Department of Occupational Therapy

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I'm going back to work: perceptions and experiences of back rehabilitated clients regarding their worker roles
(University of the Western Cape, 2004) Soeker, Shaheed; Wegner, Lisa; Pretorius, Blanche; Dept. of Occupational Therapy; Faculty of Community and Health Sciences
Clinical research has shown that patients experience difficulty in adjusting to their pre-morbid worker roles after they have been through a back rehabilitation programme. The pressure and competitiveness of modern day society to achieve competence and to survive has proven to be stressful, both for the injured and uninjured, the unemployed and employed. Back rehabilitation and the successful return of the injured worker to the workplace have been of great interest to industry for the last decade, due to the ever-increasing support of legislature for the injured. There is a range of medical interventions available but few of these achieve successful outcomes due in part to the fact that many intervention strategies do not take the patients perspectives into consideration. Therefore, the purpose of the study was to explore back rehabilitated clients perceptions and experiences of the challenges they face in adapting to their worker roles.
Transformation through Occupation
(Taylor & Francis group, 2004) Wegner, Lisa
Working in the context of a developing country such as South Africa provides a multitude of challenges for professionals in all fields. The last few years since democratisation have seen a transformation in the way occupational therapy is being practiced in South Africa, as the profession redefines itself to meet the needs of the people. The book “Transformation through Occupation” provides an outlet for the voice of South African occupational therapists to be heard, and showcases occupational therapy intervention with groups, communities and populations characterised by poverty, disadvantage and social problems
Exploring the sensory compatibility of ten children with autism and their mothers
(University of the Western Cape, 2008) Pillay, Sarosha; van Rensburg, Viki Janse; NULL; Faculty of Science
Children with autism typically present with sensory processing difficulties that affect their ability to relate to people. This qualitative study focused on exploring the sensory processing of children with autism and their mothers, using a frame of reference of sensory integration theory. The purpose of the study was to help mothers gain knowledge and understanding into their own sensory processing so that they could develop a better understanding of their child's sensory processing in order to facilitate better mother-child relationships. An evaluation tool, the Sensory Profiles by Dunn (1999) and the Adolescent/Adult Sensory Profile by Brown & Dunn (2002) was used as the instrument for gathering information on sensory processing. The population consisted of ten sets of mothers and their children with autism who attend Vera School for Learners with Autism. The Sensory Profiles was completed to investigate the phenomenological issues regarding the sensory modulation aspects of the parent-child relationship. Each mother received individual feedback on their own and their child's sensory processing. Two focus groups were then conducted with the mothers to determine the value of the information gained from the profiles. Data consisted of two audio taped feedback from the focus group. Data was analysed for emerging themes. The three major themes that emerged were, (a) You realize how similar you are to your child, (b) I also have needs (c) They walk away and leave you with this wreck of a child. The findings of the study suggest that an understanding of sensory processing can influence the mother-child relationship positively.
The effect of an injury prevention programme on the lower limb soft tissues in fast bowlers an intervention study
(University of the Western Cape, 2008) Govender, Craig; Frantz, J.M.; Stretch, R.A.; Dept. of Physiotherapy; Faculty of Community and Health Sciences
The aim of the study was to determine the effect of astatic stretching programme on injury prevention. Educational pamphlets and a static stretching regime were implemented to the experimental group.
Leisure boredom and high school dropout in Cape Town, South Africa
(Elsevier, 2008) Wegner, Lisa; Flisher, Alan J.; Chikobvu, Perpetual; Lombard, Carl; King, Gary
This prospective cohort study investigated whether leisure boredom predicts high school dropout. Leisure boredom is the perception that leisure experiences do not satisfy the need for optimal arousal. Participants completed a self-report questionnaire which included the Leisure Boredom Scale. The original cohort of grade 8 students (n ¼ 303) was followed up twice at 2-yearly intervals. Of the 281 students at the second follow-up, 149 (53.0%) students had dropped out of school. The effect of leisure boredom on dropout was investigated using logistic regression taking into account the clustering effect of the schools in the sampling strategy, and adjusting for age, gender and racially classiﬁed social group. Leisure boredom was a signiﬁcant predictor of dropout (OR ¼ 1.08; 95% CI: 1.01–1.15) in students 14 years and older, but not so in younger students (OR ¼ 1.0; 95% CI: 0.95–1.05). The study has shown that measuring leisure boredom in grade 8 students can help identify students who are more likely to drop out of school. Further research is needed to investigate the longitudinal association between leisure boredom and school dropout.
