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Browsing by Author "Struthers, Patricia"

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The attitudes of physiotherapists in Gaborone and Ramotswa, Botswana, towards treating people living with HIV/AIDS
(University of the Western Cape, 2007) Kambole, Mercy Mulenga; Struthers, Patricia; Dept. of Physiotherapy; Faculty of Community and Health Sciences
Physiotherapists are increasingly treating peole living with HIV/AIDS. However, there is little information which has been reported on their attitudes in providing treatment to people with HIV/AIDS or what facilitates positive attitudes. The aim of this study was to determine attitudes of physiotherapists towards treating people living with HIV/AIDS in Botswana.
Barriers experienced by parents/caregivers of children with clubfoot deformity attending specific clinics in Uganda
(University of the Western Cape, 2006) Herman, Kazibwe; Struthers, Patricia; Dept. of Physiotherapy; Faculty of Science
Clubfoot is the most common congenital structural deformity that leads to physical impairments in children in many poor developing countries. Inadequately treated or neglected clubfoot has been found to be a common cause of ohysical disability globally among children and young growing adults. Many children are referred to the clinics for treatment but some parents do not comply with the treatment regimen whcih requires attending for consecutive treatment sessions. The purpose of this study was to investigate barriers to treatment attendance parents/caregivers of children with clubfoot encounter in complying with clubfoot treatment during the plaster csting phase in Uganda.
Barriers to school attendance among children with disabilities in Rwanda
(University of the Western Cape, 2008) Sagahutu, Jean Baptiste; Struthers, Patricia; Faculty of Community and Health Sciences
The number of children with disabilities under the age of 18 years around the world varies from 120 to 150 million. In many countries, throughout the world, the majority of children with disabilities either do not receive any form of education or, if they receive any, it is often inappropriate. UNESCO estimates that more than 90% of children with disabilities in developing countries do not attend schools. Rwanda has recently started inclusive education in a number of schools around the country for ensuring that children with disabilities have access to education. Despite this, in Rwanda, many children with disabilities do not attend school and this number is not known. This study aimed to identify the barriers to school attendance by children with disabilities in Rwanda.
Building a health-promoting schools conceptual framework model as a strategy to address barriers to learning and to promote healthy development of school-aged children
(University of the Western Cape, 2014) Ntagungira, Egide Kayonga; Struthers, Patricia; Van Hove, Geert
After suffering almost total collapse. Rwanda has made impressive post-genocide progress. Many children of school going age are now attending school, but regrettably, only half complete primary school. High numbers of orphans, disabled children and a growing number of children from child-headed households still suffer the consequences of the poverty inherited from the past. Health problems include HIV/Aids, STIs, malaria, tuberculosis, enteric diseases, mental health problems, hunger and malnutrition. Use of drugs and substance abuse, unwanted pregnancies, lack of support services, unavailability of teaching and learning materials, inflexible curricula and poor teaching methodologies also contribute to learning breakdown. It is against this background that this thesis was conducted to investigate the development of a health-promoting schools model to provide an appropriate strategy to address barriers to learning and to promote healthy development of school children in Rwanda. Two research questions were the focus of this research, first, how does a health-promoting schools model provide an appropriate strategy to address barriers to learning and to promote healthy development of school-aged children in Rwanda and second, what are the participants’ views on and understanding of the model and its potential use in their schools? A mixed methods research design that employed both qualitative and quantitative approaches was used. The study followed sequential implementation: Phase 1 was concerned with the identification of the components for the model. It was a case study of four schools, two rural schools and two urban schools in Kigali City. The sample included 60 teachers, pupils, principals and parents from schools and nine key informants who were policymakers from the Ministries of Education and Health and Social Welfare, line institutions and the UNICEF. Data collection strategies included focus group discussions, semi-structured, in-depth individual interviews, a transect walk and observations. Data analysis was through content analysis. Eight themes emerged out of the data: school leadership and management; school health policies; pupil wellbeing; school partnership with parents, families and local communities; school health services; factors affecting teaching and learning for all children; teacher wellbeing; and a healthy physical school environment. These themes became the components that informed the development of a health-promoting schools model. In Phase 2, the degree of understanding of this proposed model and its components were investigated in each school community.
