteen occupational therapists practicing in the PHS of the FS between November and December 2008. The thirty-five respondents in the quantitative investigation, as well as the sixteen participants in the semi-structured interviews, represented a largely homogenous group of white, Afrikaans-speaking females on senior, chief and assistant manager level. Community service occupational therapists who had already completed at least six months' tenure were also included. Only occupational therapists directly involved in clinical services were eligible to participate in the study. The results of the study showed that the occupational therapists in the PHS of the FS experienced low levels of job satisfaction. This was found to be in contrast with most other studies conducted on the job satisfaction of occupational therapists in other parts of the world. This disparity was clarified when the contextual factors of the PHS such as; inadequate resources, excessive red-tape, poor management and an undesirable working environment were configured. The results and findings showed that the afore-mentioned facets were sources of dissatisfaction for the participants and consequently increased their job dissatisfaction. More so however, the main causes of the occupational therapists dissatisfaction were; the low status of occupational therapy as a profession and poor salary. Inadequate career-paths and disillusionment with the current performance appraisal system of the PHS added to further dissatisfaction for the participants in this study. The main source of the occupational therapists' satisfaction with the job was that of "working with people, making a difference and experiencing success with clients". Secondary facets of satisfaction were the relationships colleagues had with each other, inherent characteristics of the profession such as autonomy, creativity, diversity and to a lesser degree some advantages to working in the PHS such as fringe benefits and job/income security. In conclusion it was found that the job satisfaction status of the occupational therapists in the PHS of the FS was low. This was mainly due to the influence of contextual factors and not with regards to profession itself. As was the last objective of the study, extensive recommendations were made to redress the balance between job satisfaction and dissatisfaction for this population.
Open Access
Job satisfaction of occupational therapists in the public health sector, Free State Province
(University of the Free State, 2010-11) Swanepoel, Juanita Millicent; Van Heerden, S. M.; Van der Merwe, T.
Open Access
Performance skills of Grade 1 learners: educators' knowledge and attitude
(University of the Free State, 2010-11-30) Vermaas, Susanna Helena; De Villiers, D.; Van Jaarsveld, A.; Joubert, G.
English: South African children’s performance in reading, numeracy and writing performance is well below expected levels. In the Quality Improvement, Development, Support and Upliftment Programme Baseline Study (QIDS-UP) conducted in the Free State in March 2008, the results for the Grade 3s in respect of literacy and numeracy were 43,32% and 38,24% respectively. There are a myriad of reasons why learners are unable to read and write, among which educators’ knowledge and attitudes could be contributing factors. A significant conceptual change to the Inclusive Education System is the early identification of learners with barriers, such as developmental delays, and the subsequent support of such learners. Developmental delays can become evident in writing, numeracy and reading deficits in scholastic tasks. Occupational therapists do not remediate the reading or writing delays, but assess a child to determine the underlying performance skills delays that cause the scholastic problem. Currently, there is only one occupational therapist working for the Free State Department of Education at the district level. An effective means of delivering occupational therapy services within this particular context would be to empower educators to identify, manage and support learners who demonstrate poor performance skills. This research attempted to determine educators’ knowledge and attitudes regarding the age-appropriate performance skills of a typical Grade 1 learner. This was a cross-sectional study involving a stratified, randomly selected sample of 48 of the 257 schools in the Motheo District. All the Grade 1 educators at the selected schools were requested to complete a questionnaire designed by the researcher. The questionnaire was developed by considering the age-appropriate performance skills that underlie the scholastic skills of a Grade 1 learner and further by extracting the associated Grade 1 outcomes from the National Curriculum Statement with which educators are familiar. This research focused on the following components: gross-motor, fine-motor and cognitive skills. Educators’ attitudes regarding behavioural, cognitive and affective aspects were determined. The sample comprised 117 educators of whom 47,3% had completed their training more than 20 years before. Only 18,8% had a four-year qualification, the minimum requirement for educators. The mean age of the participants was 46,6 years. The mean for Grade 1 teaching experience was 88 months, while the median for Foundation Phase teaching experience was 16,6 years. The mean number of learners per class was 42 (ranging between 21 and 67). The medians of the total correct scores for knowledge regarding gross-motor skills, fine-motor skills and cognitive skills were 25,0%, 25% and 28,6% respectively. There were 2,6% who could not answer any questions correctly and 91,5 % of the educators scored below 46,7% on the composite knowledge score. The highest score (66,7%) was obtained by 2,6% of the educators. Educators were found to have a generally positive attitude in respect of support to learners experiencing performance-skills delays (mean = 80,0%). Relationships were determined between training, experience, knowledge and attitude. It was evident that as the number of years of training increased, so attitude improved (p=0.0321). No relationship was apparent between training and knowledge, nor between experience and knowledge or attitude. The poor scores for the identification of motor and cognitive skills could indicate that educators will not be able to identify learners with barriers in their classes. The exceptionally positive attitudes found among educators could have resulted from this lack of knowledge, which, in turn, led to skewed perceptions regarding the demands of teaching learners with barriers and developmental delays. These findings will guide the researcher to develop educator-friendly and purposeful training that will empower educators to identify and support learners who present with delays in development. The important role that the occupational therapist at the district level should play in supporting educators and learners to embrace inclusive practices was also emphasised.
