Magister Scientiae - MSc (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.
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.
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.
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.
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.
Exploring the experiences of rehabilitated stroke survivors and the perceptions of stakeholders with regard to stroke survivors returning to work in South-West Nigeria
(University of the Western Cape, 2013) Olaoye, Olumide Ayoola; Soeker, Shaheed; Olaogun, M O B
Stroke has been identified as a global cause of neurological disability with a resultant burden shared not only by the survivor but also by the society. The resumption of one’s role as a worker after having a stroke is an important rehabilitation goal. South-West, Nigeria has experienced high incidence and prevalence of stroke leaving a quarter of survivors with severe disability and difficulty in community integration after rehabilitation. As a disability resulting from a stroke could be viewed as being a dynamic interaction between the health condition and contextual factors, a client-centred approach should be focal to stroke management to facilitate return to work. Therefore, it became necessary to explore the return to work process from stroke survivors and stakeholder’s perspective in order to understand the challenges stroke survivors face while adapting to their worker roles, to improve service design and delivery as well as to facilitate the return to work after having a stroke. The study was aimed at exploring and describing the experiences of rehabilitated stroke survivors and perceptions of stakeholders about stroke survivors returning to work in South-West Nigeria. A qualitative research design was used to explore these experiences and perceptions from nineteen participants that comprised of nine stroke survivors, two key informants (rehabilitation specialists) and eight caregivers of the respective stroke survivor. Two methods of data collection were used by the researcher to access the perceptions and experiences of the participants. The researcher made use of focus groups with the caregivers while in-depth interviews were conducted with the stroke survivors and rehabilitation specialists. One pilot testing in-depth interview and eleven in-depth interviews were conducted with the stroke survivors and rehabilitation specialists while two focus group discussions were held with the eight caregivers consisting of four participants per group. The data from the study was analysed using thematic analysis. All data were managed manually. The study was further aimed at obtaining participants` perceptions and experiences of barriers and facilitators as well as adaptation processes that influenced the stroke survivors’ ability to resume their worker role. The findings were revealed in five themes. Theme one and two describes the barriers experienced by the stroke survivors while returning to work in the form of loss of former self and returning to work is a struggle. The resumption of the previous worker role by the stroke survivors was construed to be a contest which entails a struggle between the survivor, survivor’s job characteristics, rehabilitation intervention and stigma from the society. Poor access to rehabilitation interventions, inadequacy of treatment and poor insight of the stroke survivor regarding condition, job characteristics as well as social stigma related to the condition were observed as factors that posed great challenges to the participants. Theme three describes the factors that facilitated the resumption of the worker role for the stroke survivors. Engagement in rehabilitation as well as social support enabled the stroke survivors to overcome the barriers and returning to work. Theme four describes the adaptation strategies that enable the return to work for the stroke survivors. Theme four was described by an intrinsic adaptation process that involves the acceptance of the illness and being motivated to return to work and an extrinsic adaptation process that involves gradual work exposure, workplace and home adaptation. Theme five describes the participants’ perception of changes needed in the rehabilitation services and policies that would facilitate the quick return to work of the stroke survivor. Promoting participation of stroke survivors in work through government policies was observed to be a necessary recommendation for the study. These were seen to be achievable through the improvement of rehabilitation resources, enabling access to rehabilitation through financial assistance, change of the regulatory environment to accommodate for the disabled and the initiation of health promotion through public awareness campaigns in the community regarding stroke. The Person Environment Occupation model of occupational performance was used as a framework to interpret the findings of the study; the barriers, facilitators and adaptation process was placed into perspectives as they impacted on the experience of the stroke survivors ‘resumption of their worker role. The resumption of the worker role of the stroke survivors was observed not only to be influenced by the individual characteristics of the survivors but also by the environmental context within which the return to work process took place.