Caregivers' satisfaction with physiotherapy services at a cerebral palsy clinic in Kampala, Uganda
(University of the Western Cape, 2006) Omare, Helen; Struthers, Patricia
INTRODUCTION: The evaluation of satisfaction with health care service provision is important when trying to provide quality care. Satisfaction with service provision has been found to be related to the expectations prior to receiving the service and the actual experience of the service. OBJECTIVES: To explore the expectations and satisfaction that caregivers of children with cerebral palsy havewhen they attend physiotherapy services. Methods: A qualitative study using two focus groups. A semi-structured interview guide was used to facilitate the focus group discussions. Data was collected and thematic analysis was undertaken PARTICIPANTS: Nine caregivers, five mother, three grand mothers and one grandfather, participated in the focus group discussions. SETTING: A cerebral palsy clinic in Kampala, Uganda. Intervention: No intervention but an interview schedule was used to obtain information. RESULTS: The caregivers were satisfied with seeing an improvement in the children's abilities, the outcome of the home programme and the assistive devices. Not all the caregivers were satisfied with the knowledge they had gained and the development of their skills. Caregivers were dissatisfied with regards to communication with the physiotherapists. CONCLUSION: Physiotherapy plays an important role in the improvement of cerebral palsy children's physical abilities and knowledge given to caregivers but physiotherapists need to improve in their communication skills.
Experiences of caregivers of children with spastic cerebral palsy regarding splinting in Uganda
(2013) Tusiime, Christine; Struthers, Patricia
Splinting is one of the many strategies used globally for managing neuromuscular impairments related to cerebral palsy. In Uganda, some children with cerebral palsy who have been provided with splints return to the physiotherapy department with contractures or deformities. A qualitative research methodological approach was used to understand and describe the experiences of caregivers of children with cerebral palsy regarding splinting in Uganda. The theoretical framework used was the bio-psychosocial model of disability. Purposive sampling was used to select 24 caregivers of children with spastic cerebral palsy who received splints in 2010 at two research settings in Uganda. In-depth interviews were conducted with all the participants at their homes using an interview guide. The data collected was transcribed verbatim and translated from Luganda to English. Inductive content analysis was used to analyse the data. Six themes concerning experiences emerged, namely: caregivers‟ expectations and beliefs; acquisition of splints; knowledge and skills; attitudes to splinting; compliance and benefits of splinting. The results of this study show the overwhelming challenges caregivers face while their children require splinting. When considering providing splints to children, the results highlight the need, to take into account the personal (child) factors, the splint characteristics and the environmental (family and community) factors. There is a need to provide information on splints to both the children with cerebral palsy and their caregivers.
External stakeholders and health promoting schools: complexity and practice in South Africa
(Emerald, 2014) Preiser, Rika; Struthers, Patricia; Mohamed, Suraya; Cameron, Neil; Lawrence, Estelle
Purpose: This paper examines the role of two higher education institutions in the Western Cape, South Africa, and how their initiatives and collaboration brought about a particular Health Promoting Schools (HPS) program in a resource poor setting. The aim of this paper is to reflect on the importance of the role that external systemic actors and stakeholders can play in the process of designing and implementing HPS programs in resource poor settings. Design/methodology/approach: In this paper a complex systems approach is employed to describe two different participatory methods of engagement with HPS by higher education institutions. On the one hand, engagement took place in terms of a formal and funded project, directed at the organizational level of the school, with capacity building as its aim. On the other hand, engagement was initiated informally (as part of a service learning project) via collaboration with the formal project, directed at the individual level of learners in the school. Findings: In recognizing the complex nature of planning and implementing HPS programs, the paper demonstrates that HPS approaches could benefit from engaging with resources outside the ambit of institutional health and educational policies and structures. Originality/value: By acknowledging the systemic nature of implementing HPS strategies, novel collaborations emerge as a result. The paper highlights the important role that external stakeholders such as higher education institutions play in creating and sustaining tailor-made HPS programs for schools based in resource poor settings.
