UWCScholar :: Browsing by Author "Hess-April, Lucia"

Browsing by Author "Hess-April, Lucia"

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Academics’ knowledge and experiences of interprofessional education and practice
(Health and Medical Publishing Group, 2016) Julie, Hester; Hess-April, Lucia; Wilkenson, J.; Cassiem, Wagheda; Rhoda, Anthea
BACKGROUND. Interprofessional education (IPE) can be seen as the vehicle to address the health and social problems of society through collaborative approaches. Since IPE should be facilitated by educators who are skilled in this area, faculty development initiatives should be based on the principles of IPE and collaborative practice (IPECP). OBJECTIVE. To explore academics’ knowledge and experiences of IPECP. METHODS. The study used an exploratory descriptive design and the appreciative inquiry framework underpinned data gathering and analysis. The data were collected using workshops, and the participants of the workshops shared their knowledge and experiences of IPECP, which were audio-recorded and analysed using thematic analysis. Ethical clearance was obtained from the University of the Western Cape, Cape Town, South Africa. RESULTS. The analysis revealed three themes: knowledge of IPE; experiences of IPECP; and enablers of IPECP aligned to the dream and discovery phases of appreciative inquiry. The findings revealed that academics were knowledgeable about the concept of IPE and that their experiences with IPECP ranged from clinical supervision to research. Regarding enablers of IPECP, they provided important input, which could facilitate IPECP in a university faculty. These included competencies for IPECP, professional development and a common practice framework. CONCLUSION. The academics who attended the faculty development workshops were knowledgeable about the concepts of IPECP. They concluded that for IPE to be effective, a common practice framework should be adopted in the faculty to inform specific teaching and learning strategies and outcomes.
Curriculum transformation: a proposed route to reflect a political consciousness in occupational therapy education
(Occupational Therapy Association of South Africa, 2012) De Jongh, Jo-Celene; Hess-April, Lucia; Wegner, Lisa
Introduction: Curriculum review is an ongoing, dynamic, long-term process that forms part of occupational therapy education. The Department of Occupational Therapy, University of the Western Cape (UWC) recently responded to the challenge of becoming socially responsive and politically relevant by engaging in curriculum review. The review revealed that political reasoning was not clearly delineated previously in the curriculum. In response to this problem, over a period of several years we engaged in a process of curriculum transformation so that students become politically conscious. Methods: The process entailed environmental scanning, feedback from teaching staff and clinicians, students’ evaluations, regular curriculum revision meetings, academic development meetings, workshops and seminars. A qualitative study using a cooperative enquiry approach was conducted to analyse the data. Findings: From the analysis the following themes emerged: (1) identifying the essence of occupational therapy education at UWC, (2) understanding political practice on a theoretical and then a personal level, (3) integrating and operationalising political consciousness into the curriculum. We discuss the debates and critical questions raised in our efforts to develop a curriculum that prepares graduates to be politically conscious and socially responsive. Finally, we present key strategies for the way forward. Conclusion: Curriculum transformation around a political practice of occupational therapy does not merely mean just a change in curriculum content, but requires the internalisation of a political consciousness by educators individually and collectively.
Development and implementation of an occupation-based community development programme with women to address the prevention of non-communicable diseases, in a low socio-economic community of the Western Cape
(University of the Western Cape, 2024) Kalam, Aziza; Hess-April, Lucia; Wegner, LIsa
While non-communicable diseases (NCDs) were historically regarded as diseases of the wealthy, they are now a concern amongst people living in poverty and those who are vulnerable in society. NCDs kill approximately 71% of the global population which equates to 41 million deaths each year, mostly affecting people living in poverty. Health-risk factors for NCDs include poor diet, lack of exercise, excessive use of alcohol and tobacco, and are mostly preventable. NCDs are preventable but may be inherited through health-risk behaviours and lifestyles. Women, in their roles as mothers are the ideal agents of change who could influence the behaviour and occupational choice of the next generation as they are ideally positioned within their families and communities to be empowered to take ownership of their health and well-being. The aim of this study was to develop and implement an occupation-based community development programme to address the prevention of NCDs with women in a low socio-economic community of the Western Cape. The objectives of the study were to explore and describe: 1) the women’s perceptions of NCDs; 2) how the women perceived their current health-risk behaviours and occupational choices, 3) their occupational needs for participation, 4) their enablers in relation to their occupational participation; 5) the selection and design of occupation-based strategies to address the health-risk factors for NCDs and 6) the process of implementation to empower the women to prevent health-risk factors for NCDs. The critical research paradigm was adopted, and a qualitative, participatory action research design integrated within the occupation-based community development practice framework, was utilised. A total of 27 women aged 20 to 65 years living in a low socio-economic community near Cape Town, South Africa participated in the study over a period of two and a half years.