Physical activity participation among adults with hypertension in Mbabane, Swaziland
(2013) Masona, Sharon; Phillips, Julie
Scientific studies have shown that chronic diseases of lifestyle (CDL) such as hypertension and diabetes mellitus are major causes of mortality and morbidity, accounting for about 60% of the disease burden globally. Available statistics for Swaziland indicate that hypertension and heart diseases are on the increase and are responsible for 33,540 and 3,146 cases per year respectively. Regular physical activity (PA) is widely recognised as a means for the primary and secondary prevention of CDL due to their multi-factorial beneficial effects on an individual‟s health. Therefore, the aim of this study was to determine PA participation among adults with hypertension in Mbabane, Swaziland and the extent to which they are encouraged to be physically active. A cross-sectional design, utilising quantitative methods was employed in the study and three validated standardised interview administered questionnaires were used to collect data from both hypertensive individuals and health professionals. A sample size of 422 hypertensive individuals and 72 health professionals was included in the study. Statistical Package for Social Sciences (SPSS) version 20 was used to analyse the data. Descriptive statistics were employed to summarise data and was expressed as means, standard deviation, frequencies and percentages. The Students‟t-test was used to compare mean age and PA. Chi-square tests were used to test for associations between categorical variables with significant levels set at 5% (p < 0.05). Blood pressure was classified into controlled (≤ 140/≤ 90 mmHg) and uncontrolled (≥ 140/≥ 90 mmHg). PA was dichotomised into active (> 600 MET-minute/week) and sedentary (< 599 METminute/ week). BMI was classified as underweight (<18.5), normal (18.5-24.9), overweight (25-29.9) and obese (>30). The findings of the current study revealed that a considerable number of individuals with hypertension (53%) were physically inactive with poorly controlled blood pressure (57%). A statistical significance was found between mean age and PA (sedentary and active) (P= 0.000 ˂ 0.05). iii The study also revealed that the perceived benefits of PA as reported by individuals with hypertension outweighed the perceived barriers. In addition, the majority of health professionals were found to be poor counsellors of PA (58%). Most health professionals informed their patients on becoming physically active but did not include important components of PA counselling such as the types of PA, intensity and duration. The common reasons for not including PA as part of the daily routine include: not my area of specialty and lack of time. These factors could significantly contribute to sedentary behaviour among hypertensive individuals in developing countries such as Swaziland. For this reason, an urgent need for PA promotion programmes which will motivate hypertensive individuals to participate in sufficient levels of PA as recommended by public health research has been established. The programmes should include educating health professionals on current trends in the promotion of PA. A combination of these approaches will help to reduce morbidity and mortality from cardio-vascular disease (CVD), in particular hypertension.
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.
Meeting the occupational needs of recovering drug addicted adolescents
(University of the Western Cape, 2014) Parker, Insauf; Soeker, Shaheed
The growing phenomenon of drug abuse has alerted the attention of health professionals, addiction counsellors, school educators, the media and community members. Susceptible sub groups of the population such as adolescents have been seriously affected as addiction destroys their identities, health, daily performance, family structure and ultimately results in social disintegration. Consequently, rehabilitation facilities have been established and addicts are entering the treatment system via referrals from school principals, the judiciary court or desperate parents and family members. Despite this, after having spent a reasonable amount of time and money in rehabilitation centres, relapse rates are significantly high and addicts are returning to treatment. The question was then raised as to whether recurrent relapses were as a result of their occupational needs not being met in treatment. To understand whether the occupational needs of these recovering adolescents are met, a true client-centred approach was employed. A descriptive approach was used within a qualitative research paradigm. The participants that were selected from four drug rehabilitation facilities in the Cape Town Metropolis, included 8 recovering drug addicted adolescents, 2 rehabilitation workers employed at two different facilities, and a sum of 26 parents of recovering addicts. Purposeful sampling was used for the adolescents and rehabilitation workers while convenient sampling was used for the parents. To access the perspectives and perceptions of the participants the researcher used individual semi-structured interviews for the recovering adolescents and drug rehabilitation workers, and focus groups for the parents. The data was analysed thematically using Lincoln & Guba’s (1985) method of qualitative data analysis. All data was managed manually. The objectives of the study explored perceptions of drug addicted adolescents with regard to relapse, to describe the barriers with regard to drug rehabilitation and their occupational needs, to reveal facilitators with reference to the recovery process, and to present suitable strategies which may improve drug treatment practice. Three themes were constructed based on the findings of the study. The themes were: 1) easy to get in, difficult to get out, 2) breakdown on life caused by drug addiction, and 3) moving forward towards recovery. Since adolescence is known as a transitional period