Factors influencing the implementation of health promoting schools : a multiple case study of three secondary schools in a resource limited community in Cape Town
(University of the Western Cape, 2016) Mohamed, Suraya; Stern, Ruth; Struthers, Patricia
Introduction: This study was conducted because of a gap in information on the factors influencing the health promoting schools (HPS) implementation process in South Africa (SA) specifically and in secondary schools globally. The aim of this context- sensitive, practice-based study was to explore and understand the complexity of the factors that influenced the implementation process of HPS in three secondary schools in a resource-limited setting in Cape Town, SA. This research drew on a five year project that initiated the implementation of HPS in these schools. Methodology: An exploratory qualitative study was used, adopting a multiple case study design. The sample included two principals, ten teachers and 30 students involved in HPS implementation at their schools, and the three school facilitators, who served as mentors to the schools. The data collection methods included: individual interviews, focus group discussions, documentary review, secondary data and observations. A conceptual framework was developed drawing on the settings approach and various implementation frameworks and was used to analyse the findings. Thematic analysis was employed and the data for each case were analysed separately first before undertaking cross case analysis. Findings: A combination of several internal and external factors influenced the ability of the schools to implement and integrate HPS as a whole school approach. A key factor was the degree of understanding of the HPS concept by all key actors and where there was lucid understanding, there was better integration. Significant school factors included the schools’ readiness for change; a culture of collaboration and cooperation; existing school structures, practices and workload; the leadership style and management role of the principals; the role and influence of HPS champion teachers; and the role that students played. The major external factors included the role of the education district; the role of project team as external catalysts for change; and the community context. The main achievements in all schools were discrete activities, including co-curricular activities rather than changes to routine school functions. This highlighted the difficulty in implementing HPS as a whole school approach, a challenge typical of all health promoting settings. Conclusion: The findings illustrate the challenge of achieving full integration of HPS, although the influencing factors, and hence level of integration varied mainly according to context. This highlights the complexity of the different factors and their impact. The study demonstrates the paradox of HPS implementation. In that, despite the recognition of the value of HPS, the challenges to address the complexity of factors that would have brought about change through a whole school approach were too great. It was too difficult to change the status quo from what was routinely done to a more radical way of working due to the conservatism of traditional ways of working and extent of adjustment that it would have resulted. It was therefore only possible to put simple, discrete, strategies in place and that was not too resource intensive. The study concluded that this does not imply that HPS should not be attempted, particularly where there are adverse conditions that would benefit from HPS. Starting with marginal changes, it can be effective in increasing the schools’ readiness for change, building on the achievements both in activities and structures, and the resultant commitment by those involved. Once they experience these changes it will more likely enable schools to incrementally attempt more complex changes. The key recommendations for within the school include: building the understanding and capacity of relevant actors to actively support the implementation of HPS; building the capacity of the principal to create an environment which is conducive to change; and providing support for the HPS champions and students. Recommendations for those external to the school include: support from external catalysts who can provide expertise and mentorship; support from the education district, especially in terms of policies on integration, resources, and raising the profile of HPS; and better collaboration between the education and health sectors. Although most of the literature on HPS implementation identifies similar issues to those found in this study, the complexity has not, to date, been sufficiently described. The contribution of this study, therefore, is to take the debate on the complexity of the factors influencing HPS implementation forward.