Understanding leisure-related program effects by using process data in the HealthWise South Africa Project
(American Academy for Park and Recreation Administration, 2008) Caldwell, Linda L.; Younker, Anita S.; Wegner, Lisa; Patrick, Megan E.; Vergnani, Tania; Smith, Edward A.; Fisher, Alan J.
As the push for evidence-based programming gathers momentum, many human services programs and interventions are under increased scrutiny to justify their effectiveness across different conditions and populations. Government agencies and the public want to be assured that their resources are being put to good use on programs that are effective and efficient. Thus, programs are increasingly based on theory and evaluated through randomized control trials using longitudinal data. Despite this progress, hypothesized outcomes are often not detected and/or their effect sizes are small. Moreover, findings may go against intuition or “gut feelings” on the part of project staff. Given the need to understand how program implementation issues relate to outcomes, this study focuses on whether process measures that focus on program implementation and fidelity can shed light on associated outcomes. In particular, we linked the process evaluation of the HealthWise motivation lesson with outcomes across four waves of data collection. We hypothesized that HealthWise would increase learners’ intrinsic and identified forms of motivation, and decrease amotivation and extrinsic motivation. We did not hypothesize a direction of effects on introjected motivation due to its conceptual ambiguity. Data came from youth in four intervention schools (n = 902, 41.1%) and five control schools (n = 1291, 58.9%) who were participating in a multi-cohort, longitudinal study. The schools were in a township near Cape Town, South Africa. For each cohort, baseline data are collected on learners as they begin grade 8. We currently have four waves of data collected on the first cohort, which is the focus of this paper. The mean age of the sample at wave 3 was 15.0 years (SD = .86) and 51% of students were female. Results suggested that there was evidence of an overall program effect of the curriculum on amotivation regardless of fidelity of implementation. Compared to the control schools, all treatment school learners reported lower levels of amotivation in wave 4 compared to wave 3, as hypothesized. Using process evaluation data to monitor implementation fi147 delity, however, we also conclude that the school with better trained teachers who also reported higher levels of program fidelity had better outcomes than the other schools. We discuss the implications of linking process data with outcome data and the associated methodological challenges in linking these data.
Healthwise South Africa: cultural adaptation of a school-based risk prevention programme
(Oxford University Press, 2008) Wegner, Lisa; Flisher, Alan J.; Caldwell, Linda L.; Vergnani, Tania; Smith, Edward A.
There is a need for effective prevention programmes aimed at reducing risk behaviour among South African adolescents. Health Wise South Africa is a school-based programme designed to reduce sexual and substance use risk behaviour, and promote positive use of leisure time among high-school learners (students). Based on successful programmes in the United States of America, Health Wise was developed for use in South Africa and pilot tested in four South African high schools. We carried out a process evaluation to establish the fidelity of implementation and make sure HealthWise was culturally relevant. Data sources comprised focus groups with educators and learners, lesson evaluations and observations, and interviews with school principals. Qualitative analysis of data highlighted pertinent cultural and contextual factors and identified areas for modifying Health Wise in order to promote better programme-consumer fit. These areas centred on time, language, and leisure. We noted a dynamic tension between the educators’ desire to adhere to plan, and to make adaptations in accordance with learners’ needs and the context. Ultimately, researchers need to find a balance between fidelity of implementation and programme adaptation to obtain effective programmes that are culturally acceptable to local consumers.
Inconsistent reports of sexual intercourse among South African high school students
(Elsevier, 2008) Palen, Lori-Ann; Smith, Edward A.; Caldwell, Linda L.; Flisher, Alan J.; Wegner, Lisa; Vergnani, Tania
Purpose: This study aims to describe patterns of inconsistent reports of sexual intercourse among a sample of South African adolescents. Methods: Consistency of reported lifetime sexual intercourse was assessed using five semiannual waves of data. Odds ratios related inconsistent reporting to demographic variables and potential indicators of general and risk-behavior-specific reliability problems. Results: Of the sexually active participants in the sample, nearly 40% reported being virgins after sexual activity had been reported at an earlier assessment. Inconsistent reporting could not be predicted by gender or race or by general indicators of poor reliability (inconsistent reporting of gender and birth year). However individuals with inconsistent reports of sexual intercourse were more likely to be inconsistent reporters of substance use. Conclusions: These results suggest that researchers need to undertake efforts to deal specifically with inconsistent risk behavior data. These may include modification of data collection procedures and use of statistical methodologies that can account for response inconsistencies
Adolescent substance use: a prospective longitudinal model of substance use onset among South African adolescents
(Informa Healthcare, 2009) Patrick, Megan E.; Collins, Linda M.; Smith, Edward A.; Caldwell, Linda L.; Flisher, Alan J.; Wegner, Lisa
Substance use onset among Colored adolescents between eighth and ninth grades in an urban area of Cape Town, South Africa was examined using latent transition analysis. Longitudinal self-report data regarding substance use (N = 1118, 50.9% female) were collected in 2004 and 2005. Results indicated that the pattern of onset was similar across genders; adolescents first tried either alcohol or cigarettes, followed by both, then dagga (cannabis), and then inhalants. The prevalence of lifetime cigarette use was slightly greater for females; dagga (cannabis) and inhalant use were greater for males. The similarity of developmental onset in the current sample to previous international work supports the promise of adapting prevention programs across contexts. The study’s limitations are noted.