characterised by identity development, adolescents are naturally influenced by their social and physical environment, particularly their peer groups at school and in the community. Consequently, adolescents enter treatment with numerous physical, psychological, social, intrapersonal, and legal needs. The constant pursuit of drugs and its lifestyle leads to dysfunction and imbalance in the individual’s daily performances with relapse remaining a common element in the recovery process. The lack of knowledge from participants pertaining to the concept of relapse was perceived as a barrier to recovery. The physical and social environment such as the general availability and accessibility of drugs in adolescent’s community, the unfavourable influence that peers and family relationships play, organisational challenges such as staff handling principles regarding their developmental stage and ineffective communication within the rehabilitation centre, and personal barriers including manipulative and behavioural difficulties, emerged as contra-indicative to the recovery process. Many of the recovering drug addicted adolescents were unable to cope with the array of needs and triggers, and found themselves relapsing and returning to the rehabilitation facility. Among the many facilitators as perceived by the participants, the actual programme at the rehabilitation centre was significant in promoting progress. If it included education groups, where clients are taught about substance abuse, relapse and how to restructure their lifestyle of recovery, it was deemed as beneficial. Another facilitator highlighted by the participants was the involvement of family by incorporating parent support sessions, and an interesting factor suc Recommendations for the study included that adolescents who abuse substances need to be treated very differently to adults or children, and that maintaining communication or a connection with them via aftercare for example, will enable them to sustain their sobriety outside of the rehabilitation facility. Since addiction affects the individual’s identity, roles, and habits on an occupational performance level it is paramount that treatment should be addressed from an occupation-based perspective in collaboration with existing evidence-based addiction models. Occupational therapists are uniquely equipped to deal with these components. h as including spirituality as a resource was raised as valuable in their recovery process.
Exploring the challenges that women with traumatic brain injury experience in their work environment after vocational rehabilitation
(University of the Western Cape, 2015) Darries, Zareena; Soeker, Shaheed
Traumatic brain injury (TBI) has enjoyed extensive research and several therapeutic modalities, approaches and models have been developed where the main outcomes are focused on the successful return to work of individuals with brain injury. Research into women with TBI has, however, been negligible compared to research into the young adult male population. Gaining insight into how women with traumatic brain injury participate in their work environment would contribute valuable feedback to clinicians utilising return to work approaches and models. The study aimed to explore the challenges women who sustained TBI experience in the work environment after vocational rehabilitation. A qualitative research design was used to explore these experiences and perceptions from ten female participants. The method of data collection used to access the experiences and perceptions of the participants was in-depth semi-structured interviews. Furthermore semi-structured interviews were conducted with two occupational therapist, who were selected as key informants. The data from the study was analysed using thematic analysis. The study further aimed to obtain the participants` perceptions and experiences of barriers and facilitators as well as adaptation processes that influenced their ability to resume their work roles. Four themes originated from the findings of this study. Theme one describes the barriers experienced by women with TBI while returning to work in the form of barriers to work participation for women with TBI, loss of functional capacity hindering return to work, experiences of negative stigma and exploitation in the workplace, and contextual hindrances in the form of parental roles as well as public transportation systems. Theme two describes the factors that facilitated the resumption of the work role for women with TBI. Reestablishing a worker identity by means of vocational rehabilitation, utilising the Model of Occupational Self-Efficacy (MOOSE) as an approach, enabled the women with TBI to overcome their barriers and return to work. Theme three describes an inherent adaptation process where participants could come to terms with their losses, accept the present self and aspire towards a future self, by utilising personalised response approaches to overcome demands and challenges in the work context as well as experiencing success at work by adapting to the work environment. Theme four describes the participants’ views of changes needed in the rehabilitation program and services as well as policies that would aid in the quick return of women with TBI to productive roles. These suggestions are discussed as attainable through developing a multi-dimensional rehabilitation program for women with TBI as well as partnering with relevant stakeholders in the promotion of work opportunities for women with disabilities. The Model of Occupational Adaptation (MOA) was used as a framework to interpret the findings of this study; the barriers, facilitators and adaptation process were assessed as they impact on the experiences of the women with TBIs return to work. The return to work of the women with TBI was not observed only to be influenced by the personal characteristics but also by the environmental context within which the return to work process took place.