Open Access
Prevalence of sensory integrative dysfunction in the childhood cancer population
(University of the Free State, 2011) Rencken, Gina; Van Jaarsveld, Annamarie
Results from assessment on the SIPT and sensory profile were discussed with reference to earlier studies and available literature on long term effects of childhood cancer treatment and literature on sensory processing disorders. SIPT SD scores in domains of function, as determined by the grouping of SIPT tests were discussed. The scores obtained by members of the study population receiving chemotherapy documented in previous studies and the literature review was discussed in each domain of function. The prevalence of members of the study population in each SIPT diagnostic group was discussed, with the most prevalent disorders being visuo- and somatodyspraxia and generalised sensory integrative disorder. No conclusive results were obtained in analysis of scores in partial patterns of sensory processing disorders. Behavioural observations made in testing were indicative of difficulties with modulation of sensory information, specifically in the tactile sense, and inability to cope with demands of testing. Clinical observations made indicate inadequate vestibular and proprioceptive processing, and the possible functional implication of this is discussed. The hand function, bilateral hand skill test performance and observations made in the behaviour and test scores of members of the study population receiving chemotherapy through peripheral lines is discussed.
Open Access
Occupational therapy assessment and the medico-legal report: the legal perspective
(University of the Free State, 2012) Jansen van Vuuren, Mariechén; Hough, P.; Rauch-van der Merwe, T.
The involvement of the occupational therapist in medico-legal work or third party claims is not a new phenomenon. Research in this area however previously focused on the skills and other traits of the occupational therapist. Little is known about the legal profession’s knowledge and expectations regarding the occupational therapist serving as an expert witness, especially in the South African legal, economic, social and cultural context. Discovering how especially attorneys perceive and experience the role of the occupational therapist in medico-legal work is therefore essential as occupational therapists’ involvement in medico-legal work is mostly facilitated by attorneys who instruct medico-legal assessments. The process and methods of instructing and utilising expert witnesses such as occupational therapists is unfortunately often not optimally effective with potentially dire effects for a country such as South Africa which already battles with poverty and unemployment, especially under workers with disabilities. International research has furthermore placed an increased emphasis on the role of the occupational therapist in encouraging and working towards aspects such as various forms of occupational justice and the impact of a person’s inability or altered ability to participate in occupations as before injury or illness. Therefore, against a backdrop of changing legislation regarding third party claims and an increase in medical negligence claims, the scope and role of occupational therapy in this field was explored and defined in this study, based on information obtained directly from members of the South African legal profession. Barriers between the occupational and legal profession that could hinder fair compensation for the claimants, such as communication transgressions or ineffective service delivery, were also identified. This study aimed to gather such information by means of a quantitative study under South African trained and based attorneys. A nominal group was used to support questionnaire development and also served to encourage the researcher that aspects addressed in this study through the questionnaire was vital to the everyday practice of the South African occupational therapist performing medico-legal assessments and reports. Research results indicated that attorneys have distinct expectations from the occupational therapist, but that some confusion exists pertaining to the unique role and contribution of the occupational therapist compared to other health professions. Where attorneys appeared to have a generally good understanding of terminology used by occupational therapists in assessment reports, several occupation therapy specific terms had different meanings for the legal profession. Recommendations made based on this study are believed by the researcher to address the specific problems identified in this study and should encourage future research in this field.