Leisure boredom and adolescent risk behaviour: a systematic literature review
(Taylor & Francis, 2009) Wegner, Lisa; Flisher, Alan J.
There has been very little research investigating leisure boredom and risk behaviour among adolescents in South Africa. A systematic review of literature was conducted to synthesise current knowledge within the field of leisure boredom and risk behaviour among adolescents. An online and a hand search for relevant articles were conducted using keywords. This resulted in the retrieval of 25 articles that met the inclusion criteria. It was evident that the experience of leisure boredom is influenced by a variety of different factors, not least of which is the environment or context within which adolescents are situated. A key finding was how few studies have focussed on leisure boredom and risk behaviour in adolescents, particularly in the developing world. Also, gaps in the knowledge basis were identified, thus providing direction for future research. The review focuses attention on leisure boredom as a factor contributing to risk behaviour in adolescents. Expanding knowledge in this area is useful for individuals and organisations concerned with adolescent health, education and development.
Play to promote development and learning in children infected with Human Immune Virus (HIV): Case studies of three children
(University of the Western Cape, 2010) Symonds, Gene; van Rensburg, Viki Janse; Dept. of Occupational Therapy; Faculty of Arts
The aim of this study was to explore the use of play with toddlers who are HIV positive to facilitate play, playfulness and sensory-motor development. The objectives were to explore how the therapist facilitated play, to explore how the child responded to the intervention, to explore how playfulness manifested as a facilitatory strategy and to explore how playfulness manifested as a response. A qualitative approach framed the case study research method with three participants between the ages of twelve months and three years. The main source of data was a record of the play-based intervention with the three participants. Additional data was obtained from participant observation of the children's responses to the play-based intervention, and hospital and occupational therapy record notes. A theory analytical strategy was used by coding data using theoretic propositions inductively. Each case was first analyzed individually, and then an analysis was made across the cases. Qualitative analysis of the data was done manually by coding, seeking categories and eliciting emergent themes by using an analytical strategy of theoretical propositions and an analytical technique of explanation building. Coding was done inductively, using theoretical constructs from the occupation by design, namely the elements of appeal, intactness and accuracy. Signs of playfulness were coded according to evidence of the elements of playfulness, namely perception of control, intrinsic motivation, suspension of reality or framing were evident in the data. Findings of the study were reported under two themes: Playful enablement - the therapist and Engaging, playing and developing - the child.
Leisure constraints for adolescents in Cape Town, South Africa: a qualitative study
(Taylor and Francis, 2010) Palen, Lori-Ann; Patrick, Megan E.; Gleeson, Sarah; Caldwell, Linda L.; Smith, Edward A.; Wegner, Lisa; Flisher, Alan J.
This study identified leisure constraints, constraints negotiation strategies, and their relative frequencies among 114 high school students from one under-resourced area of South Africa. Through focus group discussions, participants identified intrapersonal, interpersonal, structural, and sociocultural constraints to leisure, suggesting some degree of universality in this previously documented typology. Intrapersonal constraints were mentioned most often. Whereas participants readily identified ways to overcome interpersonal and structural constraints, strategies for overcoming intrapersonal and sociocultural constraints were not mentioned frequently, suggesting a potential need to help adolescents identify and employ these types of strategies.
A qualitative assessment of South African adolescents’ motivations for and against substance use and sexual behavior
(Wiley-Blackwell, 2010) Patrick, Megan E.; Palen, Lori-Ann; Caldwell, Linda L.; Gleeson, Sarah; Smith, E.D.; Wegner, Lisa
Focus groups (N 5 15 groups; 8 with girls, 7 with boys) with adolescents in high schools near Cape Town, South Africa, were used to conduct a qualitative investigation of reported reasons for using and not using substances and for having and not having sex. Adolescents reported Enhancement, Negative States, Social, and Aversive Social motivations for both sub- stance use and sexual behavior. In addition, being addicted as a reason for using drugs and rape as a context for sexual behavior were frequently reported. Motivations against behaviors included Physical/Behavioral Consequences, Ethical Objections, Social Disapproval, and Incompatible Activities and Goals reasons. Preventive interventions should address existing motivations for and against substance use and sexual behavior to acknowledge adolescents’ experiences in context.
