Browsing by Author "Michau, Cecile"

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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.