The evaluation of the integrated client-centred intervention programme (ICIP) for clients with MDR-TB at DP Marais Hospital in the Western Cape
(University of Western Cape, 2020) Firfirey, Nousheena; Hess-April, Lucia; Soeker, Mogammad Shaheed
Although TB is a curable communicable disease, poor adherence to TB treatment is a major barrier to TB control in South Africa as it increases the risks of morbidity, mortality and drug resistance at individual and community level. As a result, multi-drug-resistant TB (MDR-TB) has become a serious public health issue. Underpinning this study was the assumption that a client-centred approach to treatment of MDR-TB clients, with a hospital programme which adopts an integrated multidisciplinary approach that is client-centred and is not purely biomedically driven, would improve treatment outcomes of MDR-TB clients.
An exploration of undergraduate Occupational therapy students’ perspectives on occupational balance
(University of Western Cape, 2019) Apollis, Josephine Lizelle; Mthembu, Thuli G; Hess-April, Lucia
Occupational justice empowers individuals, especially the previously disadvantaged, to have their basic needs met, as well as turn their potential into reality, through human rights and labour legislation, which provides access to equal opportunities. However, with the amount of different choices, in terms of occupational roles, facing the individual to fill their time with, effective management thereof to preserve one’s health and well-being on a daily basis, is not necessarily guaranteed. Occupational science, and more specifically, occupational therapy education imparts the importance of occupational balance, a concept which denotes a balance between the person, their environment and their occupations, some of which are strenuous and others relaxing. Occupational balance can be achieved by adapting the physical, mental, social and rests occupations.
Exploring occupational therapy graduates’ conceptualisations of occupational justice in practice: Curriculum implications
(Health and Medical Publishing Group, 2016) Hess-April, Lucia; Smith, Juliana; De Jongh, Jo-Celene
BACKGROUND. The concept of occupational justice was derived from a social justice perspective in response to a renewed commitment by the occupational therapy profession to address the occupational needs of individuals, groups and communities who experience social injustice. Accordingly, it is acknowledged that education with regard to occupational justice has the deliberate intention of preparing graduates, who would be change agents as critical practitioners. Nonetheless, while occupational therapy education programmes may seek to instil broader professional values, theory covered in the curriculum may not always assure congruent practice. OBJECTIVE. To explore how occupational therapy graduates’ conceptualisations of occupational justice, as instilled by the occupational therapy curriculum of the University of the Western Cape, South Africa, manifested in their practice while undergoing community service. METHODS. Seven occupational therapy graduates were selected to participate in the study through purposive sampling. A descriptive case study of their practice was generated through qualitative methods. Semi-structured interviews, document review and participant observation were used as data collection methods, analysed through a process of inductive thematic analysis. RESULTS. The findings revealed that while the participants conceptualised occupational justice as broader social change through occupational enablement, they encountered several constraints related to structural and systemic power issues in their practice contexts. CONCLUSION. The study supports the utilisation of transformative learning and inter-professional education in developing critical competencies such as agency and political proficiency to assist graduates in dealing with the complexities of practice during community service.
Exploring the lived experience of leisure travelling for people with disabilities
(University of the Western Cape, 2018) van der Westhuizen, Yolanda; Wegner, Lisa; Hess-April, Lucia
Historically travelling was an option only for the affluent; however, with the turn of the 20th century, travelling shifted to an important form of free-choice learning by means of discovery. Travelogues of able-bodied travellers state that travelling offers them an opportunity for constructing new identities as it broadens their perspectives of self. This caused the researcher to question if the same experiences could be prompted amongst people with disabilities. Various disciplines recognise that travelling is a valuable opportunity for growth, but no literature could be found within Occupational Therapy. This led to the research question explored in this study: what is the shared, lived experience of travelling for people with disabilities? The objectives of this study are to describe and explore the purpose and overall experiences of travelling for people with disabilities, explore how people with disabilities perceive, understand and make sense of their experiences of travelling, and lastly to explore the meaning that travelling has for people with disabilities. The theoretical framework underpinning this study is the Peron-Environment-Occupation Model and the Model of Human Occupation, with specific reference to the philosophy of occupational science. Embedded in a philosophical worldview of social constructivism, a Hermeneutical Phenomenological design was chosen using a qualitative approach. Through purposive sampling, six participants were interviewed using a semi-structured interview guide. Interpretative phenomenological analysis was applied to analyse data subsequent to cross analysis, thereby developing a composite understanding of the meaning of travelling to the participants. The findings present three themes, namely: a Double edged sword which highlights the contradictory effects that travelling can have, followed by People are part of the package, which emphasises the participants’ interpretations of the immense role that society plays in disability, and lastly the most prominent theme Pilgrimage to self-discovery. Additionally, an Integrated Model was developed which integrates two prominent models within Occupational Therapy. Conclusively this study provides insight into how travelling facilitated the participants to develop a new identity.