Occupational adaptation : the experiences of adult patients with MDR- TB who undergo long- term hospitalisation
(University of the Western Cape, 2011) Firfirey, Nousheena; Hess- April, Lucia
TB is a multi- faceted public health problem spurred on by the biological progression of the disease as well as the social issues associated with it. The treatment of TB is however primarily driven by the medical model where the focus is on the disease and not on a holistic view of the patient. Occupational therapy is a profession concerned with the use of occupation in the promotion of health and well being through the facilitation of the process of occupational adaptation. There is however a paucity of literature pertaining to the role that occupational therapy could play within the TB context. The aim of this study was to explore how adults with MDR- TB who undergo long-term hospitalisation at a hospital in the Western Cape experience occupational adaptation. The objectives of the study were to explore how the participants perceive their occupational identity, to explore the meaning and purpose the participants assign to their occupational engagement and to explore the how the participants perceive their occupational competence. The interpretive research paradigm employing a phenomenological qualitative research approach was utilized in this study. Purposive sampling was used to select four participants based on specific selection criteria. The data gathering methods utilized included diaries, semistructured interviews, participant observation and a focus group. Photographs taken by the researcher for the purpose of participant observation were used to elicit a rich, in depth response from the participants during the focus group discussion. All data was analysed through thematic content analysis. The study findings highlighted that the participants viewed themselves as occupational beings and that they valued the role that occupational engagement played in facilitating their occupational competence and ultimately their ability to adapt to long- term hospitalisation. The environmental demands and constraints that they experienced however infringed their engagement in meaningful occupation and hampered their ability to achieve occupational competence. It was recommended that the hospital adopt an integrative intervention approach to the management of MDR- TB patients that include principles of psychosocial rehabilitation and occupational enrichment to address occupational risk factors and institutionalisation.
Through the lens of a peer: understanding leisure boredom and risk behaviour in adolescence
(Occupational Therapy Association of South Africa, 2011) Wegner, Lisa
There has been very little research investigating leisure boredom and risk behaviour among adolescents in South Africa. Using a qualitative approach, this study investigated adolescents’ perceptions of leisure boredom and risk behaviour during free time. The sample of participants comprised three groups of adolescent: a community group, a school group and a group who had dropped out of school. Participants documented their free time experiences by taking photographs that were later discussed in focus groups. The findings showed that the participants were bored in their free time mainly because they had nothing to do. The low socio-economic environment where they lived contributed to occupational deprivation and imbalance in their free time, maintaining or ‘trapping’ the adolescents within the situation and contributing to feelings of boredom. The participants spent much of their free time ‘hanging out’ on street corners or in backyards, which allowed them to socialise, but inevitably led to boredom. Participants felt that boredom was part of life, although some perceived it to be ‘dangerous’ because it often led to risky behaviour. In conclusion, the study showed that for the participants, leisure is an occupational concern due to the occupational deprivation and imbalance occurring within their free time. Occupational therapists should consider how leisure boredom influences adolescent health, wellbeing and development, and plan interventions accordingly.
Predicting substance use behavior among South African adolescents: The role of leisure experiences across time
(SAGE Publications, 2011) Sharp, Erin Hiley; Coffman, Donna; Caldwell, Linda L.; Smith, Edward A.; Wegner, Lisa; Vergnani, Tania; Mathews, Catherine
Using seven waves of data, collected twice a year from the 8th through the 11th grades in a low-resource community in Cape Town, South Africa, we aimed to describe the developmental trends in three specific leisure experiences (leisure boredom, new leisure interests, and healthy leisure) and substance use (cigarettes, alcohol, and marijuana) behaviors and to investigate the ways in which changes in leisure experiences predict changes in substance use behaviors over time. Results indicated that adolescents’ substance use increased significantly across adolescence, but that leisure experiences remained fairly stable over time. We also found that adolescent leisure experiences predicted baseline substance use and that changes in leisure experiences predicted changes in substance use behaviors over time, with leisure boredom emerging as the most consistent and strongest predictor of alcohol, cigarette, and marijuana use. Implications for interventions that target time use and leisure experiences are discussed.