Open Access
The occupations and socio-cultural context of Sesotho speaking adults with mental health problems
(University of the Free State, 2012-02) Vermaak, Mia Elsabie; Van Heerden, S. M.; Van der Merwe, T. Rauch
English: The aim of this study was to explore the occupations and socio-cultural context of the Sesotho speaking adult with mental health problems, attending either of the group therapy programs at The Clinic or The Second Clinic (both psychiatric hospitals in the Free State, South Africa). This exploration was undertaken due to a lack of literature and formal guidance on providing culturally relevant and meaningful therapy to the Sesotho speaking adult with mental health problems. Most sources of literature on occupational therapy in the field of mental health, originates in Western societies, specifically the United States of America and the United Kingdom; and are therefore not directly applicable to practice settings in South Africa. Since the researcher wanted to ‘understand’ more about the daily experiences of the Sesotho speaking adult with mental health problems, a qualitative study of interpretive nature was conducted, with a collective case study as the strategy of inquiry. The first set of data was captured by conducting individual interviews with volunteering Sesotho adults as the sample. These interviews were based on the Kawa Model, a conceptual model of occupational therapy which uses the metaphor of ‘life as river’. The sample of patients that participated in the individual interviews, consisted of Sesotho speaking adults with mental health problems, admitted to The Clinic by psychiatrists. All participants were permanently employed, in jobs ranging from teaching and policing, to traffic officers and performance managers. Data collected during the interviews based on the Kawa Model, needed to be supplemented specifically regarded the socio-cultural context of the Sesotho-speaking patient at The Clinic. A focus group interview was then conducted at The Second Clinic, to further explore the themes identified in the interviews. The sample of patients for the focus group at The Second Clinic, was included according to the same selection criteria than with the individual interviews, and the sample was very similar to that of the individual interviews at The Clinic. Data was analyzed by the researcher and two co-coders. The interpretive thematic analysis approach was used to first analyze the transcriptions of individual interviews, and thereafter the focus group interview. Findings elaborated on the occupations and socio-cultural context of participants, as per the aim of the study. Participants were found to experience much stress at work, relating to strained interpersonal relationships. At the same time, their personal finances, family responsibilities and lack of sleep were found to be stressors. Participation in leisure, as well as experiencing work and family as sources of support (in spite of also regarding those as stressors), were regarded as positives in their daily occupational participation. Values that may influence occupational participation, were described as involvement in community and family; having a positive mindset and an active spiritual life. The participants’ socio-cultural context was described as a context containing habits and ‘ways of doing’ with a strong influence on their occupations and relationships. In conclusion, recommendations towards culturally relevant therapy, were made. These recommendations included suggestions for the content of an occupational therapy program, as well as suggestions for presenting such a program appropriately for the Sesotho speaking person with mental health problems. The limitations of the study were acknowledged and discussed, and recommendations for future research were set out.
Open Access
Quality of life and occupation for people with dementia: the perception of caregivers
(University of the Free State, 2012-07) Kotze, Corne; Du Toit, S. H. J.; Van Heerden, S. M.
English: Advanced dementia is a very complex condition and requires that caregivers be equipped to administer care successfully. Therefore, quality of life (QoL) for persons with dementia in long-term care facilities relies heavily on the knowledge, skills and attitudes of caregivers who spend the majority of time with these residents. Although various professional bodies all over the world encourage person-centred care, (i.e. promoting the focus on the resident with dementia as a unique individual), most residential care facilities in the South African context still measure QoL as a list of completed tasks at the end of the day. Therefore, the caregivers’ understanding and application of a person- centred care approach needed careful consideration. Due to the fact that consultant occupational therapists who designed individualised personcentred care programs for residents with dementia depends on the caregivers to implement these programs, a study was undertaken to describe and explore caregivers’ perceptions of QoL, person-centred care and occupational engagement for residents with dementia. A triangulation, mixed methods design was applied with a comprehensive sample of full-time caregivers employed at a residential care home (RCH) in Bloemfontein. The researcher specifically chose this approach with interview schedules (qualitative findings) and structured questionnaires (quantitative results). Qualitative findings were compared and contrasted with quantitative results in order to verify similarities and to identify discrepancies between the two data sets. Literature was also consulted to support similarities and discrepancies. The mixed methods triangulation design, therefore, contributed to the trustworthiness of the study. Results and findings indicated that personal and organisational factors had a major impact on the perspectives of the caregivers. The caregivers were mostly conditioned to operate within an approach associated with meeting the physiological needs of the residents and addressed individualised care as a list of separate chores associated with each resident. One of the reasons supporting a more physiological approach is the organisational culture found in units where care is provided for persons with dementia. It was also evident that if person-centred care could be experienced by caregivers as receivers (employees of an organisation), it might enable them to embrace the personal perspectives and needs of each resident individually. Personal factors that impacted the perspectives of the caregivers were their home circumstances, the general public opinion and the relationship between them and the family of residents. It appeared that stress factors associated with their home circumstances further aggravated the burden of care at work, negatively impacting person-centred care. The general public opinion was led by ageism, which emphasised the low status of their job as caregivers. Lastly, the relationship between the caregivers and family of the residents was guided by misunderstandings, unrealistic expectations and role confusion between these two stakeholders. The caregivers were guided by the priorities of the family which were, similar to those of the organisation, focused on physiological care associated with the traditional model, rather than person-centred care. The value of the study is that it indicated that a culture change towards care would be beneficial to the organisation at every level. A move away from the traditional medical-focused care approach could provide new opportunities for growth and development. This implies that the personhood and dignity of every employee and resident could be promoted, leading to a life worth living.
