South African parents' perceptions and experiences of occupational therapy using a sensory integrative approach (OT/SI)

Geral, Jacintha (2014-12)

Thesis (MOccTher)--Stellenbosch University, 2014.

Thesis

ENGLISH ABSTRACT: As a South African occupational therapist (OT) trained to provide occupational therapy using a sensory integration approach (OT/SI), to children and their families, I have personal experience of different parent perceptions and experiences regarding OT/SI as a treatment approach to improving their children’s occupational performance. This made me question the various factors that may influence a parent’s perceptions and experiences, and how these factors may ultimately influence the outcome of OT/SI intervention for the child and family. Additionally, I wanted to know what OT/SI intervention was like for parents of a child with difficulties processing and integrating sensory information and what changes should be made to ensure we are meeting both child and parents’ needs. To date, no research exists regarding parents’ perceptions and experiences of OT/SI intervention in South Africa. Despite this, OT/SI intervention is widely used among South African paediatric occupational therapists. This study focused on the lived experience of OT/SI intervention for parents in the Western Cape, South Africa. The purpose of this study was to explore and describe South African parents’ perceptions and experiences of OT/SI intervention received. This study not only sought to explore whether parents thought OT/SI intervention was valuable or not, but also to understand the meaning, the broader context and the process by which parent’s opinions had come into being, and how these may have influenced the meaning ascribed to the intervention. The study sample consisted of nine parents, including mothers and a father, of children with difficulties processing and integrating sensory information, who lived in various regions of the Western Cape, South Africa. Purposive sampling was used to select participants in this study. Using a qualitative, phenomenological approach, data was collected during face=to=face interviews, participant observation and researcher’s field notes. Four themes that pertain to the aims of the study were revealed during the analysis. They included: “It was tough because we didn’t understand”, “Just suddenly everything made so much sense”, “Mobilized my child into the world”, and “OT/SI intervention facilitators proposed by participants”. These themes describe the progression of the participant’s perceptions and experiences before OT/SI intervention, during intervention, and after having received the intervention, as well as the recommendations they proposed to facilitate OT/SI intervention in South Africa. I found that factors such as poor awareness and understanding of OT/SI intervention amongst the participants negatively influenced their understanding of their child’s occupational performance, their role as parents and their social performance as a family in various social contexts. Key points of transformation were identified during the ‘input phase’ of OT/SI intervention, which either facilitated or created a barrier in the participants’ shift to the ‘after phase’ of OT/SI intervention. Despite the barriers, all participants perceived and experienced a shift to the ‘after phase’ of OT/SI intervention. For some participants, this shift included changes they perceived in their child, which influenced social performance of the child and family. However, for the majority of participants, this shift meant a number of factors: a better understanding and expectations of their child; changes in their child’s abilities, activities and self=worth; changes in themselves as parents and how this influenced their parent=child relationship; as well as changes in their child’s and family’s social performance in various contexts. Insight gained from the participants’ recommendations and my interpretation of findings, allowed recommendations to be made in an attempt to overcome the barriers and promote the facilitators that will make a difference to OT/SI intervention in South Africa. Recommendations were made within two contexts: the broader social context of South Africa and the context of OT/SI intervention received by children and their parents.