Functioning, disability and health in people living with HIV on antiretroviral therapy in Rwanda
(University of the Western Cape, 2014) Kagwiza, Jeanne Nyirankumbuye; Struthers, Patricia; Jelsma, Jennifer
The study aimed to explore the need for and nature of care that PLWH living in Rwanda receive from their health care providers using a bio-psychosocial framework. A further aim was to determine if the Kinyawanda version of the World Health Organisation Disability Assessment Schedule 2.0 (WHODAS 2.0), which was used to gather the functional data, was valid within the Rwandan context. A mixed methods approach was used. A quantitative survey was used to determine the profile and the prevalence of disability among PLWH, by measuring impairment, activity limitation and participation restriction amongst PLWH who are also on antiretroviral treatment. In addition the relationship between functioning and medication was explored. A Kinyarwanda version of the ICF core set of questions and the WHODAS 2.0 outcome instrument was used. Face-to-face interviews were conducted among PLWH at 15 selected hospitals representing all provinces in the country. The final sample size included 502 PLWH. Participants‘ health status showed that the longer they had HIV and had been on antiretroviral treatment, the more likely they were to have impairments. Pain (69%) and fatigue (83%) were more prevalent than any other problems found in all domains measured under impairments. Problems with mobility function (57%) scored the highest prevalence under activity limitations, and problems in participation/social functions had the highest prevalence in comparison to the other domains. The mean score of the different domains were significantly different with participation scoring the highest (46%, with 100% the worst score rate)
HIV/AIDS management: the roles of physiotherapy
(University of the Western Cape, 2009) Munishi, M; Frantz, Jose M.; Struthers, Patricia
BACKGROUND: HIV/AIDS is a major health problem that has affected many people globally and it is the primary cause of death in Sub-Saharan Africa. Approximately 68% of the global total i.e. 22.5 million people living with HIV/AIDS (PLWHA) are in Sub-Saharan Africa. With antiretroviral therapy, PLWHA now live longer and present with various opportunistic neuro-musculo-skeletal and cardio-pulmonary conditions. PURPOSE: To explore the global, regional and local existing literature concerning knowledge, attitude and roles of physiotherapy in the management of PLWHA. METHOD: A retrospective search of articles published between January 1990 and March 2008. Outcome measures: Documented information concerning physiotherapy management of PLWHA, including physiotherapists' knowledge and attitudes, based on inclusion criteria. RESULTS: The search yielded 17 reviews of good or reasonable quality. Physiotherapy rehabilitation can address impairment and activity limitation. There is some evidence that aerobic training with a progressive exercise component is effective in improving the cardio-vascular system, distribution of adipose tissue and on quality of life. There is evidence that ice or dry-towel massage has a positive effect on neuropathic pain. Evidence from case studies suggests that joint mobilization, soft tissue mobilization, stretching, and the use of micro-current, pressure garments and orthotics may be effective. There was no evidence of the effect of other physiotherapy roles mentioned including chest physiotherapy, counseling and health education. CONCLUSION: There is some evidence that exercise is safe and beneficial to PLWHA. Further studies are needed to determine if other physiotherapy techniques are effective for treating PLWHA.
Mentoring and coaching in promoting publications in the Department of Physiotherapy at a local university in South Africa
(AOSIS, 2010) Frantz, Jose M.; Rhoda, Anthea; Rowe, Michael; Phillips, Julie; Karachi, Farhana; Mlenzana, Nondwe; Pharaoh, Hamilton; Steyl, Tania; Struthers, Patricia
A growing shift towards research and evidence based practice in academia is associated with requirements to disseminate research results in the form of publication in peer reviewed journals. Mentoring has been identified as an important component of developing young authors, as it increases confidence and competence, and facilitates professional development. This led to the formation of a support group to stimulate peer-review publication in the physiotherapy department at the University of the Western Cape. The Kirkpatrick Framework of Evaluation was used to evaluate the success of the mentoring process which made use of a participatory action research methodology. The writing group consisted of nine academic members of staff and took place over ten weeks. The programme included writing, giving feedback, discussion and peer review on a weekly basis. Focus group discussions were taped and transcribed in order to evaluate the mentoring process by identifying relationships within the data and categorising key concepts, which were shaped into a thematic framework. The findings indicated that participants experienced a variety of emotions throughout the programme, with an overall feeling of personal growth by the end. In addition, participants also reported improved writing, reviewing and communication skills. Six months following the programme, six participants had submitted at least one article to a peer reviewed journal. It is clear from this study that some academics still find the task of writing and reviewing articles daunting, and that guidance and support in the form of a writing programme can be useful.