Open Access
Sensory integration intervention and the development of the extremely low to very low birth weight premature infant
(University of the Free State, 2012-12) Lecuona, Elise R.; Van Jaarsveld, A.; Van Heerden, S. M.; Raubenheimer, J.
English: This study aimed to investigate the effect of ASI intervention on the development of premature infants with ELBW to VLBW, within the first 12 months. ASI intervention approach is from the sensory integration theoretical and practice frame of reference used in occupational therapy. ASI provides playful meaningful activities aimed at enhancing sensory processing abilities of the brain and ultimately lead to appropriate adaptive functioning in daily life. From the literature review it was evident that newborn premature infants are at risk for possible SI difficulties and developmental delays due to their immature CNS and possible times of medical instability, discomfort, pain and stress during the first weeks or months after birth. Research on effective developmental intervention strategies for premature infants is however limited and previous research related to ASI intervention on the development of the premature infant post discharge from the NICU could not be found by the researcher. Since SI forms the underlying foundation for learning and social behavior (Ayers, 2008:7), research in this field is essential for prevention of developmental delays and learning difficulties of premature infants. The research proposal for this study was approved by the Ethics Committee, Faculty of Health Sciences of the University of the Free State (ECUFS no. 117/2011). Permission was obtained from appropriate authorities to conduct the study at the Occupational Therapy Department of Universitas Academic Hospital. A pilot study was done to determine the feasibility of the study. A quantitative research approach was used to determine the effect of ASI intervention on the development of the ELBW to VLBW premature infant. Through a pre-test/post-test experimental design, the population of 24 premature infants was randomly divided into an experimental and control group with 12 infants in each group respectively. Infants were matched according to their corrected ages and gender. Participants had corrected ages between four and 10 months, VLBW to ELBW, adhered to the inclusion criteria for the study and were referred from the High-Risk Infant Clinic at Universitas Academic Hospital. The developmental status of participants was determined with the Bayley III Scales of Infant and Toddler Development (Bayley, 2006a), Test of Sensory Function in Infants (TSFI) (DeGangi & Greenspan, 1989) and Infant /Toddler Sensory Profile (Dunn, 2002) before and after a 10 week ASI intervention period with infants in the experimental group. The results of the Fidelity Measure indicated that the interventions sessions complied with the requirements for ASI intervention. The pre- and post-test results were analyzed, interpreted and compared. The anthropometric and demographic profiles of the infants in both groups indicated that there was no statistical difference between the two groups except for the time hospitalized which was in favour of the control group and therefore the researcher was able to make reliable conclusions in terms of the study results. This study has found that ASI intervention had a positive effect on the sensory processing and developmental progress of ELBW to VLBW premature infants especially in terms of cognitive-, language-, motor- and adaptive behaviour development within a short period of 10 weeks. Parents showed more interest and a better understanding of the developmental progress and sensory processing of their infants. This study has therefore provided sufficient evidence that early intervention in terms of ASI plays a critical role in the intervention approach of the sensory integration trained occupational therapists, working with premature infants and their parents. The study results did not only indicate the importance of ASI intervention for better developmental outcomes for ELBW to VLBW premature infants, but also revealed that a lack of ASI intervention leads to a deterioration of developmental and behavioural outcomes.
Open Access
Life skills that enable resilience: a profile of adolescents from a coloured community in Kimberley
(University of the Free State, 2013) Jansen, Anthea Natalie Blanche; Van Vuuren, S.; Van Heerden, S. M.; Nel, M.
