Occupational Therapy

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Browsing Occupational Therapy by browse.metadata.advisor "Bester, Juanita"

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    An exploration of the occupational-life-trajectories of five young men in the Heideveld community
    (Stellenbosch : Stellenbosch University, 2013-03) Du Preez, Karlien; Watson, Ruth M.; Bester, Juanita; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Occupational Therapy.
    ENGLISH ABSTRACT: Heideveld, a suburb that forms part of the “Cape Flats”, is plagued by high levels of crime, gangsterism, unemployment and relative poverty. I became specifically interested in the occupations of the young men in Heideveld, as I often observed them loitering in the streets, at an age when they should have been in school, studying or starting a career. This led me to wonder about the repertoire of occupations that they had performed over the course of their lives, i.e. their occupational-life-trajectories. I became interested in the influence that the environment and their personal attributes had on the occupations that they performed over time. Guided by the Person-Environment-Occupation model as a conceptual tool I decided to explore the occupational-life-trajectories of men between the ages of 20 and 25 throughout the course of their life, up to their current age. At the organisation where I volunteered during my time in Heideveld, there was a weekly programme for the children and young women (aged 12 to 22), but nothing for young men, which prompted my interest in doing research about this age group. My initial thinking was to form the theoretical basis from which an occupation-based intervention group could be developed. I intended to explore what had motivated occupational participation throughout their lives, how certain occupations developed over time and the influence of the environment on their occupations. Snowball sampling was applied to gain access to the participants. Using a qualitative approach I combined a method called PhotoVoice with individual, narrative interviews, in order to collect data on the occupational-life-trajectories of five young men from Heideveld. PhotoVoice is a participant-based method that allowed the interviewees to take photos of occupations that they have performed throughout their lives. The photographs were used to facilitate the interview process along with two or three guiding questions. Within-case and cross-case analysis were used to find themes that pertained to the aims of the study. I uncovered five themes in my analysis: “Ons gee nie krag weg nie/We don’t give away power”, “Ons het saam geloop/We ‘hang out’ together”, “Ek het baie probleme by die huis gehet/I had many problems at home”, “Die lewe is swaar hier buite/Life is hard out here” and “Ek wil net uit hierdie plek kom/I just want to get away from this place”. I found that the environment played a large role in the occupational-life-trajectories of the participants. I also found that the participants’ sense of masculinity, gender and identity affected their occupational choices and participation. I explain the peer nature and motivational factors influencing gangsterism and drug use as they manifested in the young men’s lives. I concluded that an occupation-based intervention programme might address certain aspects such as occupational choice and exposure, but that wider, more long-lasting intervention was necessary to truly make a difference in the occupational-life-trajectories of young men in Heideveld. After taking the support structures in the physical environment into consideration, recommendations were made in terms of the family unit, the peer group, education, skills training and community empowerment. Furthermore, as the organisation already serves boys between 10 and 14 years and a greater impact may be possible at this life stage, more detailed recommendations were developed regarding a possible occupational therapy intervention programme.
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    Exploring the experiences of mothers on their daily occupations while having a child on the spectrum of autism
    (Stellenbosch : Stellenbosch University, 2013-03) Laminette, Elana; Bester, Juanita; Vlok, E. D.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Occupational Therapy.
    ENGLISH ABSTRACT: Prior to the commencement of this study, an abundance of information on the topic of autism spectrum disorders and its symptoms, its prevalence and the effect on the family’s psychosocial- and emotional wellbeing were available. However, studies to describe the impact of a child with autism spectrum disorder on the occupations of families were limited, especially within the South-African context, and the researcher could find no information describing the impact of such a child specifically relating to the daily occupations of their mothers. This qualitative study used a phenomenological approach to explore how mothers with children on the spectrum of autism experience the impact of the child on their own daily occupations, and the meaning they derive from these experiences. Purposive sampling was used in selecting eleven mothers whose children attended therapeutic and medical follow up at one of the tertiary public hospitals in the Western Cape. In-depth semi-structured interviews following an interview guideline were conducted with each of the participants. The interviews were audio taped, and thereafter transcribed verbatim. A process of open coding was used to analyze the transcribed interviews. The findings emerging from the data-analysis process, uncovered three themes, namely ‘mothering as an identity’, mothering as an occupation’, and ‘making sense and moving forward’. These themes emphasized the immense changes the mothers had to face with regards to their occupational engagement, as well as on a personal level due their children’s diagnosis of autism spectrum disorder. It also brought to light the factors influencing the experiences and actions of mothers, shaping their mothering identities, as well as their needs and barriers in terms of successful participation in their everyday occupations. The study reported on the occupational risk factors these mothers face, as well as the enabling elements with regards to successful and meaningful occupational engagement. Occupational therapists working with children should be especially conscious of the inseparable relationship between the occupations of the child they are treating, and the occupations of the primary caregiver when implementing therapy programs. Only through ensuring the successful and meaningful participation in occupations of both the mother and the child, the occupational therapist will be able to improve the health and well-being in the one or the other. Careful selection and collaborative goal setting when planning therapy programs are therefore essential.
