Magister Scientiae - MSc (Occupational Therapy)

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Stroke patients’ perspective of community reintegration after receiving occupational therapy intervention at a district hospital in the Western Cape, South Africa
(University of the Western Cape, 2022) Van Der Westhuizen, Sunel-Marie; de Jongh, Jo-Celene
Strokes have a major impact on disability globally. According to literature, stroke patients may find it difficult to resume activities and roles post stroke as well as experience limited community reintegration due to lack of services and knowledge within South Africa. The aim of the study was to explore and describe stroke patients’ experiences of community reintegration after receiving occupational therapy intervention. The study followed a qualitative research approach with an exploratory descriptive design. Purposive sampling was used to recruit participants.
Mental health care users’ perceptions and experiences of the use of social networking sites
(University of the Western Cape, 2022) Andrews, Claudia; Wegner, Lisa
The emergence of Social Networking Sites (SNS) has changed the way people communicate and connect with their world and has become a large part of our daily lives. While this is a global phenomenon, South Africa has amongst the highest rates of SNS usage worldwide. Coupled to this and with modern life becoming more demanding, there has been an alarming increase in mental health diagnoses. However, there is limited occupational therapy research that has explored the influence of SNS on mental health care users in South Africa
An exploration of the experiences and perceptions of TBI survivors about accessing rehabilitation during the COVID-19 pandemic and how this has affected their worker roles
(University of the Western Cape, 2022) Petersen, Tarryn Lee; Soeker, Mogammad Shaheed
Traumatic brain injury (TBI) often results in residual cognitive, behavioural, physical, and functional impairments that may influence the person’s independence in most areas of occupation, including work. Few resources are available for the rehabilitation of patients with TBI in South Africa, and access to rehabilitation facilities in the public sector is limited. On 7 January 2020, ‘Severe Acute Respiratory Syndrome Coronavirus 2’ (SARS-CoV-2) was confirmed as the causative agent of ‘Coronavirus Disease 2019’ or COVID-19. On 15 March 2020, the president of South Africa, Cyril Ramaphosa, declared a national state of disaster.
Mental health care users’ perceptions and experiences of community re-integration in the Dikgatlong sub-district
(University of the Western Cape, 2022) Arendse, Nawaal; Hess-April, Lucia
Community re-integration is regarded as one of the most significant outcomes of communitybased rehabilitation of mental health care users (MHCUs). Without community-based rehabilitation MHCUs experience difficulties with re-integration into communities, resulting in high readmission risks and defaulting on clinic visits and medication. The study aimed to explore and describe the experiences and perceptions of MHCUs community re-integration in the Dikgatlong sub-district. A key objective of the study was to report on the facilitating factors and support needs of MHCUs after their discharge from hospital.
People with disabilities’ perspectives on how participation in a supported employment programme facilitates access to work.
(University of Western Cape, 2021) Otty, Michaela Ellen; Hess-April, Lucia
Despite extensive literature highlighting the role of supported employment in ensuring access to work for people with disabilities, there is limited research on their perspectives of supported employment. This thesis presents a research study conducted in two different supported employment programmes in South Africa. The aim of the study was to explore and describe people with disabilities’ perspectives on how participation in a supported employment programme facilitates access to work. The research objectives sought to explore the barriers to, and facilitators of, inclusion and access for people with disabilities to work; describe key elements of a supported employment programme that influences access and inclusion for people with disabilities to work; and finally, to explore people with disabilities’ perspectives regarding the value of participating in a supported employment programme.
Best practice interventions for improving executive functioning in individuals returning to work post traumatic brain injury: A systematic review
(University of Western Cape, 2021) Hutchinson, Lauren; Soeker, Shaheed
The recovery process for traumatic brain injuries (TBIs) can be lengthy and taxing on the patient, family and healthcare resources. Part of this recovery process includes interventions for the improvement of executive functioning (EF) required for high level functioning such as return to work (RTW). However, evidence for best practice interventions to improve EF for RTW post TBI is lacking. Randomised control trials (RCTs) evaluating interventions for EF for RTW post TBI are available but have not been synthesised. The review aimed to determine the best practice interventions for improving EF for successful RTW post TBI. Method: A systematic review using a predetermined search strategy to find relevant titles published from inception to June 2020 in six electronic databases (EBSCOhost and PUBMED [both including MEDLINE]; CINAHL, Cochrane Database for Systematic Reviews, OT Seeker, and Taylor and Francis Online) was conducted following ethics approval by the Institutional Ethics Review Board.