Adolescent development is synonymous with physical and emotional changes and challenges. This development has previously been termed “storm and stress” to further illustrate these turmoils that adolescents experience. Adolescents generally growing up in a coloured community further experience hardships such as gangsterism, unemployment, overcrowding and substance abuse. The implementation of life skills could be seen as a way to possibly reduce engagement in risky behaviour and effectively face adversity. Life skills include an unlimited list of complex and integrated skills and assist in the participation of meaningful occupations. The main occupation of an adolescent is that of a learner. Within schools, life skills are part of the form of Life Orientation. Life Orientation includes subjects such as vocational guidance, religion and physical education and it addresses the most crucial life skills. Not only can life skills assist with positive adaptive behaviour amongst adolescents, but supportive environments also contribute to resilient behaviour. Resilience is being able to bounce back from challenges. Adolescents engaging in risky behaviour, having poor to little knowledge of life skills, not applying their life skills and negative environmental factors all influence their ability to be resilient. The researcher undertook this study to establish a profile of coloured adolescents and their knowledge and application of life skills that lead to resilient behavior. This was a descriptive study involving a convenience sampling method. The study took place at four predominantly coloured schools in Kimberley in the Northern Cape. Three hundred and forty eight (348) learners returned signed permission letters that allowed them to complete the questionnaire. The sample comprised of both males and females aged 16 to 18 years. Grade 12 learners were in the minority, while there were mostly grade 11 learners (45.4%) that participated in the study. Learners mostly came from coloured suburbs with 26.4% of learners coming from other suburbs within Kimberley. The profile of coloured adolescents presented with learners possessing knowledge and/or application of different life skills. Learners presented with better knowledge of life skills within communication skills (90.3%), time management (72.8%) and values (89.9%). When expected to apply life skills, problem-solving skills (90.9%) and values (81.1%) were applied best. Learners applied time management and decision making poorly of all life skills. The researcher further noted that application of communication skills and time management (whether high or low) were directly related to resilience. Knowledge of the other life skills (whether high or low) were related to resilience. The only exception was within values, where knowledge and application were both directly related to resilience. Only small numbers of learners engaged in risky behaviour in the form of drinking alcohol mostly. Risky behaviour is considered a negative influence on life skills. Learners portrayed hope, optimism and competence within individual environmental factors. However learners from the lower socio-economic backgrounds presented with less hope (70.7%) compared to other suburbs (84.2%). Within family factors security, stability and support were prominent factors and had a positive influence on life skills leading to resilience. Peer acceptance was important for most learners (95.4%). To conclude the researcher will use findings to develop community and school programmes that could assist in the implementation of life skills that would serve to support and empower adolescents. The important role that the occupational therapist could play in adolescent development is to ensure optimal engagement in occupations through life skills in order to develop as healthy adults.
Open Access
Vergelyking van 'n aktiwiteit- en uitkomsgebaseerde program in arbeidsterapie
(University of the Free State, 2013-02) Grobler, Ina; Van Heerden, S. M.; Rauch Van der Merwe, T.; Nel, M. M.
The establishment of occupational science in 1989 created an occupational discourse that defused the debate regarding the difference between activity and occupation. This fundamental discipline employs the applied science in occupational therapy and has directed the profession back to the original paradigm of occupational therapy, namely occupation (Cole & Tufano, 2008:59; Hagedorn, 1995:79). Occupational therapy recognises the unique occupations of each individual in the context of personal experience and applies occupation as part of the therapeutic process. Scientific proof of an occupational focus to enable the mental health care user (MHCU) to function optimally in the community after discharge, is necessary (AOTA, 2008:625, 626, 664). An occupational focus firstly involves the understanding of the therapeutic power of occupation as described by Pierce (2003:9). This consists of the subjective dimension, contextual dimension and application of an occupation based approach. Secondly, occupation is used as both means and as ends, to enable the MHCU to become skilled in his / her own life tasks and roles. The aim is to optimize functioning in the community (Trombly, 1995:963; 2002b:257). For the study, a retrospective match-control study design was used in a quantitative approach. An activity- and outcome based program were compared in order to investigate the effectiveness of the respective programs. Approval for the execution of the study was granted by the Ethics committee, Faculty of Health Science, University of the Free State (ETOVS nr. 12/2011). The occupational therapy files of hundred and two MHCU’s, 51 from the activity program and 51 from the outcome based program, were included in the study. Files were matched according to specific criteria, namely age, gender, diagnosis, language and educational level. The files of MHCU’s that had attended the activity program from 2009 to June 2011 were matched with files of MHCU’s that attended the outcome based program from July 2011 till Julie 2012. The data (pre-and post test) was abstracted from the occupational therapy evaluation, which was based on the ICF (International Classification of Functioning, Disability and Health) and recorded in the occupational therapy process notes. The researcher entered all the data from the files onto data forms. The results of the pre- and post tests of both programs were analysed, and the clinical improvement of MHCU’s in each program and the similarities of the program were compared to one another. The Department of Biostatistics, University of the Free State used descriptive statistics to analyse the collected data. Clinical and statistical significant improvements were observed in both programs. The largest clinical improvement in the activity program was seen in occupational performance components like attention, motivation, energy levels, decision making and range of emotion. In the outcome based program, the largest clinical improvement was found in functional aspects like handling of stress, management of own health and managing daily routine. Statistical significant differences in the activity program were noted in the components of motivation, handling own activity level, complete daily routine and in informal relationships. Statistical significant differences in the outcome based program was noted in the components regarding handling of stress, management of own health, time management, insight and social cues in relationships. The findings from this study indicated that the activity program addressed the occupational performance components more effectively, while the outcome based program was more effective in addressing functional skills. From the findings, it is proposed that a combined program be developed, consisting of elements from both programs, such as, activities and occupations that would address OPC’s and OPA’s through the use of psychomotor activity, craft activities and life skills groups. This should be combined into a full day program. Further research is recommended to gain further clinical proof of the value of an occupational focus in occupational therapy practise, and to verify the conclusions of this study.
