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- ItemA qualitative exploration of the enablers and challenges that mothers of children with disabilities experience in accessing primary healthcare in Lwandle(2023-03) Torres, Marcia; Ohajunwa, ChiomaENGLISH ABSTRACT: Introduction Children with disabilities do need special protection and proper healthcare. The purpose of this study was to gain an insight into the experiences of mothers of children with disabilities on accessing primary healthcare in Lwandle. The main objectives were to identify the enablers and challenges that influenced this healthcare access for their CWD. Methods This study had a qualitative approach to answer the research question. Six mothers of children with disabilities, recruited through total population sampling, participated in the research. In-depth data was gathered by face-to-face interviews which were audio recorded. Data was transcribed and analysed through thematic analysis. Findings Findings of this study highlight six themes which are: Living in the water, Alone and isolated, I am struggling, Spirituality, Helpful healthcare professionals and Family and neighbours. The demands of caring and the mental health challenges that mothers of CWD experience have an impact on accessing PHC for their children. However, spirituality provides mothers with strength and together with caring healthcare professionals and family, these were identified as enablers to PHC access. Conclusion It is critical to also provide the mothers of CWD with optimal care together with their CWD, and the creation of a contextually relevant, multidimensional support system is important going forward to improve health outcomes for CWD.
- ItemHigh-impact chronic pain : barriers and facilitators identified by Western Cape primary healthcare physiotherapists(Stellenbosch : Stellenbosch University, 2023-03) Mason, Brett James Nairn; Geiger, Martha; Parker, Romy; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY: Purpose of the study: The barriers and facilitators to the provision of effective care for individuals with high-impact chronic pain (HICP) identified by physiotherapists working in the Western Cape primary healthcare (PHC) setting were described to inform the development of curricula, policy, and practise of physiotherapists within the South African PHC system. Methods: A qualitative descriptive study was conducted utilising semi-structured interviews of eight purposively selected physiotherapists from Western Cape PHC facilities. Inductive thematic analysis was implemented to interpret the data. Findings: HICP is a complex and disabling condition that adds to physiotherapists’ burden in PHC. Participants identified that patient-centred approaches and collaborative strategies were facilitators to care, while time, patient, systemic, environmental, and physiotherapist factors were barriers. Participant’s identified needs can be summarised as relating to issues of time, knowledge, and support. Conclusion: HICP is a complex and disabling condition that increases the burden on physiotherapists in PHC. Participants recognised that a patient-centred and collaborative approach allows them to better treat these individuals. Multifaceted barriers to offering effective care could be overcome by providing resources such as more physiotherapists, rehabilitation-proficient managers, and pain-specific training in the PHC setting alongside facilitating physiotherapist skills such as innovative practice and networking with existing support structures.
- ItemCaregivers’ perceptions of the sexuality of adolescents with severe intellectual disability in special care centres in the North West Province of South Africa(Stellenbosch : Stellenbosch University, 2023-03) Motshwane, Judith Ntsiki; Kahonde, Callista; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY: Background: Caregivers in special care centres play many roles in the lives of children and young adults with severe intellectual disabilities which include being a carer, an educator and a companion. In South Africa, there is lack of research to guide the understanding of how caregivers perceive sexuality issues of these young people with severe intellectual disabilities under their care. It has also been noted from the literature that many studies have focused on service providers’ perceptions of sexuality of people with mild to moderate intellectual disabilities and there is paucity of literature on caregivers’ perceptions of the sexuality of people with severe intellectual disabilities in South Africa. This study therefore took an initial step in addressing the gap by exploring caregivers’ perceptions of the sexuality of adolescents with severe intellectual disabilities in five special care centres in the North West Province of South Africa. Aim: To explore and describe caregivers’ perceptions of the sexuality of adolescents with severe intellectual disabilities in five special care centres in the North West Province of South Africa. Method: The study used an exploratory descriptive qualitative design. Semi-structured in-depth telephonic interviews were conducted with nine caregivers working in the special care centres. The data was analysed using thematic analysis. Findings: The findings show a range of participants’ perceptions. The participants thought the adolescents were not coping with their body changes and they lacked understanding of both the emotional and physical changes experienced at puberty. They also believed that adolescents must be discouraged from sexual expression or activity. The findings also revealed that the participants find responding to the adolescents’ sexuality challenging as they lacked skills and knowledge to guide their approaches. They expressed a need for training. The findings further revealed participants’ perceptions of the role of parents, pointing towards the impact of parents’ restrictive attitudes, disinterest and misunderstanding of their children with intellectual disability’s sexuality. Conclusion: The study gave an insight into the perceptions of caregivers of the sexuality of adolescents with severe intellectual disabilities in the study setting. The findings identify an urgent need for caregivers to receive training so that they gain skills and confidence to respond to the sexuality of their care recipients in a positive and supportive way. There is also need for strategies to educate parents and involve them in the sexuality education of the adolescents. Sexuality policies, guidelines and structured programmes are essential for caregivers to have tools to guide them.