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    Factors that affect the persistence of Master of Occupational Therapy students at Stellenbosch University
    (Stellenbosch : Stellenbosch University, 2014-04) Sheik Ismail, Arifa; Troskie-De Bruin, Christel; Bester, Juanita; Stellenbosch University. Faculty of Medicine and Health Sciences. Department of Interdisciplinary Health Sciences. Occupational Therapy.
    ENGLISH ABSTRACT: The retention and throughput rates of postgraduate students are a national and an international concern. There is a tendency for postgraduate students, irrespective of which Master of Occupational Therapy programme they are registered for, to have difficulty in completing the thesis or research assignment, resulting in delayed throughput or non-completion. This study aimed to understand and describe from the postgraduate student’s perspective, what factors facilitated or hindered the completion of the Master of Occupational Therapy programmes. Qualitative research using a phenomenological design was used in order to obtain a rich description of the students’ lived experiences in the M-programmes so as to gain insight into their experiences. Purposive sampling was used and data was generated by means of in-depth, one-to-one interviews. The findings have shown that numerous factors in various combinations at different points in time during the study period shaped the experience of the mature, female, part-time postgraduate student. Participants were intrinsically motivated to engage in studies as they desired the growth in their professional knowledge and skills. The experience of supervision varied depending on how the student and supervisor were matched and on the student’s expectations and needs of the relationship. The development of critical thinking and writing skills required effort and time, which influenced the postgraduate student’s motivation, retention and throughput rate. Within the work environment very little negotiation for study opportunity was possible. Although this negotiation was far more likely within the home and with family, household and family responsibilities persisted over the long study period of two or more years. This study has shown that the main hindrances to the completion of studies are the lack of time and the demands of the multiple roles that the mature, female part-time postgraduate student has to contend with.
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    Occupational balance of mothers and fathers raising a child with special needs in Flanders
    (Stellenbosch : Stellenbosch University, 2017-12) Engelen, Anne-Marie; Sheik Ismail, Arifa; Bester, Juanita; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health & Rehabilitation Sciences. Occupational Therapy.
    ENGLISH SUMMARY : After the birth of a first child, a new role appears. Successful integration and performance of this parent role will positively affect the well-being of both parents, which in turn will enhance child and family well-being. Being a parent of a child with special needs, leads to extra parental occupations. A new distribution of all these different occupations within the occupational pattern urges and can be viewed from three different perspectives, namely: occupational areas, occupational characteristics and time use. The aim of the study was to explore occupational balance as experienced by mothers and fathers rearing a child with special needs in Flanders. Objectives related to this study were to explore the influence of occupations on the occupational balance of mothers and fathers and to explore the differences and similarities between ‘mothers’ and ‘fathers’ perceptions of occupational balance. A qualitative research methodology with semi-structured interviews of 12 parental couples was used. Participants were selected by purposive sampling through chain referral. Once both parents agreed to participate voluntarily a semi-structured interview was conducted, audiotaped and transcribed verbatim. Results, obtained through thematic analysis, showed that extra time for special needs was primarily found in the change of the occupational pattern. So called we- and me-time occupations were reduced. We time was lacking most, as both parents prioritized facilitating the me-time of their spouse above the joyful moments together as a couple. As so called necessary support was already provided by the grandparents, asking extra assistance to obtain time as a couple felt uncomfortable and therefore was often ignored. Although gender related differences were limited, generally mothers were less active at the labour market but conducted more household, care and support activities when compared with fathers. Gender dissimilarities were available in special needs caring and supporting activities. Direct care and support were mainly provided by mothers while fathers were more active in indirect care. To give an example the father takes care of the siblings (indirect care) while the mother is attending the child’s therapy (direct care). Besides the three above mentioned perspectives to view the occupational pattern and to determine the occupational balance, two perspectives were added. Specific characteristics of an individual parent, labelled as personal factors had an effect on the occupational pattern, on the perception of the desired and needed occupations, on the coping strategies and therefore on the perceived occupational balance of each parent. External factors of support were components of support to be transmitted from one individual to another. On the one hand giving support and on the other hand receiving support had an influence on the occupational pattern and balance. Some occupations had to be included while other occupations could be skipped as they were conducted by someone else. To conclude two perspectives namely, personal factors and external factors of support were added to the concept as initially used in this study. All five perspectives are intertwined and used to view the occupational pattern towards the subjectively perceived occupational balance which is a layered and dynamic concept. Focusing on the occupational balance of both parents provides new and valuable information in order to improve parents’ occupational balance.
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    'n Ondersoek na die effek van okkulomotoriese oefeninge in kombinasie met 'n visuelepersepsieprogram op die visuele persepsie by sewejarige leerders met visueel-perseptuele probleme
    (Stellenbosch : University of Stellenbosch, 2005-12) Vlok, Elizabeth Daphne; Smit, N. E.; Bester, Juanita; University of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Occupational Therapy.
