Novice therapists in a developing context: Extending the reach of hand rehabilitation

Abstract

Introduction: Hand rehabilitation needs in some parts of the world extend beyond the impact of specialised hand therapists. This study aimed to establish what hand rehabilitation services novice occupational therapists in South Africa were providing; the supports and barriers for such services; and, therapists' perceptions of being equipped for hand rehabilitation. Methods: A descriptive cross-sectional study was conducted, and an online questionnaire was sent to all occupational therapists in their first year of practice (n ¼ 240). Data were analysed with Stata 12 and IBM SPSS Statistics, version 21.0. Responses to open ended questions were post-coded. Results: A 43.3% response rate was obtained. Participants (n ¼ 104) treated an average of 20 clients requiring hand rehabilitation per month often without adequate equipment (73%). Central nervous system (91.3%), bone and joint (72.8%) and arthritic conditions (72.4%) were treated most frequently. Most participants felt confident (64%) and competent (79%) in hand rehabilitation. Conclusion: Participants were undertaking hand rehabilitation that in other contexts is considered to require specialised skills. To ensure quality rehabilitation, supervision and mentoring of novice therapists and appropriate professional development opportunities are required.

Hand health for all: Do undergraduate occupational therapy hand curricula respond to the call?

“…They also may, or may not, represent those with experience and expertise in this area, although de Klerk 19 reported that more than 90% of therapists with more than five years' experience in hand rehabilitation a worked in the private sector. Furthermore, within the broader study in which this article is situated, CS occupational therapists confirmed the limited availability of hand surgery services and hand rehabilitation expertise in rural and underserved areas of South Africa [8][9] . It can therefore be surmised that many patients requiring this expert service are unlikely to be able to access it, and that services for the majority of the population fall predominantly to novice and inexperienced therapists such as CS occupational therapists.…”

“…The article reports one aspect of a larger study that investigated the extent to which community service occupational therapists are equipped to treat patients with hand impairments. The larger study, parts of which have been published previously 8,9 , captured aspects of the general practice experience of the 2013 Community Service occupational therapists, as well as their perceived preparedness for treating patients with hand impairments.…”

“…CS occupational therapists also reported treating a range of health conditions including those to the hand which they reportedly see regularly (median: 20 per month; range: 0 to 225 per month) [8][9] . Conditions treated most frequently included bone and joint conditions, arthritic conditions, thermal injuries, tendon injuries, complex injuries, infections and peripheral nerve injuries [8][9][19][20] , many of which are caused by accidents or injury implying a significant need to refocus services towards prevention and promotion. Therapists use a variety of treatment modalities with home programmes, manual therapy, exercise, activity as a means/end, training in activities of daily living, strengthening and education being used most regularly [8][9] .…”

“…Conditions treated most frequently included bone and joint conditions, arthritic conditions, thermal injuries, tendon injuries, complex injuries, infections and peripheral nerve injuries [8][9][19][20] , many of which are caused by accidents or injury implying a significant need to refocus services towards prevention and promotion. Therapists use a variety of treatment modalities with home programmes, manual therapy, exercise, activity as a means/end, training in activities of daily living, strengthening and education being used most regularly [8][9] . Others, such as splinting, were used less frequently partly due to a lack of resources [8][9] .…”

“…Therapists use a variety of treatment modalities with home programmes, manual therapy, exercise, activity as a means/end, training in activities of daily living, strengthening and education being used most regularly [8][9] . Others, such as splinting, were used less frequently partly due to a lack of resources [8][9] .…”