The experiences of occupational therapists regarding returning clients with traumatic brain injury to work through the utilisation of the Model of Occupational Self-efficacy
(University of the Western Cape, 2016) Arendse, Lee-Ann; Soeker, Mogammad Shaheed
Traumatic brain injury (TBI) is a major public health concern which mostly affects the economically viable population. In addition, the Code of Good Practice as described in South African Labour Law serves as a guide for employers to encourage equal and fair opportunities for employees with disabilities. However, despite the presence of this policy, as well as other legislation, research has shown that individuals with TBI are failing to return to work. The Model of Occupational Self-Efficacy (MoOSE) was developed as a client centered approach to return individuals with TBI to work. The aim of the current study was to explore, and describe the experiences and perceptions of occupational therapists who have used the MoOSE in the vocational rehabilitation and return to work process of clients with TBI. The participants in the study were selected by means of purposive sampling and semi-structured face-to-face interviews were conducted on a monthly basis for three months with 10 occupational therapists. The semi-structured interviews were used to gain insight into and explore the perceptions of the occupational therapists who have used the MoOSE in their vocational rehabilitation programmes with clients who have suffered TBI. The findings of the study were analyzed by means of thematic content analysis. The outcome of this study was aimed at finding ways to enhance / improve the model when it is used in the vocational rehabilitation process with people who have suffered TBI. Informed consent was obtained from the research participants and confidentiality of their information was maintained. Data was collected by means of semi-structured interviews which were audiotaped and transcribed. Transcriptions were analysed by using constant comparative methods of data analysis which resulted in categories, which reflected the purpose of the study being created. The analysis of transcripts was done using Microsoft Word. Results were then divided into themes and discussed holistically. Four themes emerged that answered the research question. Theme one described how client related factors impacted on the implementation of the MoOSE. Theme two explored the therapist related factors that impacted on the implementation of the MoOSE while theme three discussed how characteristic of the model impacted on the vocational rehabilitation and return to work process. The participants appreciated the clear four stages of the MoOSE and the dynamicity of the model. Theme four described how the job market and employer perceptions impacted on the return to work process. Recommendations were then discussed that could further improve the model and the implementation thereof. Recommendations included adding a motivation component to the MoOSE, involving family members in the rehabilitation process and therapist reflection as a means to foster client-centered practice. Other recommendations were aimed at addressing policy issues which interferes with the return to work process and encouraging interdisciplinary collaboration in the vocational rehabilitation of individuals with TBI.
An exploration of the experiences and perceptions of employers and caregivers of individuals with mild-moderate traumatic brain injury returning to work
(University of the Western Cape, 2016) Ganie, Zakeera; Soeker, Shaheed
An estimate of 89 000 cases of new traumatic brain injuries (TBI) are reported annually in South Africa. South African legislation advocates for the employment of persons with a disability. Individuals with mild-moderate TBI that do qualify to return-to-work (RTW) often do not have access to vocational rehabilitation (VR) and, as a result, return to the occupational therapy work assessment units for Disability Grant assessments. Not having the necessary insight and understanding about the condition influences the affected individual’s chances of returning to work. Failing to return to work results in dependency on a caregiver. The aim of this study was to explore the perceptions and experiences of employers and caregivers of individuals with mild traumatic brain injury returning to work after completing a VR programme, using the Model of Occupational Self-Efficacy. A purposive sample comprising employers and caregivers of 10 individuals with mild TBI was selected. Semi-structured interviews were completed and data manually managed, with confidentiality and anonymity strictly ensured. The findings of the study were analysed by means of thematic analysis, from which five themes emerged. Themes one and two described the employers’ and caregivers’ experiences and perceptions that hindered the RTW process. Theme three related to the enabling aspects they derived from engaging in the VR process, along with the individual with mild-moderate TBI. Themes four and five presented the coping strategies that aided the employer and caregiver in playing a continued role in the RTW process. The International Classification of Function, Disability and Health (ICF) was used to conceptualise the findings and interpret the perspective of the barriers, enablers and coping strategies as seen through the lens of the employer and caregiver. The results of the study can be used to help individuals with TBI adapt to the work environment, as well as inform policy development regarding social grants and access to rehabilitation services for TBI survivors. Occupational therapists (OT) using the MoOSE should regard the employer and caregiver as key role players during therapy. Employers should gain a better understanding of TBI and allow for sick leave during rehabilitation. Caregivers would benefit from finding or establishing a support network for themselves, and by connecting with employers of the individual with TBI in order to understand the individual’s work environment.
