Research Articles (Occupational Therapy)

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    Exploring 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, Lana
    Background: 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.
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    Occupational therapists’ views on core competencies that graduates need to work in the field of neurology in a South African context
    (2020-03) Jacobs-Nzuzi Khuabi, Lee-Ann; Bester, Juanita
    BACKGROUND: The burden of neurologically related conditions in South Africa (SA) necessitates that undergraduate occupational therapy education and training provide students with core competencies to deliver comprehensive, effective client-centred interventions. Given developments in the practice of neurology and changes in policy, funding and infrastructure, it is essential that training remains relevant and responsive to the needs of individuals and their context. Occupational therapists should be in touch with the local context and its challenges and consider the practicalities of the suggested interventionsOBJECTIVES: To explore occupational therapists' perspectives on the knowledge, skills and attitudes that graduates need to work in the field of neurologyMETHODS: An explorative qualitative study consisting of semi-structured interviews was conducted with 10 occupational therapists in Western Cape Province, SA. Data were analysed using inductive analysisRESULTS: Four themes emerged from the findings, including foundational knowledge and skills, intra- and interpersonal attitudes, suggestions to consider when revising a neurology curriculum and resource constraintsCONCLUSIONS: This study highlighted that, in addition to neurology-specific skills, graduates also require core generic knowledge, skills and attitudes that address the evolving needs of society. These competencies are further necessary to allow graduates to work within the constraints of the health and educational systems
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    Cognitive 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, Lana
    When 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.
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    Motor skill intervention for pre-school children : a scoping review
    (AOSIS, 2020) Van der Walt, Janke; Plastow, Nicola A.; Unger, Marianne
    Background: There is a high prevalence of motor skill difficulties amongst pre-school children living in low socio-economic areas. Motor skill impairment can affect these children’s school readiness and academic progress, social skills, play and general independence. Objectives: This scoping review investigates the key elements of existing motor skill interventions for pre-school children. Method: We gathered information through structured database searches from Cinahl, Eric, PubMed, Cochrane, ProQuest, Psych Net, PEDro and Scopus, using a keyword string. The PRISMA-SCR design was used to identify 45 eligible studies. All included studies investigated a motor skill intervention with well-defined outcome measures for children aged 4–7 years with motor skill difficulties. Studies that exclusively focused on children with neurological conditions such as cerebral palsy, physical disabilities or medical/physical deteriorating conditions were excluded. Information was charted on MS Excel spreadsheets. Fundamental concepts were categorised into common key themes and were converted into a proposed framework. Results: Fifteen intervention approaches were identified. Treatment is mostly managed by occupational therapists and physiotherapists. Evidence supports individual and group treatment with a child-centred, playful approach in a school or therapeutic setting. Whilst session information varied, there is moderate evidence to suggest that a 15-week programme, with two weekly sessions, may be feasible. Conclusion: Children with motor skill difficulties need therapeutic intervention. This study identified the key elements of existing therapy intervention methods and converted it into a proposed framework for intervention planning. It is a first step towards addressing motor skill difficulties amongst pre-school children in low socio-economic areas.
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    An 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, Kirsty
    Background: 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.