ObjectiveTo examine the literature on how recovery of people with severe mental illness (SMI) is conceptualised in low/middle-income countries (LMICs), and in particular what factors are thought to facilitate recovery.DesignScoping review.Data sources and eligibilityWe searched 14 electronic databases, hand searched citations and consulted with experts during the period May–December 2019. Eligible studies were independently screened for inclusion and exclusion by two reviewers. Unresolved discrepancies were referred to a third reviewer.Data extraction and synthesisAll bibliographical data and study characteristics were extracted using a data charting form. Selected studies were analysed through a thematic analysis emerging from extracted data.ResultsThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram offers a summary of the results: 4201 titles, 1530 abstracts and 109 full-text articles were screened. Ten articles were selected for inclusion: two from Turkey, two from India, and one each from China, Swaziland, Indonesia, Egypt, South Africa and Vietnam. Although most studies used qualitative methods, data collection and sampling methods were heterogeneous. One study reported on service provider perspectives while the rest provided perspectives from a combination of service users and caregivers. Three themes emerged from the data analysis. First, studies frame recovery as a personal journey occurring along a continuum. Second, there was an emphasis on social relationships as a facilitator of recovery. Third, spirituality emerged as both a facilitator and an indicator of recovery. These themes were not mutually exclusive and some overlap exists.ConclusionAlthough there were commonalities with how high-income countries describe recovery, we also found differences in conceptualisation. These differences in how recovery was understood reflect the importance of framing the personal recovery concept in relation to local needs and contextual issues found in LMICs. This review highlighted the current sparse evidence base and the need to better understand recovery from SMI in LMICs.
The case study intervention design process Childhood HIV infection is of paramount concern in South Africa 7. The majority of HIV infected children in South Africa live in low-income conditions 7. HIV places children at great risk for developmental, play and learning difficulties and its interrelationship with negative social circumstances exacerbates this risk 8-10. In 2012 a group of four occupational therapists working for a nongovernmental organisation (NGO) were tasked with designing a new play informed caregiver implemented home based intervention (PICIHBI) targeting caregivers of children on highly active antiretroviral treatment (HAART) in South Africa. The first author's doctoral study drew on a Case Study design 11-14 to explore the process by which this group of occupational therapists designed this
Substance abuse is a rising global problem, associated with medical, psychiatric, family, occupational, legal, political, financial, and spiritual problems. Recovery is an important area of consideration in occupational therapy's quest to promoting health and well-being. This narrative inquiry explored the journey of recovery from substance abuse among young adult Zimbabwean men. Three men were purposively selected to participate in in-depth narrative interviews about their occupations during recovery. Data were analyzed using a narrative analysis. Explanatory stories and three superordinate themes illustrated how substance abuse was associated with both positive and negative outcomes. The recovery process emerged as an ongoing occupational transition, influenced by occupational identity and involving changes in occupational participation. Recovery from substance abuse can be conceptualized as an occupational transition. Ongoing participation in "healthy" and meaningful occupations is key factor in this process. Construction of a positive occupational identity is also central.
Social and political contexts are known to influence people's opportunities to engage in occupations. Occupational therapy in the domain of community development practice addresses the social determinants of health by contributing towards social transformation. Socially IH transformative practice refers to occupational therapy practice that strives to and addresses the social determinants of health and social Π I injustice through drawing on critical perspectives. Educators applied an autobiographical form of study, data were generated firstly through keeping a written reflective journal and audio recorded reflections on practice. Secondly, written comments and feedback to students ~\ during their community development practice placements were also included in the data set. Data were thematically analysed, yielding (/) I a theme and two categories. The theme: Towards socially responsive practice revealed the value of adopting a critical and collaborative approach to practicing occupational therapy in various domains of practice. Working towards social transformation was demonstrated as possible through the categories of being able to See and Feel the invisible and enabled as Equals working for change. The findings suggest that critical reflexivity together with implementation of participatory practices are necessary requirements towards addressing the conditions of people's health and occupational well-being. Key words: Occupational therapy practice; social transformation; participatory practice; Occupation-based community development
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