Met and unmet palliative care needs for people living with HIV/AIDS in selected areas in Rwanda
(University of the Western Cape, 2005) Uwimana, Jeannine; Struthers, Patricia; Dept. of Physiotherapy; Faculty of Community and Health Sciences
The aim of this study was to investigate met and unmet palliative care needs for people living with HIV/AIDS in selected areas in Rwanda. The achieve this aim, the study, firstly, identified the palliative care needs of people living with HIV/AIDS, secondly, it identified the health care services available to meet these needs, and thirdly, it determined the extent to which palliative care needs were met.
A mobile school-based HCT service – is it youth friendly?
(Taylor & Francis Open, 2016) Lawrence, Estelle; Struthers, Patricia; Van Hove, Geert
BACKGROUND: Despite an increase in HIV Counselling and Testing (HCT), few young people have been tested. It has been suggested that they do not test because formal health services (where HCT is provided) are often not youth friendly. The World Health Organisation describes a youth-friendly health service (YFHS) as one which is accessible, equitable, acceptable, appropriate, and effective. A mobile school-based model has been implemented by a non-governmental organisation in Cape Town in an attempt to make HCT more youth friendly and accessible to young people. The objective of this study was to explore whether this mobile school-based HCT service is youth friendly. METHODS: The study was descriptive, using three qualitative data collection methods: observation of the HCT site at two secondary schools; interviews with six service providers; and direct observation of 21 HCT counselling sessions. KEY RESULTS: The mobile school-based HCT service fulfilled some of the criteria for being a YFHS. The service was equitable in that all students, irrespective of race, gender, age, or socio-economic status, were free to use the service. It was accessible in terms of location and cost, but students were not well informed to make decisions about using the service. The service was acceptable in that confidentiality was guaranteed and the service providers were friendly and nonjudgemental, but it was not considered acceptable in that there was limited privacy. The service was appropriate in that HCT is recommended as an intervention for decreasing the transmission of HIV, based on evidence and expert opinion; however, in this case, HCT was provided as a stand-alone service rather than part of a full package of services. Moreover, studies have suggested that young people want to know their HIV status. The service was ineffective in that it identified students who are HIV positive; however, these students were not assisted to access care. CONCLUSION: Providing HCT in the school setting may make HCT more accessible for students, but it needs to be provided in an equitable, accessible, acceptable, and effective way.
Parent/caregiver satisfaction with physiotherapy services for children with cerebral palsy: an explorative qualitative study at the cerebral palsy clinic in Mulago Hospital, Kampala, Uganda
(University of the Western Cape, 2004) Irochu-Omare, Margaret Helen; Struthers, Patricia; Dept. of Physiotherapy; Faculty of Community and Health Sciences
The extent to which customers are satified with the care they receive from the health professionals has been an important area of interest for researchers, managers and health care workers. The physiotherapy cerebral palsy clinic at Mulago Hospital in Kampala Uganda provides physiotherapy services for parents caregivers of children with cerebral palsy. The parents caregivers visit the clinic seeking physiotherapy services that will address their problems and those of the child. The purpose of this study was to explore the satisfaction that the parents caregivers of children with cerebral palsy get from utilising the physiotherapy services at the clinic and to identify the barriers problems that they encounter that might affect their attendance.
“The pen is a powerful weapon; it can make you change”: The value of using reflective writing with adolescents
(Occupational Therapy Association of South Africa, 2017) Wegner, Lisa; Struthers, Patricia; Mohamed, Suraya
INTRODUCTION: Adolescent programmes have been criticised for implementing activities but not allowing opportunities for reflection. One way that reflection can be facilitated is through writing. This paper describes the use of reflective writing with adolescents as part of a health promoting schools project in Cape Town, South Africa. METHOD: The project included an annual leadership camp for adolescent learners. A descriptive, qualitative study was conducted to describe how the learners responded to writing as a means to express their feelings about, and experiences of, the camp. Thirty learners participated in two writing sessions resulting in 53 written reflections that were analysed thematically. FINDINGS: Three themes emerged: (1) Reflections on self; (2) Reflections on self in relation to others; and (3) Reflections on writing. Participants reflected on connecting with complex, positive and negative feelings, and felt that reflective writing had enabled them to express themselves with courage and honesty, connect with themselves, identify weaknesses and let go of negative emotions and feelings. Furthermore, writing was perceived as being non-judgmental, providing a sense of relief and release, and evoking emotions. CONCLUSION: Reflective writing enabled the participants to acknowledge personal changes and development, and provided insight into their feelings and experiences. This study shows the value of reflective writing for use by health professionals such as occupational therapists, as a tool for empowerment in the pursuit of health and wellbeing.