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.
The adaptation of the model of occupational self-efficacy for returning individuals living with tuberculosis to work
(University of the Western Cape, 2018) Jainodien, Ayesha; Soeker, Shaheed; Smith, Mario
Tuberculosis (TB) and multi-drug resistant (MDR) TB have been identified as one of the largest health problems in the world, and notably recognized as a big issue in democratic South Africa. Socio-demographic factors such as poverty and unemployment were identified to be major contributing factors to the epidemic. Individuals with TB reportedly have poor levels of occupational self-efficacy and found it challenging to return to work after prolonged hospitalization. The Model of Occupational Self-Efficacy (MOOSE) has been used effectively to assist individuals with traumatic Brain Injury (TBI) to return to work. Adaptation of the MOOSE was recommended for application with other syndromes associated with long hospitalization and absence from work. The aim of the study was to adapt the MOOSE for clients living with tuberculosis and to aid them in returning to work. The study was conducted through exploratory research. Semi-structured interviews were conducted with ten purposively selected key informants from private and public health facilities in the Western Cape. The data was analysed through thematic analysis from which six themes emerged. Themes One, Two and Six describe the barriers experienced by the participants when returning to work following their diagnosis of PTB or MDR-TB. Theme Three, Four and Five discussed the factors that facilitate the resumption of the worker role for the PTB and MDR-TB survivors. The findings of this study were used to inform the adaptation of the MOOSE for use with patients living with TB. Ethics clearance was obtained from the Biomedical Research Ethics Committee (BMREC) of UWC. Permission was given by the Department of Health to conduct the study on the clinical platform. All ethics principles were upheld.
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.
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.
Exploring the experiences and perceptions of individuals with schizophrenia about the use of the model of occupational self-efficacy in enhancing work skills
(University of the Western Cape, 2018) Abbas, Iesrafeel; Soeker, Mogammad
Globally, high unemployment rates exist amongst individuals with schizophrenia. Evidence suggests that these individuals have a desire to return to work (RTW), however, they experience difficulty in finding as well as sustaining employment. Work plays a pivotal role in the functioning of individuals with schizophrenia and has a substantial positive influence on their quality of life (QOL). Several studies recommend supported employment as a practice aimed at improving rates of competitive employment for individuals with schizophrenia. The current study aimed to explore the experiences and perceptions of individuals, with a primary diagnosis of schizophrenia, about the use of the Model of Occupational Self-Efficacy (MOOSE) as a supported employment strategy in enhancing the work skills and facilitating RTW in the open labour market. A qualitative research design was utilised to explore these experiences and perceptions from nine participants. Additionally, one occupational therapist and one occupational therapy technician were selected and participated as key informants of the study. Participants were selected through the use of purposive sampling. Written informed consent was received from the participants, and their confidentiality was upheld throughout the study. Semi-structured interviews were used to collect data, and were audiotaped and transcribed verbatim. Transcriptions were anal
The relationship between spirituality, health related quality of life and occupational balance among adults with chronic diseases
(University of the Western Cape, 2019) Parker, Yasmeen; Mthembu, Thuli G.
Background: One of the most significant current discussions in public health and occupational therapy is the challenges facing adults with chronic diseases. Adults living with chronic diseases experience challenges of activity limitations and occupational disruptions which may influence their health, quality of life and well-being. Chronic diseases seem to have implications for adults’ areas of occupation, client factors and performance patterns as well as performance skills. Spirituality is considered as important in the lives of adults living with chronic diseases as a coping strategy assisting them to deal with the challenges of life in relation to physical, social, emotional and functional well-being. Despite the importance of spirituality in adults with chronic diseases, there is little known about the relationship between spirituality, health-related quality of life and occupational balance among adults with chronic diseases in the Western Cape, South Africa. Aim: The aim of the study was to examine the relationship between spirituality, healthrelated quality of life and occupational balance from the perspectives of adults living with chronic diseases. Methods: A sequential exploratory mixed methods two phase design approach was used for the purpose of the study. Thus, to examine the perspectives and determine the relationship on spirituality, health related quality of life and occupational balance of adults living with chronic diseases. Furthermore, to explore and describe the perceptions of adults with chronic diseases regarding the relationship between spirituality, health related quality of life and occupational balance.

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