Open Access
Die korttermyn invloed van sensoriese integrasie intervensie op die geestesgesondheidsorg verbruiker met versteurings gekenmerk deur simptome van psigose
(University of the Free State, 2013-02) Annandale, J. C. A.; Van Jaarsveld, A.; Van Heerden, S. M.; Nel, M.
English: The Mental Health Care User (MHCU) with psychosis presents with symptomology that impairs functionality and occupational performance. This limits the ability of the MHCU to perform activities of daily living and to actively take part in Occupational Therapy treatment. Sensory integration intervention addresses the functionality and the occupational performance of the MHCU (Smith-Roley, Mailloux, Miller-Kuhaneck & Glennon, 2007:1). The short term influence of sensory integration intervention on the MHCU with disorders charactarised by symptoms of psychosis was investigated by using a quantitative, randomised, controlled single blind clinical trial. The Ethics Committee of the Faculty of Health Sciences, Universtiy of the Free State, approved the study (ETOVS 30/11). Data were collected between October 2011 and July 2012 at the acute wards of a psychiatric institution in the Free State. Ninety-nine (99) MHCU‟s with symptoms of psychosis participated in the study. The median age of the study participants in the two groups varied between the ages of 30 and 32 years and 65.7% of the participants were males. Participants adhering to the inclusion criteria checklist were divided into an experimental and a controle group through a process of randomization and matching. Matching was done according to age, gender, level of functioning and pathology. The occupational performance of both groups were established with the “Therapeutic Functional Level Assessment” (TFLA) and the sensory integration dysfunction of the experimental group were established with the “Schroeder, Block & Campbell Adult Psychiatric Sensory Integration Measure” (SBC). After the pre-tests both groups were exposed to the standard Occupational Therapy intervention program of the specific wards and the experimental group was exposed to a two week (eight sessions) sensory integration intervention program. The TFLA and the SBC were used in the same manner to do the post-tests. The same assessors (qualified Occupational Therapists) were used to do the pre- an post-tests. The medication and the level of psychosis were also noted on a daily basis. These notes were completed according to the process notes of the clinical staff of the specific wards. Results were analysed by the Department of Biostatistics, University of the Free State. Despite the fact that there were limited statistically significant differences observed during the study, both groups showed clinical improvements. The experimental group showed statistically significant differences in the improvement of selfcare, social behaviour (logical speech and communication), appearance and the occurance of delusions and hallucinations, when compared to the control group. The SBC showed a statistical difference in the physical assesment aspects of the experimental group. Improvements were noted in the vestibular-proprioceptive system, the somatosensory system and the visual-vestibular system. Ongoing research with regard to the effect of sensory integration intervension on the MHCU appears to be warrented and will be of value within this field. Occupational Therapists should consider using sensory integration intervention, together with the standard Occupational Therapy intervention program in the treatment of the MHCU with psychosis in order to optimise function.
Open Access
Parents, educators and children: perceptions on dyspraxia
(University of the Free State, 2013-02) Van Staden, Carli; Van Jaarsveld, A.
English: Dyspraxia is a developmental condition in which the ability to ideate, plan and execute new and novel actions is impaired (Bundy, Lane & Murray, 2002:477- 478). The aim of this study was to investigate the child’s, parent’s and educator’s perceptions on dyspraxia, in order to identify comprehensive client-centred treatment goals. This study was carried out in order to further the understanding of the complexities surrounding a child with dyspraxia, as it pertain to the occupational performance areas of school, play and leisure, and self-care. A lack of literature on the use of a family-centred approach in assessment and treatment of children by South African occupational therapists and the growing emphasis on including the voice of the child in decision-making that affects them, gave relevance to this undertaking. A descriptive, cross-sectional study was done. The study population consisted of children aged 5 years 4 months to 8 years 2 months, living in Bloemfontein and surrounding areas, and diagnosed with dyspraxia as per the criteria of the Sensory Integration and Praxis Test (SIPT) (Ayres, 1989). The study sample further consisted of the parent(s) of the child who were involved in the occupational therapy process, as well as the educator of the child concerned. The PEGS (Missiuna, Pollock & Law, 2004) was used as the measuring instrument to obtain the perceptions regarding dyspraxia from the child, parent and educator. The PEGS’s assessment for children consists of 24 pairs of cards showing children participating in activities from the occupational performance areas of self-care, school/productivity and leisure/play. The child had to indicate if he is like the picture of the child who is “more competent” or “less competent” in the activity. During separate interviews with the parents and educators, the researcher asked the parent(s) and educators to rate the child’s competency on the same activities as those of the child’s cards of the PEGS. The child, parent and educator respectively also chose activities as goals to be addressed during occupational therapy intervention. Demographic information was also obtained from the parent(s) during a structured interview. The data analysis was done by Department Biostatistics, Faculty of Health Sciences, UFS. Findings indicated that dyspraxia reached across all functional spheres. Play and leisure was perceived by all to be the occupational performance area children with dyspraxia were the least competent in, with skipping with a rope perceived by all as the most troublesome activity. The perceptions of the parent, child and educator regarding the child’s competence in specific activities differed. Children were able to express their perceived efficacy and made themselves out to be both less and more competent in some items the adults did not agree with. A statistical significant difference was found between the child and educator’s summary score percentages of their perceptions of the child’s competence as it relates to the OPA of school/productivity. Parents, children and educators selected different combinations of items as goals, with almost half of the total number of goals selected by all participants related to the OPA of leisure. Printing, playing ball games that require hitting a ball, such as tennis and cricket, skipping with a rope and cutting with scissors were the specific goals selected by the greatest number of participants. In conclusion, recommendations towards child-centred practice were made. These included realising the extent of the influence of dyspraxia on all areas of the child’s functioning, considering all environments and all role-players in the child’s life when planning intervention and providing the child with an opportunity to express his perceptions of his abilities and goals for therapy. The limitations of the study were acknowledged and recommendations were made for future research.