- ItemChallenges faced by occupational therapists and teachers in the implementation of vocational programmes in selected special needs schools for learners with severe intellectual disability in the metro district within the City of Cape Town(Stellenbosch : Stellenbosch University, 2023-03) Solomon, Elana Tina; Ned, Lieketseng; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY: Introduction: Vocational programmes run by Occupational therapists (OTs) and/or vocational teachers in the special needs school context can play a significant role in the vocational development of learners with severe intellectual disability. They can also lead to positive postschool employment outcomes or opportunities in the open labour market. However, challenges such as limited resources in the implementation can have a direct impact on the post-school employment outcome of these learners. Aim: This study explored the challenges that Occupational Therapists and teachers faced in the implementation of vocational programmes in selected special needs schools for learners with Severe Intellectual Disability in the metro district within the City of Cape Town, South Africa. Methods:A qualitative descriptive design was used to allow the opportunity to gather in-depth information and to bring consciousness of the lived challenges. Eighteen Severe Intellectual Disability schools in the metro were contacted, 12 participants (six OTs and six teachers) from six special needs schools, volunteered and partook in the study. One-on-one semi-structured interviews with teachers and occupational therapists were done. An interview schedule was used as a tool and all interviews were transcribed and translated into English verbatim. Thematic analysis was applied to analyse data. Findings: The data showed that OTs and teachers encounter many challenges in the implementation of vocational programmes in special needs schools for learners with SID. Seven themes derived from the data included: (1) Poor to lack of proper facilities/resources, (2) Inadequate support systems, (3) Challenges with the DCAPS curriculum, differentiation and integrated learning areas, (4) Learner skills and limitations, behaviour and emotional challenges, (5) Lack of training, guidelines and support, (6) Accessing work-based learning (Job shadowing) and (7) Advising and facilitating opportunities for learners with SID. The overall ability of participants to successfully implement the vocational programmes at their respective special needs schools was hindered by inadequate support, resources and lack of relevant training. This study also highlights the issues of existing policy and the lack of a mandatory policy on vocational programmes for special need schools. Conclusion: The participants’ experiences provided knowledge on the challenges in the implementation and added value to the existing literature. To address the challenge, a multi-faceted policy framework is much needed in the South African context that includes a set of principles for effective implementation, procedures, responsibilities, and comprehensive support plans for vocational programmes for special needs schools for SID. The recommendations propose ideas that can be used by policy makers and educational institutions to better support OTs and teachers and improve post-school employment outcomes for learners with SID.
- ItemStroke survivors’ psychosocial challenges upon reintegration into their homes, after inpatient rehabilitation at a private facility in Cape Town(Stellenbosch : Stellenbosch University, 2023-03) Solomons, Jameelah; Luger, Rosemary; Geiger, Martha; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY: Purpose: The difficulties that individuals experience post-stroke can result in psychosocial challenges which may influence their daily functioning. The aim of this study was to describe the psychosocial challenges of stroke survivors upon reintegration into their homes, after inpatient rehabilitation at a private facility in Cape Town. Method: Qualitative semi-structured one-to-one virtual synchronous interviews were conducted to collect data. Adult stroke survivors that were discharged home from the rehabilitation facility in Cape Town, within 2-12 months’ post discharge were recruited. Results: Eight stroke survivors (two females and six males; age range 43-81 years; time range post discharge between 2-9 months) participated. Participants’ subjective experiences regarding their psychosocial challenges upon reintegration into their homes, after inpatient rehabilitation at a private facility in Cape Town, were captured in the following three themes: (1) emotional distress, (2) changes in social relations, and (3) alterations in self-identity. Conclusion: Stroke survivors are confronted with many psychosocial challenges upon reintegration home after inpatient rehabilitation, that may impact their sense of self-identity, emotional state, and their daily participative interactions. Individuals involved with stroke survivors are encouraged to address stressors linked to the sequel of the stroke by facilitating psychological intervention throughout the stroke trajectory, especially encouraging and nurturing coping strategies.