Occupational therapy relies primarily on communication between the therapist and client for effective intervention. Adequate communication may be influenced by language and cultural differences between the therapist and client. Cultural competence in relation to language and culture is thus a vital part in practice. Limited research exists on cultural competence in occupational therapy students. This study thus aimed to explore the cultural competence of final year students and their perceptions of their own cultural competence, with respect to language and culture in their practice as students. An explorative qualitative study design was utilised with a nonprobability purposeful sample of 21 final year undergraduate students at a tertiary institute in South Africa. Three focus groups were conducted, comprising between 6 and 8 students in each group. Thematic analysis using inductive reasoning was undertaken in order to analyse the students' experiences and understanding of cultural competence. Findings of the study suggest that cultural competence, in relation to language and culture, influences the occupational therapy intervention process. It was shown to both positively and negatively influence intervention through supporting or hindering rapport building, client centeredness, and effective intervention.
Background: The ICAM splint programme was developed in the 1980s and is known to produce favourable results in the management of extensor tendon repairs from zone IV to zone VII. It has only become popular in South Africa over the past several years and to the authors' knowledge its application in South Africa has not previously been reported. Aim: The study sought to describe the use of the ICAM splint programme following an extensor tendon repair from zone IV to VII at a specialised hand unit in SA. Methods: The study followed a concurrent mixed methods design. In phase one, a retrospective file audit was conducted with a sample of patients following the ICAM programme (n=75). Phase two involved individual therapist interviews (n=3), surgeon interviews (n=2) and a focus group with physiotherapists and occupational therapists (n=7) that had experience with the ICAM splint programme. Microsoft excel was used to descriptively analyse phase one data and thematic analysis was used to analyse phase two data. Data were merged and represented in a joint display. Results: The majority of patients (83%) were male with 40% in the age range of 26-35 years old. The injuries were mainly violence related (69%) in comparison to accidental injuries (31%) with extensor tendon zone V (40%) and VI (47%) being the most commonly involved. Adherence was reportedly influenced by factors such as patients' financial status, education and language barriers. Conclusions: The results suggest that the ICAM splint programme is beneficial in managing extensor tendon repairs from zone IV to VII. Therapists should consider factors that affect non-adherence when selecting patients for the ICAM programme to determine its suitability. Educating patients on the ICAM splint programme is essential to facilitate adherence. Novice therapists to the ICAM programme should receive formal training to improve confidence and skill. Week 4 Post-Surgery Description of the wound (clean, slough, septic, macerated, dry, healed, other) Presence or absence of oedema (yes, no) Did the therapist provide education to the patient on the ICAM splint programme? (yes, no) If the patient reported pain or not? (yes, no) Reason for remoulding the yoke splint (tight, loose, broke, discomfort, incorrect position, lost yoke, other) Adherence with splint and exercises as recorded by the therapist (yes, no) Attendance to appointment or not (yes, no) Goniometric AROM readings of the affected digit Calculation of TAM Assessing extensor tendon function using Miller's criteria (Miller's total extensor lag classification, Miller's total flexion loss classification) Rated as excellent, good, fair and poor. Week 6-8 Post-Surgery Description of the wound (clean, slough, septic, macerated, dry, healed, other) Presence or absence of oedema (yes, no) Did the therapist provide education to the patient on the ICAM splint programme? (yes, no) If the patient reported pain or not? (yes, no) Reason for remoulding the yoke splint (tight, loose, broke, discomfort, incorrect position, lost yoke, oth...
order to uphold the conditions of ethical clearance and gatekeeper permissions for this study, employment details are withheld as per conditions agreed upon prior to commencement of this study. Background: Occupational therapists working in the field of occupational health in South African private industrial sectors may find themselves involved in management of medical incapacity due to their expertise in vocational rehabilitation. Aim: In this study, the authors explored how South African Acts guide the role and scope of occupational therapists in medical incapacity management, in addition to determining the scope, role and value of occupational therapy in medical incapacity management from the perspectives of occupational therapists currently working in the field. Method: An exploratory qualitative design with use of two concurrent methods of data collection (document analysis and semi structured interviews) was undertaken. Data were analysed thematically, via deductive reasoning, and pooled to provide a picture of how occupational therapists can function within medical incapacity management. Results and Discussion: Six themes emerged from the data. Occupational therapists' role and scope within legislature appears to lack detail with a disjuncture between legislation that guides medical incapacity management and current practice of occupational therapists. Notwithstanding this, the findings of this study show that occupational therapists play a critical role within management of medical incapacity.
Background: Provision of aftercare services for persons with substance use disorders (PWSUD) within a rural context is typically met with various intersecting challenges, including unclear policy implications and lack of resources. In the South African context, service providers are expected to provide aftercare services that should achieve successful reintegration of persons with PWSUD into society, the workforce, family and community life as mandated by Act No. 70 of 2008, despite population diversity. Little has been established on the provision of aftercare services in South Africa and specifically within a rural context. This article explores the perspectives of service providers in aftercare service provision for PWSUD in a rural district.Methods: A qualitative exploratory study design was conducted in a rural district in South Africa using semi-structured interviews and focus group discussions with forty-six service providers from governmental and non-governmental institutions, ranging from implementation to policy level of service provision. Data were analyzed thematically using a deductive approach. Codes were predetermined from the questions and the aims and objectives of the study used Beer’s Viable Systems Model as a theoretical framework. NVivo Pro 12 qualitative data analysis software guided the organization and further analysis of the data.Results: Four themes emanated from the data sets. Theme 1 on reflections of the interactional state of aftercare services and program content identified the successes and inadequacies of aftercare interventions including relevant recommendations for aftercare services. Themes 2, 3, and 4 demonstrate reflections of service provision from implementation to policy level, namely, identifying existing barriers to aftercare service provision, situating systemic enablers to aftercare service provision, and associated aftercare system recommendations. Conclusions: The intersecting systemic complexities of providing aftercare services in a rural context in South Africa was evident. There existed minimal enablers for service provision in this rural district. Service providers are confronted with numerous systemic barriers at all levels of service provision. To strengthen the aftercare system, policies with enforcement of aftercare services are required. Moreover, a model of aftercare that is integrated into the existing services, family centered, sensitive to the rural context and one that encourages the collaboration of stakeholders could also strengthen and sustain the aftercare system and service provision.
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