Research Articles (Occupational Therapy)

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The impact of occupational therapy using Ayres Sensory Integration® on a child with cochlear implants : a case study
Kruger, Stefanie; Uys, Kitty; Van Niekerk, Karin; Botha, Tanita (Occupational Therapy Association of South Africa, 2025-08)
INTRODUCTION : A three-year-old child with bilateral cochlear implants (CIs) was referred to occupational therapy by the cochlear team due to suspected tactile over-reactivity. The child's behaviour fell outside of typical expectations of young children who receive CIs and had a ripple effect on her language and development e.g. removing and hiding her CIs after 45 - 60 min of usage. METHODS : A retrospective, longitudinal, experimental single case study was conducted. Occupational therapy using the Ayres Sensory Integration® approach (OT-SI) was provided to the child for 48 months in a private practice in South Africa. This study aimed to show that the child's sensory perception and regulation improved overtime as a result of intervention. Results of the Sensory Integration and Praxis Tests completed at 23 and 42 months after the onset of intervention were compared. OUTCOMES : After OT-SI intervention, the child tolerated and enjoyed wearing her CIs during waking hours every day. Test results and her increased participation in occupations confirmed that the child showed significant improvement. CONCLUSION : OT-SI made a meaningful difference for this child and should be considered as part of the intervention for children with CIs. The parents and cochlear team were satisfied with the positive outcomes of intervention. The study highlights the potential contribution of the occupational therapist to the cochlear team. IMPLICATION FOR PRACTICE • This case study provides valuable insights to promote early intervention to support occupational therapists working with young children with cochlear implants. • Clinical strategies are shared to stimulate professional reasoning and articulate goal setting for a child-directed intervention plan. • Knowledge is shared to empower occupational therapists to make a valuable contribution to the cochlear team and to fill the gap in available literature. • The article reflects the value of a support system for parents of children with cochlear implants. • Fostering continuous communication between team members can create an atmosphere of empathy and recognition of each family's unique journey.
Determining the knowledge, attitudes and frequency of use of final year health care students in implementing evidence-based practice
Van Niekerk, Karin; Nel, Suzanne; Gous, Anice; Van der Westhuizen, Line; Hellberg, Anita; De Wet, Karla; Manthata, Mogale (Occupational Therapy Association of South Africa, 2025-12)
INTRODUCTION : Evidence-based practice (EBP) is crucial for delivering optimal client care. Although healthcare sciences students, including occupational therapy students at the University of Pretoria, receive the same evidence-based practice training, their attitudes, knowledge, skills and practices in EBP remain mostly unknown. Determining these aspects in final-year students is important as it may impact their future practice. METHODS : A non-experimental cross-sectional study was conducted using the Student Evidence-Based Practice Questionnaire. The survey was electronically distributed and completed by 50 final-year healthcare sciences students. Data analysis was performed using measures of central tendency. RESULTS AND DISCUSSION : Participants have positive attitudes related to the implementation of evidence-based practice. However, gaps in practice remain. Students rate their evidence-based practice knowledge as "average", which may impact their practice after graduation. Students report that they are more skilled in certain steps of EBP than others. CONCLUSION : The survey results can be used to strengthen evidence-based practice training for healthcare sciences students, potentially improving their ability to implement evidence-based practice after graduation. Several identified barriers to the implementation of evidence-based practice may be overcome through more purposeful training. IMPLICATIONS FOR PRACTICE : • Positive attitudes towards EBP do not necessarily translate into increased practice and skills in EBP. • Educators should be aware of the challenges students experience with the different steps of EBP. • Training of healthcare science students should be developed to include all five steps of EBP. • Educating students on how to effectively use resources provided by their institutions can improve the evidence they find and apply.
Exploring the Vona du Toit Model of Creative Ability : applications, strengths, and weaknesses in occupational therapy - a systematic mapping review
Casteleijn, Daleen; Sherwood, Wendy; Coulson, Kate (Occupational Therapy Association of South Africa, 2025-12)
The Vona du Toit Model of Creative Ability (VdTMoCA) is an occupational therapy practice model rooted in the work of South African occupational therapist Vona du Toit in the 1960s and 1970s. While the model is increasingly applied in predominately South Africa and the UK and included in several pre-registration occupational therapy curricula, there is limited published literature exploring its use in clinical practice. To date, only one publication addresses its presence in occupational therapy education, and no comprehensive review has mapped its clinical application. This study aimed to fill that gap through a Systematic Mapping Review, which is suited to broad topics and provides an overview of existing literature without focusing on a single research question. A total of 30 papers were retrieved and charted. Findings indicate that the VdTMoCA is used across diverse clinical and non-clinical settings and supports therapists throughout the entire occupational therapy process. It offers a structured approach to assessing and treating clients with varying levels of volition, motivation, and occupational performance, particularly in complex mental health and forensic contexts. The model enhances clinical reasoning, justifies intervention choices, and strengthens professional identity. This review also highlights gaps in research that warrant further investigation to support evidence-based practice. IMPLICATIONS FOR PRACTICE : • The VdTMoCA is an occupational therapy practice model that guides the entire therapy process, supporting therapists in diverse clinical and non-clinical settings. • The model demonstrates utility in addressing varying levels of motivation and action, and occupational performance among clients, enhancing assessment and outcome measurement capabilities. • By enabling therapists to justify interventions based on clinical reasoning, the VdTMoCA enhances therapists' professional value and identity, particularly in addressing neglected aspects of occupational therapy, such as engagement of and effective therapy for individuals whose volition, motivation and occupational performance is severely impaired in mental health and forensic services.