Open Access
Eye movements and postural alignment in children with cerebral palsy
(University of the Free State, 2013-06) Scholtz, Christina Elizabeth; Van Heerden, S. M.; Visser, M.; Ellis, S. M.
English: The level of severity of disability may have increased among children with cerebral palsy and therefore continued monitoring of the characteristics of children with cerebral palsy is necessary. Cerebral palsy (CP) can be considered as a sensory-motor disorder that results from malformations in the developing brain that disrupts the development of the neuronal network and cortical and sub-cortical pathways. Although the motor behaviours and postural deficits are defining features of CP, visual disorders are a main symptom in the clinical picture of CP. There are well sounded reasons why children with CP have difficulties to partake in everyday activities. Neurologic pathology can affect specific aspects of postural control including the ability to maintain stability with alignment in a specific position. Postural control is necessary for maintaining all body segments in an upright position and to orientate the eyes to the environment. Problems with the visual system in CP include peripheral problems related to the anterior part of the visual system, visual problems of central origin and cerebral visual impairment. Observations of eye movements and postural alignment in sitting in children with CP were the focus of this study. These are variables known to potentially influence occupational-based activities. The aim of the study was to describe eye movements and postural alignment and to investigate if there was a possible association between eye movements and postural alignment in sitting in a frontal plane of children with CP, between the age of two and ten years. A non-experimental, quantitative approach addressed the aim. A descriptive study was used to describe the eye movements and alignment in body segments over the base of support against gravity. A correlation study was used to investigate the possible association between postural alignment and eye movements in children with CP. Following the pilot study the unstructured and structured observations were administered to a convenience sample of children with CP attending a clinic, school or a private practice. Fifty seven children with CP, between two and ten years of age participated in the study after meeting the pre-determined inclusion criteria. The data collected were numbers that reflected specific measurements of the characteristics in question and were analysed by using a grounded, observed – clinical reasoning approach. The mean age of the children was 5.3 years (SD = 2.26). Discussion of results was directed at describing eye movements and postural alignment and interpreting the implications of those associations for clinical practice. The obtained data from the unstructured and structured observations were statistically analysed and compared and did produce a statistically significant positive association between eye movements and postural alignment therefore, both the posture and the eye movements are critical to the provision of intervention. The study confirms the association between eye movements and postural alignment in sitting in children with CP. This study has documented the difficulties the child with CP has to encounter. This may facilitate the establishment of effective and appropriate measuring instruments for occupational therapists, assessing functional vision and postural alignment in any setting of practice.
Open Access
Life skills that enable resilience: a profile of adolescents from a coloured community in Kimberley
(University of the Free State, 2013-11) Jansen, Anthea Natalie Blanche; Van Vuuren, S.; Van Heerden, S. M; Nel, M.