Preparation of adolescent learners with down syndrome in cape metropole schools, South Africa, for transition to work
(2009) Muvua, Ancent Muli; Struthers, Patricia; Hove, Geert Van
Transition from school to work entails the preparation, education and training of learners, leading to their placement in desired work situations. The right of children with disabilities to be included in ordinary schools and employment thereafter is being advocated internationally. However, despite this, preparation for transition from school to work still poses a major challenge for many learners with intellectual disabilities. The aim of this study was to explore how schools in the Cape Metropole, South Africa, are preparing adolescent learners with Down syndrome for the transition to work. The objectives of the study were to explore: school policies related to the transition process; schools’ physical and psychosocial environments; the link between schools and the community; learners’ acquisition of skills and education support services. Collaborative qualitative research design was used with a partnership between the researcher and the Western Cape Down Syndrome Association. The participants included two teachers with experience of teaching learners with intellectual disabilities, two parents of adolescent learners with Down syndrome, ten participants with Down syndrome, amongst them, two adolescent youths in post school training who were identified in this study as role models and eight learners at school. As learners with Down syndrome might not be fluent in verbal communication, an alternative research strategy, photovoice was used. Photovoice (photography) was used a means of accessing learners’ views of the transition planning and making these views accessible to others. The eight schoolgoing learners were given cameras and requested to take photographs of things and experiences that helped to prepare them for work. The learners were then interviewed. Subsequently adults with Down syndrome (role models), who were in post school training, were also interviewed. Finally, parents and teachers were interviewed. Data analysis included translating, transcribing of raw data from the recorded tapes and content analysis by using codes and identifying themes. The synthesis of the findings from all the participants yielded multiple themes including: education support services: acquisition of skills: supportive relationships; home, community, classroom and school environments; and dreams of the participants. Ethical considerations included getting permission from the University of the Western Cape, the Western Cape Education Department, the principals of the schools, the participants and their parents/guardians. The study has illustrated that, given opportunities and proper preparation in school, adolescent learners with Down syndrome have the potential to become active members of society. For better outcomes of the transition planning process, there is need for: teachers to work closely with the parents; increased government support; job coaches and class assistants in the schools and a greater collaboration between government departments.
Profiling children with neural tube defects and exploring experiences of mothers
(University of the Western Cape, 2012) Simpamba, Micah Mutuna; Struthers, Patricia
Neural tube defects (NTDs) are the world‘s second most common birth defects after cardiovascular defects. In developing countries, poor access to health care services among children with NTDs contributes to early infant deaths, while those who survive live with severe disabilities. In Zambia, all children with NTDs in need of surgery are referred to Lusaka and physiotherapy services are not available in health facilities below the first level hospitals. The aim of the current study was to determine the profile of children with NTDs and to explore the experiences of mothers with accessing health care services for these children. The study which was conducted at the University Teaching Hospital (UTH) in Lusaka consisted of both quantitative and qualitative methods. The quantitative phase consisted of a retrospective record review of children with NTDs, who were admitted to UTH from January to December, 2010. A sample of 50 medical records was used based on available records, and data collection was done using a data extraction sheet which was specifically designed for the study. Analysis of quantitative data was done using Statistical Package for Social Science (SPSS) version 20.0. The qualitative phase had two parts, with the first part involving in-depth interviews with a purposefully selected sample of 20 mothers of children who were admitted to UTH. The second part used a sample of convenience of four mothers who had brought their children for follow up visits. All interviews were audiotaped, transcribed verbatim and translated, and recurring ideas were coded and collapsed into categories and themes. Permission to conduct the study was obtained from the UWC Research Grant and Study Leave Committee, University of Zambia Research Ethics Committee, and University Teaching Hospital management. Informed written consent was obtained from the mothers who accepted to take part in the study. Results from the record review revealed that the majority of children were from Lusaka province, with ages ranging from one day to 48 months and a male predominance of 58%. Myelomeningocele was the most common type of NTD (44%) with