Lived experiences of family members’ adjusting to HIV/AIDS disclosure within the family.
(University of the Western Cape, 2020) Tshoto, Ncedisa; Hess-April, Lucia
HIV/AIDS is one of the major challenging illnesses globally and is increasingly recognised as an illness that affects families and not just the individual. While HIV/AIDS has brought many challenges to infected individuals and their families, the focus has primarily been on individuals with HIV/AIDS in relation to their needs. Families often provide most of the emotional and physical care to a family member with HIV/AIDS, placing a huge strain on them that could lead to tension between family members. There is a paucity of research exploring the phenomenon of being a member of a family affected by HIV/AIDS. Therefore, the aim of this study was to explore the lived experiences of family members adjusting to HIV/AIDS disclosure within their families.
Mental health care users’ perceptions and experiences of a hospital-based vocational rehabilitation programme in a rural setting
(University of the Western Cape, 2018) Msimango, Henry; Hess-April, Lucia; Soeker, Mogammad Shaheed
Return to work is a recognised goal of rehabilitation by the occupational therapy discipline that is addressed through vocational rehabilitation as a key feature of work practice. Programmes that fall under the umbrella of vocational rehabilitation include work preparation and training, work hardening and supported employment. In the case of mental health care users (MHCU), meaningful employment contributes to their sense of identity and the prevention of relapse. Vocational rehabilitation is thus important in preparing MHCU for self-employment or employment in the community after they are discharged from the hospital. There is however a dearth of literature pertaining to how vocational rehabilitation programmes particularly in a rural setting, is experienced by MHCU in South Africa. Therefore, the aim of this study was to explore the experiences and perceptions of MHCU regarding the usefulness of the vocational rehabilitation programme at a rural hospital in enhancing their worker roles. A qualitative research approach and exploratory descriptive research design was utilised. Purposive sampling was used to select participants for the study. Semi-structured interviews were conducted with ten MHCU participants as well as two focus groups. Semi-structured interviews were furthermore conducted with two key informants. All interviews and the focus group discussion were audio-recorded, transcribed verbatim and analysed through thematic data analysis. Strategies implemented to ensure trustworthiness included member checking and peer review. Ethics clearance was obtained from the UWC Research Committee and permission to conduct the study at the hospital was requested from the Mpumalanga Provincial Health Ethics Committee and hospital management. Three themes originated from the findings of this study. Theme one describes the barriers experienced by people with mental illness while returning to work. Theme two describes the programme factors that influence return to work in respect of work habits, work skills, and community re-integration. Theme three captures the value of participating in the work programme as experienced by the participants. The findings of the study is related to the Model of The Ecology of Human Performance (EHP) to show how the vocational rehabilitation programme effected the MHCU’s return to work. The findings show that the context as well as the person’s skills and abilities are very important factors in reintegrating the user back to work. The study illuminated recommendations for the further development of the vocational rehabilitation programme.
Mental health care users’ perceptions and experiences of community re-integration in the Dikgatlong sub-district
(University of the Western Cape, 2022) Arendse, Nawaal; Hess-April, Lucia
Community re-integration is regarded as one of the most significant outcomes of communitybased rehabilitation of mental health care users (MHCUs). Without community-based rehabilitation MHCUs experience difficulties with re-integration into communities, resulting in high readmission risks and defaulting on clinic visits and medication. The study aimed to explore and describe the experiences and perceptions of MHCUs community re-integration in the Dikgatlong sub-district. A key objective of the study was to report on the facilitating factors and support needs of MHCUs after their discharge from hospital.
Novice occupational therapists’ perceptions and experiences of professional socialisation in the first year of practice in South Africa
(University of the Western Cape, 2018) Philander, Tamlyn Kay; Hess-April, Lucia; Mthembu, Thuli
Professional socialisation is a key dimension within the professional development of an occupational therapy practitioner. Professional socialisation in the first year of practice involves a process of change within the individual with regards to knowledge, skills and reasoning. The process further involves the novice’s developmental induction into the culture of the profession and into the practice context. Novice practitioners who are not appropriately supported in their professional socialisation process may become demoralised as practitioners. It is necessary to explore professional socialisation from the perspectives of novice occupational therapy practitioners themselves, in order to generate an understanding of how professional socialisation can be supported in the first year of practice. This is of vital importance otherwise the profession may run the risk of attrition. Therefore, the aim of this study was to explore and describe novice occupational therapists’ perceptions and experiences regarding professional socialisation during the first year of practice. A qualitative research approach and exploratory descriptive research design was utilised in the public health system in South Africa. Purposive sampling was utilised to select nine participants for the study. Data collection methods included two semi-structured interviews and a dyad interview discussion which were audio-recorded, transcribed verbatim and analysed through thematic data analysis. The strategies of member checking, peer review, reflexivity, and an audit trail ensured trustworthiness of the study. Ethics clearance was obtained from the UWC Research Committee. Three themes originated from the findings of this study. The first theme, stepping into the unknown, illustrates a dissonance between the participants’ expectations for practice and the actual realities of practice that they encountered. The second theme, uncovering the occupational therapy culture, highlights power dynamics and inconsistencies within the profession as perceived by the participants. The third theme, becoming a professional, highlights how the participants responded to the challenge of transitioning from student to professional and started to internalise their professional identity. Recommendations to support the professional socialisation of novice therapists in the South African context are made in respect of occupational therapy education, continued professional development, support for novice therapists, transformation in the profession and future research.
