Browsing by Author "Van Niekerk, Lana"
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- ItemChanging demographic trends among South African occupational therapists : 2002 to 2018(BioMed Central, 2020-03-20) Ned, Lieketseng; Tiwari, Ritika; Buchanan, Helen; Van Niekerk, Lana; Sherry, Kate; Chikte, Usuf M. E.Background: South Africa’s quadruple burden of disease, coupled with health system challenges and other factors, predicts a high burden of disability within the population. Human Resources for Health policy and planning need to take account of this challenge. Occupational therapists are part of the health rehabilitation team, and their supply and status in the workforce need to be better understood. Methods: The study was a retrospective record-based review of the Health Professions Council of South Africa database from 2002 to 2018. The data obtained from the Health Professions Council of South Africa was analysed for the following variables: geographical location, population groups, age, practice type and sex. Data was entered on a Microsoft Excel spreadsheet and analysed using the Statistical Package for the Social Sciences (SPSS version 22.0). Results: In 2018, there were 5180 occupational therapists registered with the Health Professions Council of South Africa with a ratio of 0.9 occupational therapists per 10 000 population. There has been an average annual increase of 7.1% over the time period of 2002–2018. The majority of occupational therapists are located in the more densely populated and urbanised provinces, namely Gauteng, Western Cape and KwaZulu-Natal. Most of the registered occupational therapists are under the age of 40 years (67.7%). The majority (66%) are classified as white followed by those classified as black and coloured. Females make up 95% of the registered occupational therapists. Nationally, 74.8% of occupational therapists are deployed in the private sector catering for 16% of the population while approximately 25.2% are employed in the public sector catering for 84% of the population. Conclusions: Under-resourcing and disparities in the profile and distribution of occupational therapy human resources remain an abiding concern which negatively impacts on rehabilitation service provision and equitable health and rehabilitation outcomes.
- ItemCognitive interviewing during pretesting of the prefinal Afrikaans for the Western Cape disabilities of the arm, shoulder and hand questionnaire following translation and cross-cultural adaptation(Hindawi, 2019) De Klerk, Susan; Jerosch-Herold, Christina; Buchanan, Helen; Van Niekerk, LanaWhen patient-reported measures are translated and cross-culturally adapted into any language, the process should conclude with cognitive interviewing during pretesting. This article reports on translation and cross-cultural adaptation of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire into Afrikaans (for the Western Cape). This qualitative component of a clinical measurement, longitudinal study was aimed at the pretesting and cognitive interviewing of the prefinal Afrikaans (for the Western Cape) DASH questionnaire highlighting the iterative nature thereof. Twenty-two females and eight males with upper limb conditions were recruited to participate at public health care facilities in the Western Cape of South Africa. Cognitive interviews were conducted as a reparative approach with an iterative process through retrospective verbal probing during a debriefing session with 30 participants once they answered all 30 items of the translated DASH questionnaire. The sample included Afrikaans-speaking persons from low socioeconomic backgrounds, with low levels of education and employment (24 of 30 were unemployed). Pragmatic factors and measurement issues were addressed during the interviews. This study provides confirmation that both pragmatic factors and measurement issues need consideration in an iterative process as part of a reparative methodology towards improving patient-reported measures and ensuring strong content validity.
- ItemAn enhanced individual placement and support (IPS) intervention based on the Model of Human Occupation (MOHO); a prospective cohort study(BMC (part of Springer Nature), 2020-07-08) Prior, Susan; Maciver, Donald; Aas, Randi W.; Kirsh, Bonnie; Lexen, Annika; Van Niekerk, Lana; Fitzpatrick, Linda Irvine; Forsyth, KirstyBackground: Employment is good for physical and mental health, however people with severe mental illness (SMI) are often excluded from employment. Standard Individual Placement and Support (IPS) is effective in supporting around 55% of people with SMI into employment or education. Current research considers enhancements to IPS to improve outcomes for those requiring more complex interventions. Clinicians need to better understand who will benefit from these enhanced IPS interventions. This study offers a new enhanced IPS intervention and an approach to predicting who may achieve successful outcomes. Methods: This prospective cohort study included people with SMI who participated in an enhanced IPS service and had prolonged absence from employment. Secondary data analysis was conducted of data gathered in routine clinical practice. Univariate analysis coupled with previous research and clinical consultation was used to select variables to be included in the initial model, followed by a backward stepwise approach to model building for the final multiple logistic regression model with an outcome of successful or unsuccessful goal attainment (employment or education). Results: Sixty-three percent of participants in the enhanced IPS successfully attained employment or education. Significant relationships from bivariate analyses were identified between outcomes (employment or education) and seven psychosocial variables. Adapting Routines to Minimise Difficulties, Work Related Goals, and Living in an Area of Lesser Deprivation were found to be significant in predicting employment or education in the final multiple logistic regression model R2 = 0.16 (Hosmer-Lemeshow), 0.19 (Cox-Snell), 0.26 (Nagelkerke). Model χ2(7) = 41.38 p < .001. Conclusion: An enhanced IPS service had a 63% rate success in achieving employment or education, higher than comparable studies and provides an alternative to IPS-Lite and IPS-standard for more complex populations. Motivational and habitual psychosocial variables are helpful in predicting who may benefit from an enhanced IPS intervention supporting people after prolonged absence from employment.