the lumbar region being the common site (52%). Hydrocephalus was present in 74% of children, 30% of children had both paraplegia and incontinence and 22% (n=11) of the files had no information on the neurological impairments. Wound infection was present in 40% (n=20) of the children. The majority (66%) of children were lost to follow up. Mothers of children who were admitted in UTH cited transport to UTH and back home as the main challenge. Other challenges included the lack of a prenatal diagnosis, the need for information, uncertainty about future of their children, and concerns about their family. Interviews with mothers on experiences with accessing physiotherapy services found that the lack of knowledge among mothers was the main reason children were not accessing physiotherapy services. Findings on access to health care were related to the ―Four A‘s‖ access theory which consists of four dimensions of access namely geographical accessibility, availability, affordability and acceptability. It is recommended that health care providers and policy makers ensure that all children with NTDs are provided with free transport to and from referral hospitals. Policy makers need to consider involving physiotherapists in out-reach programmes and mobile clinics to ensure access to physiotherapy services for all children in need of the service. Health care providers must also ensure that they give adequate information to mothers of children born with birth defects as this enhances their access to appropriate health care services.
Research productivity of academics in a physiotherapy department: a case study
(Health and Medical Publishing Group, 2010) Frantz, Jose M.; Rhoda, Anthea; Struthers, Patricia; Phillips, Julie
Objective: Research productivity is an important activity among academics. This study was done to document the research productivity of the academics of a physiotherapy department in South Africa. Method: An archival research design was used to document the research productivity for the physiotherapy department between 2002 and 2009. Data were analysed by two independent reviewers and consensus was reached on the information to be included in the study. Results: Among the nine academics there were 67 publications, 20 articles in progress, 7 under review and 63 conferences attended. While the overall research productivity of the department seems to be good, the bulk of the productivity rests in the hands of the senior academics. Conclusion: There is a need to facilitate the acquisition of research skills in academic staff, particularly in upgrading staff to PhD level and improving publication output.
The role of occupational therapy, physiotherapy and speech and language therapy in education support services in South Africa
(University of the Western Cape, 2005) Struthers, Patricia; Sanders, David
This thesis investigated the education support services provided by occupational therapists, physiotherapists and speech and language therapists in the Western Cape Province of South Africa. Changes in the education policy in South Africa to an inclusive education system have major implications for the way therapists provide support. Therapists have been challenged to move from a medical model of support with a focus on highly specialised treatment for a small number of individual learners with disabilities, to a systemic and health promoting model which focuses on support for the education system, including all learners, teachers and parents. The aim of this research was to develop an appropriate and integrated approach for therapists to support schools within an inclusive and health promoting schools framework in South Africa. Participatory action research using quantitative and qualitative methodology was used. Two surveys were conducted in the Western Cape Province. The first was a survey of all therapists to determine who was working with pre-school and school-aged learners and where. The second survey was of all therapists working in special schools and a small number of private practitioners to identify the roles of the therapists in providing direct and indirect support. In two of the seven education districts in the province, focus group discussions were held with 45 teachers from special and ordinary schools, and 21 parents of school-aged learners - to identify the support they needed. Workshops, incorporating focus groups, were also held with the therapists to, firstly, identify the support they needed to give to learners, teachers, parents and the education system and, secondly, to identify the competencies they needed to give this support. The data from the surveys were subjected to simple descriptive statistical analysis. These analyses reveal that therapists have a very wide range of roles relating to direct support, including: assessment, intervention with individual learners and learners in groups, and evaluation. Interventions include the development of hearing, speech and communication skills; skills for activities of daily living; life skills; home management skills; work related skills; motor function skills; and play and leisure skills. Therapists from different disciplines frequently provide the same type of support. Indirect support provided includes support for the schools system, teachers and parents. Thirty six percent of the therapists in this study want to increase the proportion of time they spent on indirect support. The study also revealed that multidisciplinary