Occupational Therapy

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Browsing Occupational Therapy by browse.metadata.advisor "de Klerk, Susan"

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    Public service users with upper limb conditions' adherence to home programmes : occupational therapy strategies within the Eastern Cape
    (Stellenbosch : Stellenbosch University, 2022-04) Michau, Cecile; de Klerk, Susan; Bester, Juanita; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health and Rehabilitation Sciences. Occupational Therapy.
    ENGLISH SUMMARY: Occupational therapists working within the public sector in the Eastern Cape, South Africa often issue home programmes to clients with upper limb conditions. The home programmes are issued to address barriers such as transport difficulties, financial difficulties, to decrease the number of follow-up sessions required and for therapy to continue in the clients’ context of daily living. Adherence toward home programmes is known to be a problem and occupational therapists using home programmes rely greatly on the adherence to these home programmes issued. Due to this high reliance on adherence to home programmes, occupational therapists should implement strategies in an attempt to improve adherence to home programmes. This study aimed to investigate the strategies employed by occupational therapists to improve public service users with upper limb conditions’ adherence to home programmes. The objectives of this study were to explore whether occupational therapists use strategies to improve adherence to home programmes in public service users with upper limb conditions, to describe these strategies and to explore occupational therapists experience of adherence to home programmes for these clients. A qualitative phenomenological, interpretive research methodology with semi-structured interviews of 12 participants was used during this study. Participants were recruited through purposive sampling. Once the participants agreed to participate in this research study, semi-structured interviews were conducted telephonically, the audio recordings were recorded and transcribed verbatim. The data were analysed through inductive thematic analysis. Three themes emerged from the data: promoting adherence to therapy, the experience of occupational therapists and strategies used by occupational therapists. It was evident from the gathered data that occupational therapists use a three-pronged strategy to improve adherence to home programmes. This three-pronged strategy is divided into three dimensions namely the therapist and the client, the home programme, and the context in which the home programme is issued (at the clients’ home or work). Within each dimension, there are strategies that occupational therapists use to improve the adherence to home programmes for clients with upper limb conditions. Some of the strategies included therapeutic relationship and environment, health-promoting behaviour, considering the mode of offering, using feedback systems, considering the clients’ support system and financial considerations. Occupational therapists within the Eastern Cape public sector implement strategies in their day-to-day practice to attempt improving adherence to home programmes. From the strategies they use, some facilitate adherence and some hinder adherence. Most of the strategies identified in this research study have supporting evidence to justify that it may improve adherence to home programmes, but further research is needed to investigate if the strategies identified in this study are effective. It is suggested that if occupational therapists implement the strategies from the three dimensions identified, it may lead to improved adherence.
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    Rehabilitation following flexor tendon injury to the hand in African countries : a scoping review
    (Stellenbosch : Stellenbosch University, 2022-12) Marume, Martin; de Klerk, Susan; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health and Rehabilitation Sciences. Occupational Therapy.
    ENGLISH SUMMARY: Objective: To explore and ascertain the types of flexor tendon rehabilitation protocols, feasibility and outcomes following implementation in African countries. Design: This scoping review used Arksey and O’Malley’s methodological framework and the Preferred Reporting Items for Systematic Reviews extension for Scoping Reviews guidelines. Data sources: A search was conducted via Cochrane library, PubMed, Science direct, CINAHL-EBSCOhost, Sabinet online platform (Sabinet African Journal and African Journal Archive), Wiley online, Academic search premier, Google scholar, Africa wide information and Universities repositories between 1 June 2021 and 31 July 2021.The search string included the following terms; flexor tendon injury, hand injury, finger injury, hand function, rehabilitation, occupational therapy, physiotherapy, mobilisation and Africa. Eligibility criteria: All language versions from African countries, manuscripts published from 1960 up to 31 July 2021, literature on zone II-V of human hand flexor tendon injury inclusive of nerve and other additional injuries, including participants who are ten years and older were considered. Manuscripts were included if they reported on flexor tendon rehabilitation protocols and outcomes (body function and structure, and activity and participation). Data extraction and synthesis: Mendeley was used to manage identified references. Three reviewers used Covidence for title, abstract and full-text screening. Microsoft Excel and WeftQDA was used for data extraction, descriptive numerical summary and qualitative content analysis respectively. Themes and categories were developed to answer the research question. Results: 53 manuscripts were identified and their title, abstract and full text reviewed. 13 manuscripts from four countries (South Africa, Egypt, Zambia and Morocco) qualified for inclusion. The Kessler knot 4 is the surgery most practised in the African continent. The early passive mobilisation is the protocol of choice and therapists consider mostly body function and structure during outcome measurement with particular attention to range of motion. The Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire, Jebsen-Taylor Hand Function Test (JTTHF) and Michigan Hand Outcomes Questionnaire (MHQ) were used to assess functional outcomes in Africa. Despite inconsistency in rehabilitation process, outcome measurement and reporting, generally, outcomes were poor in body function and structure, and activity and participation. Several factors were identified to impact outcomes, including adhesions, infection, expertise of the surgeons and rehabilitation personal and limited resources. Conclusion: There is inconsistency in the rehabilitation, measurement and outcomes following flexor tendon injury in the African context. Despite limited information from the included manuscripts, it can be ascertained that the management procedures are yielding poor results and several contextual factors influenced the attained results. Recommendations include conscientising the health care team, involved stakeholders and education facilities to conduct more research to inform good practice and better results for patients on the African continent.