- ItemExploring the factors that affect new graduates’ transition from students to health professionals : a systematic integrative review protocol(BMJ Publishing Group, 2020-05-15) Opoku, Eric Nkansah; Van Niekerk, Lana; Jacobs-Nzuzi Khuabi, Lee-AnnIntroduction: To become a competent health professional, the nature of new graduates’ transition plays a fundamental role. The systematic integrative review will aim to identify the existing literature pertaining to the barriers during transition, the facilitators and the evidence-based coping strategies that assist new graduate health professionals to successfully transition from students to health professionals. Methods and analysis: The integrative review will be conducted using Whittemore and Knafl’s integrative review methodology. Boolean search terms have been developed in consultation with an experienced librarian, using Medical Subject Heading terms on Medline. The following electronic databases have been chosen to ensure that all relevant literature are captured for this review: PubMed, EBSCOhost (including Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline, Academic Search Premier, Health Science: Nursing and Academic Edition), Scopus and Web of Science. A follow-up on the reference list of selected articles will be done to ensure that all relevant literature is included. The Covidence platform will be used to facilitate the process. Ethics and dissemination: Ethical approval is not required for this integrative review since the existing literature will be synthesised. The integrative review will be published in a peer-reviewed journal once all the steps have been completed. The findings will also be presented at international and national conferences to ensure maximum dissemination.
- ItemExploring the factors that affect the transition from student to health professional : an integrative review(BioMed Central, 2021-11) Opoku, Eric Nkansah; Jacobs‑Nzuzi Khuabi, Lee-Ann; Van Niekerk, LanaBackground: The nature of a new health professional’s transition from student to health professional is a signifcant determinant of the ease or difculty of the journey to professional competence. The integrative review will explore the extent of literature on the factors that impact the transition of new health professionals into practice, identify possible gaps and synthesise fndings which will inform further research. The aim was to identify research conducted in the last two decades on the barriers, facilitators and coping strategies employed by new health professionals during their transition into practice. Methods: Whittemore and Knaf’s methodological framework for conducting integrative reviews was used to guide this review. Sources between 1999 and 2019 were gathered using EBSCOhost (including CINAHL, Medline, Academic Search Premier, Health Science: Nursing and Academic Edition), PubMed, Scopus, Cochrane and Web of Science, as well as hand searching and follow-up of bibliographies followed. The Covidence platform was used to manage the project. All studies were screened against a predetermined selection criteria. Relevant data was extracted from included sources and analysed using thematic analysis approach. Results: Of the 562 studies identifed, relevant data was extracted from 24 studies that met the inclusion criteria, and analysed to form this review. Thematic analysis approach was used to categorise the fndings into theme areas. Four overarching themes emerged namely: systems and structures, personal capacities, professional competence and mediating processes. Each theme revealed the barriers, facilitators and coping strategies of transition into practice among new health graduates. Conclusion: The transition into practice for new health practitioners has been described as complex and a period of great stress. Increasing clinical and practical experiences during education are required to support new health professionals in the process of closing the gap between learning and practice. Continued professional development activities should be readily available and attendance of these encouraged.
- ItemIdentity construction and participation in work : learning from the experiences of persons with psychiatric disability(Thomson Reuters, 2016-03) Van Niekerk, LanaENGLISH SUMMARY : Background: In this article constructions of identity, occupation and performance are explored with a particular focus on the interrelatedness of these concepts. Insights were derived from a study in which the influences that impact on the work-lives of people with psychiatric disability were explored. Method: An interpretive biography design was utilised. Data construction took the form of narrative interviews and a combination of paradigmatic narrative analysis and narrative analysis was used. Participants, selected by means of purposive maximum variation sampling, had been diagnosed with psychiatric impairment and lived in the Western Cape, South Africa. Findings and discussion: Identity construction processes were explored, with a particular focus on how these impacted on decisions about participation in work. Conclusions: Performance elements of identity, called forth by occupational demands, occurring within work environments were found to be shaped through, and expressed as, doing. The notion of Punctualized Identity was shown to provide a lens that is able to capture the dynamic interplay of identity constructs and provide a synthesised perspective on participation.
