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dc.contributor.advisorVan Heerden, S. M.
dc.contributor.advisorDu Toit, S.
dc.contributor.authorCarroll, Esna
dc.date.accessioned2016-02-12T14:21:39Z
dc.date.available2016-02-12T14:21:39Z
dc.date.issued2015-07
dc.identifier.urihttp://hdl.handle.net/11660/2300
dc.description.abstractEnglish: 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.en_ZA
dc.description.abstractAfrikaans: Die doelwit van hierdie studie was om te verken hoe ek insig kon verkry van my huidige fasilitering van ʼn voorafopgestelde/gestruktureerde twee weke lange lewensvaardigheidprogram ten einde deurlopend kliëntgesentreerde praktyk aan te spreek vir die kliënte wat ek bedien. Die studie was by ʼn private psigiatriese kliniek (PC) in die Vrystaat, Suid-Afrika, uitgevoer. Ek het persoonlike refleksie gekultiveer ten einde ʼn beter begrip/insig te verkry oor hoe eksterne indikators en interne indikators die lewensvaardigheidprogram beïnvloed, en ek het ook verken wat die uitwerking van die lewensvaardigheidprogram op kliënte was; dit het alles in samewerking met my kliënte plaasgevind, wat hulle belanghebbendes in die studie gemaak het. Hierdie studie/verkenning was onderneem aangesien sommige kliënte na die kliniek teruggekeer het nadat hulle die arbeidsterapie-lewensvaardigheidprogram ten tyde van hul vorige opname by die PC bygewoon het, maar steeds probleme met lewensvaardighede ervaar het. Ek wou dus vasstel of ek die beste praktyk verkry met die kliënte wat ek bedien het ten tyde van hul opname en in die lewensvaardigheidsgroepe was wat ek gefasiliteer het. My begrip van beste praktyk is gepas beskryf deur Parker (2011:139), aangesien sy noem dat kliëntgesentreerde sorg as die optimale manier beskou word om gesondheidsorg te voorsien. Ten einde te verken of ek beste praktyk behaal het, moes ek verken of my fasilitering van lewensvaardigheidsgroepe kliëntgesentreerd was en ook watter ander faktore hul ervaring van die lewensvaardigheidsgroepe beïnvloed het. Al bogenoemde vrae, asook ʼn teenstrydigheid in terme van relevante navorsingsgebaseerde bevindinge (soos verder in die opsomming genoem), het bewysgebaseerde praktyk ten einde kliëntgesentreerde praktyk te verkry vir die kliënte wat ek bedien, vereis. Reflektiewe en refleksiewe praktykvoering het dus die ondersteuning gebied om kliëntgesentreerd in my groepe te bevorder. Suid-Afrikaanse literatuur oor arbeidsterapie-groeppraktyk in geestesgesondheidsomgewings is beperk, maar stel soortgelyke programme vir mense gediagnoseer met gemoeds- en angsversteurings voor, ofskoon sonder spesifieke riglyne vir die fasilitering van hierdie groepe in die konteks van ʼn sub-akute psigiatriese kliniek binne ʼn Suid-Afrikaanse opset. xxi Aangesien ek insig oor die lewensvaardigheidsgroep wat ek aanbied en die belanghebbendes se ervaring daarvan wou verkry, is ʼn studie van ʼn verkennende aard uitgevoer deur aksienavorsing (“action research”; AR) met ʼn veelvuldige metode-benadering te gebruik. Ek het hoofsaaklik kwalitatiewe elemente soos daaglikse refleksie-aktiwiteite vir belanghebbendes en myself gebruik, asook ʼn paar kwantitatiewe elemente soos kontrolelyste as metodes van dataversameling. In hierdie studie het die populasie (belanghebbendes) bestaan uit kliënte wat die Afrikaanse groepprogram by die psigiatriese kliniek bygewoon het nadat hulle deur ʼn psigiater by die PC opgeneem is. Die belanghebbendes het ingesluit manlike en vroulike kliënte ouer as 18 jaar, met verskillende geestesgesondheidsdiagnoses, waaronder gemoeds- (depressiewe) en angsversteurings die mees algemeen was. Die hoeveelheid potensiële belanghebbendes in ʼn groep in een siklus was in die algemeen tussen vyf en 12 mense. ʼn Veelsydige tematiese analise is vir die kwalitatiewe data gebruik. Ek het die data geanaliseer, tesame met twee medekodeerders. Kwantitatiewe data-analise is deur die Departement Biostatistiek, UV, voltooi nadat ek data ingelees het d.m.v. Microsoft Excel en dit deur ʼn medekodeerder laat verifieer het. ʼn “Kritiese vriend” het my ook gehelp perspektief kry binne die studie. Bevindinge beskryf die belanghebbendes se en my eie ervarings van die lewensvaardigheidsgroep en het die indikators wat ʼn negatiewe en positiewe invloed op ervarings gehad het, aangedui. Dit het ook uitgebrei op die uitwerking wat die lewensvaardigheidsgroepe op belanghebbendes gehad het; dus die kliëntgesentreerdheid van hierdie groepe, en tevredenheid van belanghebbendes. Regdeur die AR-proses is veranderinge aangebring volgens die bevindinge ten einde deurlopend kliëntgesentreerdheid, en dus beste praktyk vir die belanghebbendes in my groepe, aan te spreek. Die bevindinge, asook die rol van die AR-proses, is verder geïntegreer en bespreek deur die kliëntgesentreerde verwysingsraamwerk as agtergrond vir die bespreking te gebruik. In die slot is gevolgtrekkings en aanbevelings vir beste kliëntgesentreerde praktyk gemaak, wat bestaan uit interne en eksterne indikators gesien in die lig van die raamwerk van kliëntgesentreerdheid. Hierdie aanbevelings sluit in die erkenning en bespreking van voorstelle oor die beperkings van die studie, en aanbevelings vir toekomstige navorsing is voorgelêaf
dc.language.isoenen_ZA
dc.publisherUniversity of the Free Stateen_ZA
dc.subjectClient-centred practiceen_ZA
dc.subjectOccupational therapyen_ZA
dc.subjectGroup programen_ZA
dc.subjectLife skill programen_ZA
dc.subjectAction researchen_ZA
dc.subjectClient-centered psychotherapyen_ZA
dc.subjectDissertation (M. Occupational Therapy) (Occupational Therapy))--University of the Free State, 2015en_ZA
dc.titleTowards client-centred practice within an occupational therapy group life skill program: an action research journeyen_ZA
dc.typeDissertationen_ZA
dc.rights.holderUniversity of the Free Stateen_ZA


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