English: Adolescent development is synonymous with physical and emotional changes and challenges. This development has previously been termed "storm and stress" to further illustrate these turmoils that adolescents experience. Adolescents generally growing up in a coloured community further experience hardships such as gangsterism, unemployment, overcrowding and substance abuse. The implementation of life skills could be seen as a way to possibly reduce engagement in risky behaviour and effectively face adversity. Life skills include an unlimited list of complex and integrated skills and assist in the participation of meaningful occupations. The main occupation of an adolescent is that of a learner. Within schools, life skills are part of the form of Life Orientation. Life Orientation includes subjects such as vocational guidance, religion and physical education and it addresses the most crucial life skills. Not only can life skills assist with positive adaptive behaviour amongst adolescents, but supportive environments also contribute to resilient behaviour. Resilience is being able to bounce back from challenges. Adolescents engaging in risky behaviour, having poor to little knowledge of life skills, not applying their life skills and negative environmental factors all influence their ability to be resilient. The researcher undertook this study to establish a profile of coloured adolescents and their knowledge and application of life skills that lead to resilient behavior. This was a descriptive study involving a convenience sampling method. The study took place at four predominantly coloured schools in Kimberley in the Northern Cape. Three hundred and forty eight (348) learners returned signed permission letters that allowed them to complete the questionnaire. The sample comprised of both males and females aged 16 to 18 years. Grade 12 learners were in the minority, while there were mostly grade 11 learners (45.4%) that participated in the study. Learners mostly came from coloured suburbs with 26.4% of learners coming from other suburbs within Kimberley. The profile of coloured adolescents presented with learners possessing knowledge and/or application of different life skills. Learners presented with better knowledge of life skills within communication skills (90.3%), time management (72.8%) and values (89.9%). When expected to apply life skills, problem-solving skills (90.9%) and values (81.1%) were applied best. Learners applied time management and decision making poorly of all life skills. The researcher further noted that application of communication skills and time management (whether high or low) were directly related to resilience. Knowledge of the other life skills (whether high or low) were related to resilience. The only exception was within values, where knowledge and application were both directly related to resilience. Only small numbers of learners engaged in risky behaviour in the form of drinking alcohol mostly. Risky behaviour is considered a negative influence on life skills. Learners portrayed hope, optimism and competence within individual environmental factors. However learners from the lower socio-economic backgrounds presented with less hope (70.7%) compared to other suburbs (84.2%). Within family factors security, stability and support were prominent factors and had a positive influence on life skills leading to resilience. Peer acceptance was important for most learners (95.4%). To conclude the researcher will use findings to develop community and school programmes that could assist in the implementation of life skills that would serve to support and empower adolescents. The important role that the occupational therapist could play in adolescent development is to ensure optimal engagement in occupations through life skills in order to develop as healthy adults.
Open Access
Description of occupational therapy fieldwork supervision at the University of the Free State
(University of the Free State, 2014-01) Hattingh, Rialda; Hough, R.; van Vuuren, S.; Nel, M.
English: Fieldwork education in Occupational Therapy provides students with the opportunity to integrate theory learned at higher institutions with practical skills and professional behaviour within real-life settings to become proficient occupational therapists. Fieldwork supervisors are the key role players and facilitators in realising the purpose of fieldwork education. To this end, supervisors must exhibit effective characteristics of supervision in order to provide quality and meaningful learning experiences for students. Concern has been raised throughout literature about the characteristics that supervisors display during fieldwork placements, because it has such a major influence on students’ learning and experiences of fieldwork education. Very little research has been done on fieldwork education of Occupational Therapy in South Africa and none on the characteristics of supervisors and supervision during fieldwork placements. This study aims to describe effective and ineffective characteristics of supervisors and supervision in Occupational Therapy fieldwork education at the UFS as identified by third and fourth year Occupational Therapy students and supervisors. These phenomena of supervisor and supervision characteristics have been researched in several qualitative studies internationally from either the supervisors’ or the students’ perspective. In this study, a quantitative, descriptive study design was used to gather information about effective and ineffective characteristics of supervisors and supervision during Occupational Therapy fieldwork education. The data collection instruments implemented consisted of two similar self-report questionnaires: one for the students and one for the supervisors. The research population consisted of all the third and fourth year Occupational Therapy students enrolled at the UFS in 2012 (a total of 69) as well as all the supervisors involved in fieldwork training of these Occupational Therapy students (a total of 41). The response rate for the students was 98.6% and for the supervisors 100%. Effective supervision characteristics have been identified and described, with specific emphasis on the main findings that reflect that a supervisor must be competent, professional, approachable, considerate and knowledgeable about what is expected from the student and must spend adequate time with the student. Furthermore, the supervisor must provide sufficient guidelines, support, guidance and feedback. Results were reported according to the five categories used in the questionnaires, namely: interpersonal; curriculum; clinical and professional; feedback and environment. Ineffective supervision characteristics identified in this study were similar to those detected in international studies. This study clearly indicates that supervisors viewed the limited time they had to supervise students as a major cause of ineffective supervising. Additionally, they had less than five years of supervision experience, which influenced the effectiveness of their supervision characteristics negatively. An unexpected finding of this study was the indication by supervisors that students’ attributes – whether positive or negative – had been the biggest influence on the supervision they provided during fieldwork education. In conclusion, extensive recommendations were made to redress the ineffective characteristics of supervision identified in this study as it pertains to students, supervisors and the university. This study contributes to Occupational Therapy’s body of knowledge with regard to supervision characteristics in fieldwork education in a South African setting, which can be used as a base for future research.