- ItemA literature review on work transitioning of youth with disabilities into competitive employment(AOSIS publishing, 2017-08) Engelbrecht, Madri; Shaw, Lynn; Van Niekerk, LanaBackground: The marginalisation of youth with disabilities from employment opportunities is evident from literature in as far as they form part of the larger groups ‘people with disabilities’ and ‘youth’. A focused view of programmes that assist youth with disabilities into employment has not been presented, despite the worldwide crisis of youth unemployment. Aim: This review aimed to identify evidence on work transition programmes that are effective in assisting people with disabilities into open labour market (competitive) employment, as well as to highlight gaps in knowledge to inform future research on this topic. Methods: Literature and policy on programmes that support such transitions were considered, firstly from a global perspective and then with a view from developing countries. The SALSA (Search, Appraisal, Synthesis and Analysis) framework was used to source and analyse information from a diverse set of documents. Various online databases were searched for research papers published between 1990 and 2016, and websites were searched for reports pertaining to this topic. Results: Ninety-nine documents were selected to inform the review, out of an identified 259 scientific journal articles, policy documents, acts, organisational reports and book chapters. Conclusion: A synthesis of findings was presented in a narrative that reflects the themes of youth with disabilities and employment in the world, work transition endeavours in the developing world and a specific focus on this group in South Africa. The review revealed a gap in knowledge and evidence pertaining to youth with disabilities and employment, highlighting these as research foci, and emphasising the need for youth-focused research that generates knowledge about disability and transitions into the labour force.
- ItemThe lived experience of drivers with a spinal cord injury : a qualitative inquiry(Occupational Therapy Association of South Africa, 2016) Mtetwa, Lucia; Classen, Sherrilene; Van Niekerk, LanaIntroduction: Driving is an instrumental activity of daily living and a facilitator of meaningful participation in society for the majority of the population, including persons with spinal cord injuries. Persons with spinal cord injury may have impaired fitness to drive capabilities. Little is known about perceptions of drivers with spinal cord injury on driving, driver rehabilitation, or return to driving. This study examined the post spinal cord injury driving experiences of drivers and illuminates their rehabilitation and return-to-driving needs within the South African context. Method: This phenomenological study explored personal experiences of fourteen drivers with spinal cord injury, recruited through purposive sampling. Face-to-face, semi-structured interviews were audio recorded and transcribed verbatim. The data analysis was an inductive and iterative process. Results/findings: Six themes represent the study findings: adjusting to physical limitations, safety perceptions and influencing factors, the positive role of driving, contextual features and supports, environmental barriers, and inconsistent provision of rehabilitation services. Conclusions: The findings indicated that occupational therapists ought to consider incorporating driver rehabilitation services and adopt mediation approaches to advocate for persons with spinal cord injury, who want to drive. Plausible practice and research opportunities are discussed for occupational therapists who are interested in driving and spinal cord injury.
- ItemShared decision making and the practice of community translation in presenting a pre-final Afrikaans for the Western Cape Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire : a proposal for improved translation and cross-cultural adaptation(SpringerOpen, 2019-08-14) De Klerk, Susan; Jerosch-Herold, Christina; Buchanan, Helen; Van Niekerk, LanaBackground: Translation and cross cultural adaptation of patient reported outcome measures (PROMs) involves a step referred to as harmonisation, following forward and backward translation of the measure. This article proposes the introduction of methods not previously included in the process of harmonisation. The aim of the study was to introduce shared decision making (SDM) and the practice of community translation (CT) during the harmonisation of the Afrikaans for the Western Cape version of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, a PROM that measures symptoms and activity and participation in persons with upper limb conditions. Methods: A broader approach to harmonisation is proposed by incorporating CT and SDM in addition to existing methods toward harmonisation. Participants (n = 8) involved in the harmonisation meeting included the principal investigator, a linguistic expert, occupational therapists with knowledge of the target population, context and the DASH questionnaire and members of the target population with and without upper limb conditions. A partnership was formed with the participants (a principle of SDM) and the principles of non-parallel CT and the CT approach were applied during harmonisation. Employing CT principles ensures that the norm for the translation is set by the population the translation is intended for. Results: Forward and backward translation of the DASH questionnaire presented a version of the measure in the target language for consideration during harmonisation. There were however a significant number of conceptually problematic items on the version presented at the meeting. Only seven items (7 of 30) remained unchanged. Conclusion: SDM and CT was used during the harmonisation of the Afrikaans for the Western Cape DASH questionnaire. Both these practices could have relevance in the translation and cross-cultural adaptation of PROMs where the translation is intended for persons from low socio-economic backgrounds and low levels of education.
