Die korttermyn invloed van sensoriese integrasie intervensie op die geestesgesondheidsorg verbruiker met versteurings gekenmerk deur simptome van psigose

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Date
2013-02
Authors
Annandale, J. C. A.
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Publisher
University of the Free State
Abstract
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.
Afrikaans: Die Geestelikegesondheidsorg Verbruiker (GGSV) met psigose presenteer met verskeie simptome wat funksionaliteit en aktiwiteitsverrigting beperk. Dit beïvloed hulle vermoё om aktiwiteite van die alledaagse lewe uit te voer en om aktief betrokke te wees in Arbeidsterapie behandeling. Sensoriese integrasie intervensie spreek die funksionaliteit en aktiwiteitsverrigting van die GGSV aan (Smith-Roley, Mailloux, Miller-Kuhaneck & Glennon, 2007:1). Die korttermyn invloed van sensoriese integrasie intervensie op die GGSV met versteurings gekenmerk deur simptome van psigose was deur middel van 'n kwantitatiewe, gerandomiseerde, gekontroleerde enkelblinde kliniese proef ondersoek. Goedkeuring van die studie is deur die Etiekkomitee van die Universiteit van die Vrystaat (ETOVS 30/11) verleen en die data is tussen Oktober 2011 en Julie 2012 by die akute sale van 'n psigiatriese instansie in die Vrystaat ingesamel. Nege-en-negentig (99) GGSVs met simptome van psigose het aan die studie deelgeneem. Die mediaan ouderdom van die deelnemers in die twee groepe het tussen die ouderdomme van 30 en 32 jaar gewissel en 65.7% van die deelnemers was manlik. Nadat die deelnemers op grond van die insluitingskriteria stiplys tot die studie toegelaat was, was randomisering en paring gebruik om die deelnemers in 'n eksperimentele- en 'n kontrole groep te verdeel. Paring is volgens geslag, lewensfase, vlak van funksionering en patologie gedoen. Die aktiwiteitsverrigting van beide groepe is tydens die voortoets deur die “Therapeutic Functional Level Assesment” (TFLA) bepaal en die sensoriese integrasie disfunksie van die eksperimentele groep is deur die “Schroeder, Block & Campbell Adult Psychiatric Sensory Integration Measure” (SBC) bepaal. Na die voortoets was beide groepe aan die standaard Arbeidsterapieprogram van die akute sale blootgestel en die eksperimentele groep was aan 'n twee weke (agt sessies) sensoriese integrasie intervensieprogram blootgestel. Die TFLA en die SBC is soos met die voortoetsing weer na die intervensie tydperk gebruik om aktiwiteitsverrigting te bepaal. Dieselfde meetinstrumente en assesseringsterapeute (gekwalifiseerde Arbeidsterapeute) was in die voor- en natoetse gebruik. Die medikasie en die vlak van psigose is op 'n daaglikse basis op grond van die prosesnotas van die kliniese personeel van die sale genoteer. Resultate is geanaliseer deur die Departement van Biostatistiek, Universiteit van die Vrystaat. Ten spyte van die feit dat daar beperkte hoeveelheid statisties beduidende verskille gedurende die studie verkry was, het beide groepe kliniese verbeterings getoon. Die eksperimentele groep het statisties beduidende verskille ten opsigte van die verbetering van sosiale gedrag (logiese gesprekvoering en kommunikasie), selfsorg, voorkoms en die verminderde voorkoms van delusies/hallusinasies getoon in vergelyking met die kontrole groep. Die SBC het met die natoetsing van die eksperimentele groep 'n statisties beduidende verbetering ten opsigte van die fisiese assessering getoon. Sensoriese sisteme wat 'n verbetering getoon het was: die vestibulȇr-proprioseptiewe sisteem, die somatosensoriese sisteem en die visueel-vestibulȇre sisteem. Verdere navorsing oor die effek van sensoriese integrasie intervensie op die GGSV sal waardevol vir die veld wees. Arbeidsterapeute moet oorweeg om sensoriese integrasie intervensie aanvullend tot die standaard Arbeidsterapieprogram te gebruik, ten einde die funksionering van die GGSV met psigose maksimaal te verbeter.
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Keywords
Occupational therapy, Senses and sensation, Psychoses -- Patients, Senorimotor integration, Mentally ill -- Rehabilition, MHCU with psychosis, Sensory integration intervention, Occupational performance, Dissertation (M.Occupational Therapy (Occupational Therapy))--University of the Free State, 2013
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