The relationship between sensory integrative profiles and academic achievement of first year health sciences students at the University of the Western Cape
(University of the Western Cape, 2012) Bagus, Kulsum; Wegner, Lisa; Waggie, Firdouza
There is a high incidence of dropout in the first year of university studies. Some of the main reasons were attributed to adjustment or adaptation difficulties experienced by the new students which impacted on academic achievement. Much of this difficulty relates to the need to find their identity in relation to the new university environment with new rules, peers, and expectations. The acquisition of a sensory integrative (SI) profile could shed light on an element of the student’s identity. However, very little is known about the relationship between the SI profile and academic achievement. Therefore, the aim of the study was to determine the SI profiles of students and whether there was a relationship between the SI profiles and academic achievement of first year students from the Faculty of the Community and Health Sciences (FCHS) at the University of the Western Cape (UWC).The study followed the quantitative research paradigm and was more specifically a descriptive, cross-sectional study. Measurements included a demographic questionnaire to gather socio-demographic data, as well as the Adolescent and Adult Sensory Profile questionnaire to determine the SI profiles of the students.These instruments were administered to a sample of 357 registered first year students from the FCHS at UWC. Matriculation academic marks, as well as first year university academic marks were obtained and utilised for analysis. The SPSS statistical package was utilised for descriptive and inferential statistical analyses of the data. The results of the study indicated that the SI profiles of the first year FCHS students were that they responded "similarly to most people" on each of the four sensory quadrants of Dunn's (1997) Model of Sensory Processing. Secondary analyses were implemented by means of a collapsing mechanism to denote more specific results of the SI profiles. This analysis revealed that the students tended to have low thresholds for their neurological and behavioural continua of sensory processing.The inferential analyses that were implemented to determine whether there was a relationship between the SI profiles and academic achievement of the first year students yielded no statistical relationship between those variables. The analyses revealed relationships between the SI profiles and certain socio-demographic factors, such as age, race, and course of study.In conclusion, the research study uncovered the SI profiles of the first year university student sample, relationships between the SI profiles and sociodemographics and disproved a relationship between SI profiles and academic achievement. The study was therefore of value to the professions of occupational therapy and higher education and has opened avenues for further exploration. Furthermore the study has portrayed that occupational therapy tools and SI profiles could have a place in higher education and in relation to student development, teaching and learning.
Final year occupational therapy students' experience of supervision during community fieldwork practice
(University of the Western Cape, 2012) Vermeulen, Nicola; De Jongh, Jo-Celene; Hess – April, Lucia
Fieldwork is seen to be an essential component in the curriculum of an undergraduate occupational therapy (OT) program through which students develop their professional behavior and apply theoretical education to clinical practice. Students in their final year of the undergraduate OT program at the University of the Western Cape (UWC) use the UWC Community Process as a guide to community fieldwork in community settings. This process follows a community development approach to allow students to focus on the needs of the community. The community fieldwork placement is compulsory for all final year OT students. The main aims of the placement are for students to develop their understanding of the role of an occupational therapist in a community setting and to enhance their understanding of the occupational nature of communities. This study focuses on final year UWC OT students' experiences of the supervision they received while following the steps of the Community Process as well as their perceptions of the relationship between their supervision and their learning about occupation based community practice. The aim of the study was to explore how the 2009 final year OT students experienced fieldwork supervision during their community fieldwork placement. The study followed an interpretivist paradigm with a qualitative research methodological approach and a phenomenological design. Purposeful sampling was used to select participants from the UWC OT department who undertook their community fieldwork placement in 2009. All the data utilized in this study was directly linked to the students' experiences of supervision during their learning of the Community Process. Therefore, the methods of data collection that were used included the students' daily reflective journals, their portfolio files and an evaluative focus group held at the end of the year 2009. All data was critically analyzed through a process of thematic analysis in order to meet the research objectives. The techniques of triangulation and a detailed description of the research process were employed to ensure trustworthiness of the study. The ethical principles of autonomy, nonmaleficence, beneficence as well as informed written consent were adhered to in the study. The findings of the study highlighted the emotions that the students experienced, the development of their professional judgement and the challenges and experiences they encountered in their personal and professional development. The findings further showed that the process of becoming a part of the community allowed the students to define their role as an OT in a community setting and to increase their understanding of community development in the context of their role within the community. The findings also emphasized the students' experiences with regards to various teaching and learning techniques and approaches used within the supervision of their community fieldwork placement. The significance of this study lies in its contribution to the generation of an understanding of how supervision influences students' understanding of occupation-based community practice in occupational therapy.
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.
Interventions for out-of-school contexts
(UCT Press, 2012) Wegner, Lisa; Caldwell, Linda L.
Introduction: Violence has become part of normal,everyday life for many young South Africans.

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