collaboration and teamwork were Teachers involved in the study identified that they need an enormous amount of support in fulfilling their crucial roles in identifying barriers to learning; identifying the support learners need; and addressing the barriers. This includes the need for support to teach a diverse group of learners; adapting content, presentation and evaluation of the curriculum; adapting the physical environment; accepting new roles of teachers and therapists; making changes to the school system; developing relationships with the parents; addressing challenges related to socio-economic problems; networking with the community; facilitating positive attitudes to diversity; developing supportive relationships with therapists; and further training poorly developed. Teachers involved in the study identified that they need an enormous amount of support in fulfilling their crucial roles in identifying barriers to learning; identifying the support learners need; and addressing the barriers. This includes the need for support to teach a diverse group of learners; adapting content, presentation and evaluation of the curriculum; adapting the physical environment; accepting new roles of teachers and therapists; making changes to the school system; developing relationships with the parents; addressing challenges related to socio-economic problems; networking with the community; facilitating positive attitudes to diversity; developing supportive relationships with therapists; and further training. Parents in this study indicated that they need access to education and support for their children, including direct support for their children; effective means of communicating with their children; specific competencies to facilitate caring for their children; emotional support; advocates to work with them in support of their children addressing environmental physical and attitudinal barriers, and developing a supportive community; and supportive relationships with therapists.
School-based HIV counselling and testing: providing a youth friendly service
(2012) Lawrence, Estelle; Struthers, Patricia
HIV counselling and testing (HCT) is an essential element in the response to the HIV epidemic. Thereare still major gaps in research about the best ways to provide HCT, especially to young people. School-based HCT is a model which has been suggested for providing HCT to young people in a youth friendly manner. This study was aimed at producing recommendations for providing a youth friendly school-based HCT service using the World Health Organisation (WHO) framework for youth friendly health services. It was conducted in six secondary schools in Cape Town, where a mobile HCT service is provided by a nongovernmental organisation (NGO). It was an exploratory descriptive study, using a mixed-methods approach. Twelve focus group discussions (FGDs) were held with learners to explore their needs with regards to school-based HCT. An evaluation (which consisted of observation of the HCT site, service provider interviews and direct observation of the HCT counselling process) was done to determine whether the mobile school-based HCT service was youth friendly. A learner survey was conducted with 529 learners to investigate the factors that influence the uptake of HCT and to explore learners’ behaviours and experiences under test conditions. In the FGDs, learners said that they wanted HCT to be provided in schools on condition that their fears and expressed needs were taken into account. They wanted their concerns regarding privacy and confidentiality addressed; they wanted to be provided with information regarding the benefits and procedure of HCT before testing took place; they wanted service providers to be competent to work with young people, and they wanted to be assured that those who tested positive were followed up and supported. On evaluation of the mobile school-based HCT service, it was evident that the service did not meet all the needs of the learners nor did it have all the characteristics of a youth friendly health service. The model of ‘mass testing’ used by the NGO did not fulfil learners’ expressed need for privacy with regards to HCT. Service providers were friendly and on-judgemental but had not been trained to work with young people (especially marginalised groups e.g. young men who have sex with men). The information needs of learners were not addressed, and learners were not involved in the provision of the HCT service. Learners who tested positive were not assisted in accessing care and support. The learner survey revealed a high uptake of HCT (71% of learners) at schools with learners who do not identify themselves as Black, with female learners and older learners being more likely to have had an HIV test. Factors that influenced uptake of HCT were complex, with learners reporting many different motivators and barriers to testing. Of concern was the low risk perception of learners with regards to HIV infection and the fact that learners who tested HIV positive were not being linked up with treatment and care. Based on the findings of the study, recommendations were made for proving youth friendly school based HCT. A multisectoral approach, with learner and community involvement, was suggested in order to provide a service which is equitable, accessible, acceptable, appropriate and effective.

Browsing by Author "Struthers, Patricia"

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