Occupation-based practice in a tertiary hospital setting: occupational therapists’ perceptions and experiences
(Occupational Therapy Association of South Africa, 2017) Hess-April, Lucia; Dennis, Lynique; Ganas, Nicolette; Phiri, Lungelo; Phoshoko, Pumza
Occupation-based practice is an important feature of occupational therapy. There is however limited research regarding occupational therapists’ experiences with occupation-based practice. This study aimed to explore occupational therapists’ perceptions and experiences regarding occupation-based practice in a tertiary hospital setting in the Western Cape, South Africa. An explorative and descriptive research design within a qualitative research approach was utilised. Purposive sampling allowed the selection of four participants with a minimum of 2 years practice experience. Semi-structured interviews were conducted to gain an understanding of how they perceived and implemented occupation-based practice. Data were analysed using thematic analysis. Four themes emerged: occupation-based practice expresses professional identity; occupation-based practice necessitates relevance; constraints to occupation-based practice; and facilitators of occupation-based practice. The findings revealed that the participants’ perceived the implementation of occupation-based practice as an expression of their professional identity and that in adopting an occupation-based approach they perceived their roles as being diverse and transformational. It was however highlighted that the nature of the service context posed several constraints that influenced the implementation of occupation-based practice. Thus, occupational therapists may need to generate practice-based evidence to advocate for the service conditions necessary to implement occupation-based practice and deliver relevant occupational therapy services.
People with disabilities’ perspectives on how participation in a supported employment programme facilitates access to work.
(University of Western Cape, 2021) Otty, Michaela Ellen; Hess-April, Lucia
Despite extensive literature highlighting the role of supported employment in ensuring access to work for people with disabilities, there is limited research on their perspectives of supported employment. This thesis presents a research study conducted in two different supported employment programmes in South Africa. The aim of the study was to explore and describe people with disabilities’ perspectives on how participation in a supported employment programme facilitates access to work. The research objectives sought to explore the barriers to, and facilitators of, inclusion and access for people with disabilities to work; describe key elements of a supported employment programme that influences access and inclusion for people with disabilities to work; and finally, to explore people with disabilities’ perspectives regarding the value of participating in a supported employment programme.
A situational mapping overview of training programmes for community-based rehabilitation workers in Southern Africa: strategies for strengthening accessible rural rehabilitation practice
(Frontiers Media S.A., 2020) Hess-April, Lucia; Ned, Lieketseng; Tiwari, Ritika
In 2018, the United Nations global report showed that people with disabilities, who make up 15% of the worlds’ population, have poorer health and rehabilitation access (SDG 3). Without improving the needed person-centered health and rehabilitation services at household level, SDG 3 cannot be achieved. This includes addressing human resource shortages through training multi-skilled community based rehabilitation workers (CRWs) to build rural workforce capacity and enhance the lives of people with disabilities, particularly in LMICs where the need is higher but resources are lower. However, to date, there is no documentation and analysis of existing training and its scope for this workforce in LMICs. A situational mapping overview was undertaken to review the current status of rural rehabilitation training programs offered in Southern Africa for CRWs. CRWs are rehabilitation personnel, based in the home/community, who are not professionals (without a bachelor qualification) but render non-institutional rehabilitation and inclusive development in communities, under the supervision of rehabilitation practitioners. Information on these programs was obtained using a two-step process.
Understandings and practices: Towards socially responsive curricula for the health professions
(Springer, 2023) Hansen, Anthea; Engel-Hills, Penelope; Hess-April, Lucia
Global health inequities have created an urgency for health professions education to transition towards responsive and contextually relevant curricula. Such transformation and renewal processes hold significant implications for those educators responsible for implementing the curriculum. Currently little is known about how health professions educators across disciplines understand a responsive curriculum and how this understanding might influence their practice. We looked at curricula that aim to deliver future health care professionals who are not only clinically competent but also critically conscious of the contexts in which they serve and the health care systems within which they practice.

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