A quasi-experimental pilot study examining the effects of occupation-based hand therapy on clients with hand injuries in occupational therapy practice in the Eastern Cape, South Africa
(University of Western Cape, 2021) Nero, Kayla; Mthembu, T. G.
Occupation-based hand therapy (OBHT) is an approach to practice that integrates multiple frames of reference while remaining rooted in an occupational therapy perspective. Hand function is important for participation in daily occupations. The current focus in assessment and treatment of clients in occupational therapy remains on body structure and function which is also true in South Africa. The gap in the literature about the effects of OBHT indicates that there is a need for a study in a South African context. This research was conducted to examine the influences of an OBHT among clients with hand injuries within occupational therapy practice in a South African context.
A mixed methods study to explore and describe free time experience and substance use amongst youth who have dropped out of school in Cape Town
(University of the Western Cape, 2020) Brink, Megan Lee; Wegner, Lisa
School dropout particularly amongst youth living in impoverished areas is a major concern in South Africa because of limited opportunities and resources. Therefore, these youth may experience leisure boredom, engage in sensation seeking and other risky behaviours, such as substance use, which influences their health and wellbeing. However, little research has explored youth who have dropped out of school with a specific focus on their free time experience and use of substances.
A mixed methods study to explore and describe free time experience and substance use amongst youth who have dropped out of school in cape town
(University of the Western Cape, 2020) Brink, Megan Lee; Wegner, Lisa
School dropout particularly amongst youth living in impoverished areas is a major concern in South Africa because of limited opportunities and resources. Therefore, these youth may experience leisure boredom, engage in sensation seeking and other risky behaviours, such as substance use, which influences their health and wellbeing. However, little research has explored youth who have dropped out of school with a specific focus on their free time experience and use of substances. Aim: The aim of the study was to explore and describe free time experience and substance use amongst youth who have dropped out of school in Cape Town. Methods: A sequential explanatory mixed methods study with two phases including quantitative (Phase one) and qualitative (Phase two) was conducted. In Phase one, data from an existing dataset was analysed. The data were from 970 youth who had dropped out of school in Cape Town who had completed the HealthWise Risk Behaviour Survey in 2016. Descriptive statistics regarding the use of free time and the prevalence of substance use were computed using the Statistical Package for the Social Sciences. In Phase two, thirty-two participants were selected using convenience sampling who took part in one of four focus group discussions to explore in-depth the results computed in Phase one of the study. Steps were taken to enhance the validity, reliability and trustworthiness of the data.
Teacher - occupational therapist collaboration in the implementation of a classroom approach to enhance inclusive education in primary mainstream schools: A case study
(University of Western Cape, 2019) Arendse, Patricia; Hess – April, Lucia; de Jongh, Jo- Celene
The collaboration between occupational therapists and teachers within the classroom is a relatively new practice in South Africa and few literature sources can be found reporting on studies in this regard specifically on descriptions of relevant models for such collaboration. There is a need for a better understanding of how occupational therapists and teachers can work collaboratively within a classroom approach, together address learners’ needs and so make the curriculum accessible to all learners. According to South Africa’s key education policies, all children can learn and need support. Inclusive education acknowledges the diversity of learners and that each learner learns differently.
An exploration of undergraduate Occupational therapy students’ perspectives on occupational balance
(University of Western Cape, 2019) Apollis, Josephine Lizelle; Mthembu, Thuli G; Hess-April, Lucia
Occupational justice empowers individuals, especially the previously disadvantaged, to have their basic needs met, as well as turn their potential into reality, through human rights and labour legislation, which provides access to equal opportunities. However, with the amount of different choices, in terms of occupational roles, facing the individual to fill their time with, effective management thereof to preserve one’s health and well-being on a daily basis, is not necessarily guaranteed. Occupational science, and more specifically, occupational therapy education imparts the importance of occupational balance, a concept which denotes a balance between the person, their environment and their occupations, some of which are strenuous and others relaxing. Occupational balance can be achieved by adapting the physical, mental, social and rests occupations.