- ItemStrategies occupational therapists employ to facilitate work-related transitions for persons with hand injuries : a study protocol for a scoping review(BMJ Publishing Group, 2019) Uys, Michelle Elizabeth; Buchanan, Helen; Van Niekerk, LanaABSTRACT : Introduction Hands make it possible to be employable and productive, to communicate non-verbally and to perform fine motor tasks required in day-to-day activities. Sustaining a hand injury can be detrimental to function including the ability to work. As the literature on workrelated transitions is scattered across a range of journals, it is difficult to get a sense of how much literature there is, what is known and where the gaps lie. This scoping study will provide a single source of up-to-date evidence to inform health professionals about the strategies occupational therapists employ to facilitate work-relatedtransitions for people with hand injuries. Methods and analysis: The methodological framework by Arksey and O’Malley (2005) will form the structure of the scoping review. The search strategy has been developed in collaboration with a subject librarian. The following databases will be searched: EBSCOhost including only Medline, CINAHL and Health Source: Nursing/Academic Edition; PubMed, Scopus, The Cochrane library and Web of Science. Reference lists will be examined, and grey literature sources will be searched to ensure that literature missed in the database searches is included. Covidence will be used to manage the project. Full-texts will be uploaded for literature that meets the inclusion criteria. A process of blind review will be used to ensure that consistency and rigour is upheld. Ethics and dissemination: The findings of the scoping review will be disseminated in an article, within 2019, to be published in a peer-reviewed journal. The findings will be presented at conferences to ensure the optimal dissemination of the scoping review's conclusions.
- ItemStreet vending in South Africa : an entrepreneurial occupation(Occupational Therapy Association of South Africa, 2017) Gamieldien, Fadia; Van Niekerk, LanaBackground: Not all occupations are undertaken entirely by choice. Numerous personal, cultural, economic and social factors influence participation in occupation. In low and middle-income countries, such as South Africa, disparate socio-economic factors might necessitate participation in occupations considered to be ‘less desirable’. In this article the occupation of street vending is explored and discussed, with an emphasis on livelihood creation and the meaning and purpose derived from this occupation. Street vending is considered for its potential as a vocational occupation for people facing disabling conditions. Methods: A collective case study was done comprising six participants who were selected through maximum variation sampling. Data was collected using semi-structured interviews and participant observation. Data analysis took the form of an inductive content analysis. Results: Occupational therapists need a comprehensive understanding of occupations before making judgements about these, especially when such occupations are not considered mainstream. One such occupation, namely street vending, predominates in the informal economy of South Africa. Findings revealed that, despite hardships associated with this occupation, street vendors adapt to social, political and economic challenges in their context. Recommendations: A comprehensive approach is needed when appraising the suitability of occupations; one that focuses on the transformative value of occupations in livelihood creation, rather than focusing narrowly on their therapeutic use or potential to contribute to personal meaning. Occupational therapists should adopt a multi-dimensional approach by considering vocational occupations within their social, cultural and political context, whilst keeping the functional requirement in mind and matching these dimensions with impairment or disability if prevalent.
- ItemSupported Employment for people with mental disabilities in South Africa : cost calculation of service utilisation(Occupational Therapy Association of South Africa, 2017) Engelbrecht, Madri; Van Niekerk, Lana; Coetzee, Zelda; Hajwani, ZerinaIntroduction: Supported Employment (SE) is a strategy that facilitates positive employment outcomes for people with mental disabilities in open labour market settings. SE’s cost-effectiveness has been established internationally, but not in South Africa. This paper reports on the cost and affordability of SE services offered to people with mental disabilities in South Africa. Method: A longitudinal descriptive study was used to determine the cost of SE service components utilised by people with mental disabilities, from two programmes in the Western Cape. The utilisation of service elements was captured in 15-minute time units. Data collection continued for 12 months, commencing when a job had been identified and preparation for placement had ensued. Time utilisation data were used to calculate cost, using a government sessional salary (R189/hour) and a medical aid reimbursement rate (R367/hour) of occupational therapists acting as job coaches. Findings: The findings show SE services to be less than 10% of the cost of a monthly disability grant, and 10% - 21% lower than the current subsidy per consumer in a protective workshop. Conclusion: Evidence from the study thus reflects the cost of SE services to people with mental disability as substantially lower than the current government investment in disability grants and protective workshops subsidies.