AFRIKAANSE OPSOMMING: As ‘n Suid=Afrikaanse arbeidsterapeut (AT), opgelei om arbeidsterapie met ‘n sensoriese integrasie benadering (AT=SI) te verskaf aan kinders en hul families, het ek persoonlike ondervinding van verskeie ouers se persepsies en ervarings omtrent AT=SI as ‘n behandelingsbenadering om die kind se arbeidsprestasie te bevorder. Dit het my laat wonder watter faktore die ouer se persepsies en ervarings sou beïnvloed, asook hoe hierdie faktore die uitkoms van die AT=SI behandeling vir die kind en die familie sou beïnvloed. Ek wou ook uitvind hoe die ouer van ‘n kind met SIA (SID), AT=SI intervensie beleef het en watter veranderinge behoort aangebring te word om te verseker dat beide die kind en die ouers se behoeftes nagekom word. Tot dusver bestaan daar geen navorsing aangaande die ouer se persepsies en ervarings van AT=SI intervensie in Suid=Afrika nie. Ten spyte hiervan word AT=SI alom gebruik deur pediatriese arbeidsterapeute in Suid=Afrika. Hierdie studie fokus dus op ouers se persoonlike ervaring van AT= SI intervensie in die Wes=Kaap, Suid=Afrika. Die doel van hierdie studie was om die persepsies en ervarings van Suid=Afrikaanse ouers wat AT= SI intervensie ontvang het, te ondersoek. Hierdie studie het nie net gepoog om vas te stel of die ouers gedink het dat AT=SI waardevol was aldan nie, maar ook om die betekenis, die breër konteks, en die proses waardeur hul opinies gevorm is en hoe dit hulle beïnvloed het, te verstaan. Die steekproef het bestaan uit nege ouers, insluitend moeders en ‘n vader, van kinders met SIA (SID), woonagtig in verskillende streke in die Wes=Kaap, Suid=Afrika. ‘n Doelgerigte steekproef is gebruik om die deelnemers vir die studie te kies. ‘n Kwalitatiewe=fenomenologiese benadering is gebruik om data in te samel deur aangesig=tot=aangesig onderhoude, waarneming van deelnemers, asook die navorser se veldnotas. Vier temas wat direk verwant was aan die doelwitte van die studie, is tydens die analise van die data geïdentifiseer. Dit het die volgende ingesluit: “Dit was moeilik want ons het nie verstaan nie”, “Ewe skielik het alles so baie sin gemaak”, “My kind in die wêreld gemobiliseer ”, “AT=SI intervensie fasiliteerders voorgestel deur die deelnemers”. Hierdie temas beskryf die vordering van die deelnemers se persepsies en ervarings voor die aanvang van AT=SI intervensie, gedurende die intervensie en ook nadat intervensie voltooi is, asook die aanbevelings wat hulle gemaak het om AT=SI intervensie in Suid=Afrika te fasiliteer. Ek het bevind dat faktore soos deelnemers se swak bewustheid en begrip van AT=SI intervensie, hul begrip van hul kind se arbeidsprestasie, hul rol as ouers en hul sosiale optrede as ‘n familie in verskeie sosiale kontekste, negatief beïnvloed het. Kernpunte van verandering is geïdentifiseer gedurende die ‘inset=fase’ van die AT=SI intervensie, wat die deelnemers se vordering na die ‘na= fase’ van AT=SI intervensie òf gefasiliteer het, òf bemoeilik het. Ten spyte van die struikelblokke het alle deelnemers ‘n skuif na die ‘na=fase’ van AT=SI intervensie waargeneem en ervaar. Vir sommige deelnemers was hierdie skuif die veranderde optrede wat hulle in hul kind waargeneem het, wat die kind en familie se sosiale gedrag verander het. Vir die meerderheid deelnemers het hierdie skuif egter ‘n aantal faktore ingesluit: ‘n beter begrip en verwagting van hulle kind; veranderinge in hulle kind se vermoëns, aktiwiteite en eiewaarde; veranderinge in hulself as ouers en hoe dit hul ouer=kind verhouding beïnvloed het; asook veranderinge in die kind en familie se sosiale gedrag in verskeie kontekste. Die deelnemers se voorstelle en my interpretasie van die bevindinge het my in staat gestel om voorstelle te maak om die struikelblokke te probeer oorkom en die fasiliteerders aan te moedig wat die verskil gaan maak in AT=SI intervensie in Suid=Afrika. Aanbevelings is gemaak vir twee areas: die wyer sosiale konteks van Suid=Afrika, asook die konteks van die AT=SI intervensie wat ontvang word deur kinders en hulle ouers.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/96014
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