Investigating the prevalence of health risk behavior and the association with leisure boredom among high school students in Lagos, Nigeria
(University of Western Cape, 2019) Olatunji ,Deji Funmibi; Mthembu, Thuli; Wegner, Lisa
Health risk behaviors are public health problems which are of concern in occupational therapy because they tend to be the causes of disability and death among adolescents and youths in the world. Identifying risk factors related to health risk behaviors is therefore an important part of health promotion. The main aim of this thesis was to investigate the prevalence of health risk behaviors and the association with leisure boredom among high school adolescents in Lagos State, Nigeria.
Young men’s perceptions and experiences of disengagement from gangs and the effect on their occupational performance
(University of the Western Cape, 2020) Loubser, Cleo; Wegner, Lisa; De Jongh, Jo-Celene
Street gangs have become a permanent feature of the social landscape in the Western Cape, South Africa. Various strategies have been developed to address the issue of gangsterism. The study focused on one strategy, disengagement. Disengagement is regarded as the process in which active gang members withdraw from their affiliated gangs and re-integrate into society. Much of the research that has been conducted in the area of disengagement has been done internationally, and there is very little research that explores how youth leave gangs within the South African context. Therefore, the current study explored young men’s perceptions and experiences of disengaging from gangs and how occupations facilitate and sustain the disengagement process. In the present study, occupation is defined as activities and tasks of everyday living that give meaning or value to one’s life. Occupation is associated with health and well-being, but occupations can also be unhealthy and dangerous. A qualitative approach, using an explorative research design, was adopted in order to explore the topic within a South African context, namely the townships of Nyanga and Langa, which are located on the Cape Flats. Through the use of purposive and convenience sampling, ten members of two groups, namely, the Peace Team and Project Playground, were invited to participate in the study. The Peace Team was established in 2013 by former gang members in response to the conflict amongst the youth of Nyanga and to encourage gang members to leave gangs. Project Playground is a Non-Governmental Organisation that services the areas of Langa and Gugulethu through a variety of community development projects and after school programmes. An initial focus group was conducted with some of the participants. Thereafter, semi structured interviews were conducted with each of the ten participants (until data saturation was reached). After the individual interviews were completed, a second focus group was conducted with some of the participants to discuss and explore issues that were uncovered during the individual interviews. All focus groups and interviews were voice recorded and transcribed verbatim, and transcriptions were then compared to the recordings to assure accurate reflections thereof. Thematic analysis was used to identify codes, categories and themes. Once transcription was completed coding was commenced. Through the use of codes, the researcher was able to reorganize data in a way that facilitated the interpretation and enabled the researcher to organize data into categories that were analytically useful to the study. Categories were then grouped in sub-themes and finally themes, based on similarities and patterns. Rigor and trustworthiness was ensured through various means including triangulation of data sources (multiple participants), data gathering methods (focus groups and individual interviews), member checking, keeping an audit trail and reflexivity. Ethical clearance was obtained from the Senate Research Committee of the University of the Western Cape, registration number 15/7/86. From the data five themes emerged to form the findings. These themes were: (1) The reason why, (2) The price of gang life… the fine print, (3) Time to get out… I didn’t sign up for this, (4) Getting out and staying out, and (5) The price of my freedom. The study contributed to current knowledge in occupational therapy and occupational science regarding how engagement in meaningful occupations promotes health and well-being. In understanding these occupations and what meaning they hold, it assists occupational therapists in planning, implementing and evaluating appropriate interventions to help gang members to disengage from gangs and engage in meaningful and healthy occupations that support their reintegration into the community in pro-social ways.