    According to the Occupational Therapy Practice Framework (2002), the objective of occupational therapy is to help people to participate in activities of daily life which are purposeful and meaningful to them and in which they are expected to participate. According to educators, learners are increasingly experiencing problems with performing academic tasks, and learning barriers, especially with regard to visual perception, are on the increase. Various external factors, such as educational policy pertaining to inclusive education and a younger age for school admission, as well as internal factors, such as learning readiness, may contribute to the occurence of learning barriers that can restrict the academic progress of learners. Learners are increasingly being referred to occupational therapists. Occupational therapists also provide guidance to learner supporters. Occupational therapists refer learners with visual perception problems with possible eye tracking problems for vision therapy, after which occupational therapy is resumed. Meanwhile, learners still have to function in the school environment, which means that incorrect capturing of information processing can take place. According to literature, the promotion of eye movements is regarded as part of occupational therapy services in the USA. In South Africa the proposed model by Fishman-Hellerstein and Fishman (1999: 148) of cooperation between optometrists and occupational therapists is followed. In this approach eye movements are regarded as underlying building blocks of visual perception and the effect of eye movements on the academic performance of learners is clearly described (Green, 2001). There is a shortcoming in the literature where eye movements are promoted as integral to a visual perception programme. Occupational therapy needs to investigate effective methods of intervention that are time and cost effective in order to address the growing problem, especially in South Africa. A clinical experimental field trial with a convenience sample was used to investigate the effect of occulomotor exercises in combination with a visual perception programme on the visual perception of seven-year-old learners with visual perception problems. The study population was seven-year-old learners with visual perception learning barriers from neighbouring schools with foundation phase education. Inclusion and exclusion criteria were applied. Sifting procedures included questionnaires to parents and educators, “Beery-Buktenica Developmental Test of Visual-Motor Integration” 4th edition of Beery (1997) for visio-motor integration, and a screening test by an optometrist. A visual perception programme was presented to the control groups and the experimental groups over ten sessions. An eye exercise of 15 minutes was included with the experimental groups. The Developmental Test of Visual Perception, 2nd edition, by Hammill, Pearson and Voress (1993) was used as measuring instrument in the pre-test and post-test to determine effectiveness, which was statistically indicated by using the repeated measures ANOVA. The results indicated no significant difference between the visual perception programme with eye exercises and the one without. Two tests of the sub-ability of visual perception showed a tendency towards improvement. The educators indicated that the learners benefited functionally from the programme and that it made a difference in academic performance. Behaviour and emotional events may have influenced the results of the study because of external factors. It is recommended that the study be repeated with a larger sample and a longer programme presented over six months to a year. Occupational therapists can include eye exercises integral to activity participation by adapting activities and through the optimal use of space for activities so that the learner would have to adapt to it visually.
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    Participation in meaningful occupation : how do young adults living with cerebral palsy experience the quality of their participation?
    (Stellenbosch : Stellenbosch University, 2013-03) Pieterse, Gisele Shaline; Vlok, E. D.; Bester, Juanita; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Occupational Therapy.
    ENGLISH ABSTRACT: Participation in meaningful occupations is what defines us as human beings and is an important indicator of health and well-being. It is the way we experience the world around us and is closely linked to quality of life. As an occupational therapist at a school for learners with special educational needs, the researcher was interested in how young adults with a diagnosis of Cerebral Palsy (CP) who attended this school, experience their participation or the lack thereof in occupations and if it contributes to meaning and fulfilment in their lives? She established through informal conversation with some of these young adults or their parents, that they experience unemployment, unhappiness and poor integration within the community. The aim of this study was therefore to describe how young adults living with CP in economically disadvantaged communities within the Western Cape, experience the quality of their participation in meaningful occupations. A qualitative phenomenological study design was used, enabling the researcher to explore the value and meaning participants attach to different occupations, the participants perceptions of their experience and the factors impacting on their participation. The study population was young adults between the ages of 18-28 years with a diagnosis of CP, who attended the previously mentioned school and who exited school over the duration of the past nine years. The researcher used purposive maximum variation sampling, to ensure variation in terms of diagnosis, living arrangements, employment and marital status. Data collection took the form of ten face-to-face semi-structured individual interviews and inductive content analysis was utilized to analyse data. The following four themes emerged from the data: overcoming challenges; having equal opportunities; barriers holding me back and the future is mine to shape. These young adults participated in a variety of meaningful occupations and have learned to utilize various strategies to overcome the difficulties they faced in this process. The following factors influenced their participation positively: having meaningful relationships; accepting their disability and nurturing a positive attitude; being proud of their achievements; positive work experiences and involvement in the community. Factors contributing to these young adults not experiencing meaningful participation were the following: their perception of themselves and also how they perceived being treated by others; non-acceptance of their physical circumstances and disability; incompetence and poor self-confidence; termination of previously meaningful occupations; challenges with interpersonal relationships and unsatisfactory work experiences. The need to be as independent as possible was of utmost importance to all these young adults, as it was an indicator of being in control of their own lives. Given the above information, the researcher recommends a transition preparation program for senior phase learners that will include sessions on work habits, social skills, transportation, self-employment and integration into the community to be implemented at the school. Supported employment options should be explored as well to ensure maximum employment among these learners exiting school. A follow-up system should be established to evaluate the effectiveness of the above-mentioned program.