Exploring the perceptions and experiences of previously homeless persons regarding the impact of a work skills programme on their worker role
(University of the Western Cape, 2020) van der Pol, Petra; Soeker, Shaheed
Globally, high rates of homelessness exist and continue to grow, despite interventions offered by government and suggested by policy. Evidence suggests that long term intervention and vocational skill development can facilitate an escape from homelessness and support the transition of homeless persons into a worker role in the open labour market. Occupational therapists advocate for occupational justice in the lives of all individuals and therefore have a role to play in the intervention of the homeless who are experiencing disengagement in occupation, leading to a poor sense of well-being. The current study aims to describe and explore the experiences and perceptions of previously homeless individuals who escaped homelessness by means of a vocational skill development programme. The study explores the barriers and facilitators that the participants experienced in their change process and how the programme facilitated their adaptation to their worker role in the open labour market. A qualitative research design was employed to investigate the experiences and perceptions of ten participants who were purposively sampled. In addition, two occupational therapists were selected to participate as key informants. Written and informed consent was obtained and ethical standards were maintained throughout the study. The researcher collected data by recording semi-structured interviews, which were then transcribed. The transcribed information was analysed by use of thematic analysis, sorting the information into codes, categories and themes that emerged out of the findings. The themes looked at barriers experienced by the participants, facilitators experienced by the participants, motivational factors for engagement in the skill development programme and the usefulness of an occupational therapist as part of the intervention team. These themes were discussed, using the theory of Occupational Adaptation as well as the Trans-theoretical model of change. The researcher attempts to answer the objectives of the study by discussing the findings and themes that have emerged out of the data. Analysis of the findings suggest that if homeless persons are provided with vocational skill development, acceptance and support, mental health care and provision for sustenance needs, they can transition and adapt to a role in the open labour market and consequently experience an improvement in their sense of well-being. Occupational therapists are equipped to play an important role in the intervention of homelessness. Recommendations of the research focus on policy development, further research and intervention in homelessness. The researcher suggests that occupational therapy’s role in homelessness should be clearly defined and articulated. Research is also needed to prove the efficacy of long term development programmes as opposed to short term employment or training opportunities that may not prove to be sustainable.
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.
The experiences and perceptions of individuals with stroke about the usefulness of the model of occupational self efficacy in a rural setting
(University of the Western Cape, 2019) Smith, Melissa; Soeker, Shaheed
Individuals diagnosed with stroke particularly in rural communities have a poor return to work rate. Vocational rehabilitation has been used as an intervention strategy with various types of clients with disability or injury in order to improve their work skills. The aim of the proposed study is to describe the experiences and perceptions of individuals diagnosed with stroke about the usefulness of the Model of Occupational Self Efficacy in assisting them in returning to their worker role particularly in a rural setting. Eight participants were purposively selected from the data base of a local hospital and semi structured interviews were conducted with the participants until saturation occurred. Furthermore, two focus groups were conducted with eight participants. A key informant was also interviewed to assist the researcher with a different perspective and to avoid bias. The data was analysed by means of thematic analysis into codes, categories and themes. Trustworthiness was ensured by means of credibility, applicability, transferability and conformability. Informed consent and confidentiality was ensured. Permission was obtained from the UWC research committee and from the Department of Health. Four themes were merged from the findings: Theme one: Obstacles which affects the return to work of CVA Participants in a rural community. Theme two: Establishing a strong belief in functional ability through occupation. Theme three: Adaptation strategies that enhances the work participation of stroke survivors in a rural community. Finally Theme four: The MOOSE enables transition to the worker role in a rural context. The findings revealed that the participants experienced a loss of their former self thus affecting their worker identity as they were no longer able to experience the gratification of fulfilling their worker role. This was due to the participants not being aware of the return to work options that they had. After the stroke the participants battled with not only overcoming their condition but also the stigma which the community and their employers had of stroke. Overcoming the stroke event and returning to work required that potential barriers and facilitators be identified by the participants and the researcher. The study also identified adaptation strategies that the participants utilised in order to overcome the barriers and assist the participants to have a smoother transition into the workplace. In conclusion the findings of the study revealed that the participants suffer a loss of their former abilities and undergo a loss of their self-esteem. As a result of the loss, participants struggled to return to work not only due to their loss of abilities but also their lack of knowledge regarding return to work and stroke. The findings indicated that there should be more education regarding the stroke that needs to be conducted in communities via media such as local newspapers, local radio stations, clinics and hospitals. The findings of the study may assist Occupational Therapy practitioners to improve services in a rural community for stroke survivors and improve the facilitation of the return to work process after stroke. The MOOSE facilitates motivation for participants to regain their self-esteem and thus move forward to resume a worker role.
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.

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