Occupational therapists’ perceived ability to facilitate reasonable accommodations in the workplace for employees with major depressive disorders
Ramano, Mpho Silvia; Buys, Tania; Kotze, Carla (AOSIS, 2026-06-13)
BACKGROUND: Employees with major depressive disorder who return to work after sick leave may exhibit residual symptoms and functional limitations, which might require reasonable accommodation. In accordance with disability legislation, these employees have the right to request reasonable accommodations, and the employer must consider these requests, allowing the employee to continue fulfilling work requirements. There is a lack of research concerning the occupational therapist’s role and successes in supporting reasonable accommodation for employees with major depressive disorders. OBJECTIVES: This article aims to explore and describe occupational therapists’ perceived ability to facilitate reasonable workplace accommodations for employees with major depressive disorders. METHOD : An exploratory descriptive design was utilised, in which seven participants were interviewed individually. The authors adopted a social constructivism paradigm to understand the world in which occupational therapists live and work. An inductive analysis was carried out to formulate the themes. RESULTS : Two themes were identified from the participants’ views: (1) the dynamic process of reasonable accommodation and (2) the competencies of occupational therapists. CONCLUSION : Occupational therapists should lead the dynamic process of reasonable accommodation. To do this effectively, they must stay up to date, have the relevant skills and manage cases efficiently. CONTRIBUTION : The dynamic process of reasonable accommodation outlined in this study provides a guideline for occupational therapists to follow when implementing such adjustments. Suggested reasonable accommodations for employees with major depressive disorder may serve as valuable resources for these professionals.
Effect of aerobic exercise on depression symptoms and quality of life in patients with major depressive disorder : a systematic review protocol
Bin Muaythir, Saad; Bello, Bashir; Mshunqane, Nombeko; Ramano, Enos Morankoana; Magida, Nontembiso (BMJ Publishing Group, 2026-06)
INTRODUCTION : Major depressive disorder (MDD) is a prevalent mental illness characterised by persistent sadness, loss of interest in activities and cognitive impairment. While pharmacological and psychotherapeutic treatments remain the standard for MDD management, non-pharmacological interventions, such as aerobic exercise, have gained attention for their potential benefits in reducing depressive symptoms and improving quality of life. Although several studies have explored the effectiveness of aerobic exercise in managing MDD, there is still no comprehensive synthesis of the existing evidence. This study aims to synthesise existing evidence on the effects of aerobic exercise interventions in the management of individuals diagnosed with MDD. METHODS : The systematic review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) guidelines. A comprehensive search will be conducted across Cochrane, Medline, PEDro, CINAHL, Scopus, Web of Science and BioMed Central databases. Search terms will be developed using the Population, Intervention, Comparison, Outcome and Study design (PICOS) framework, incorporating keywords and Medical Subject Headings related to ‘Major Depressive Disorder’, ‘Aerobic Exercise’, ‘Depression’, and ‘Quality of Life’. Only intervention studies, including randomised controlled trials, quasi-experimental and pre–post intervention studies, will be included involving adults aged 18 years or older diagnosed with MDD according to standardised criteria (eg, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and International Statistical Classification of Diseases and Related Health Problems -10 (ICD-10)). For included intervention studies, the comparator will be standard care, placebo or no-exercise control groups. The primary outcome is change in depressive symptoms, and secondary outcomes include quality of life, anxiety and stress-related biomarkers. Three independent reviewers will screen studies, extract data using Covidence software (Veritas Health Innovation in partnership with Cochrane) and assess study quality using the updated Cochrane Risk of Bias 2.0 (Rob-2) tool alongside the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. If feasible, a meta-analysis will be conducted using RevMan V.5.4 (Cochrane's Review Manager), with effect sizes determined by mean differences, standardised mean differences or ORs, depending on the outcome type. This study is currently at the proposal stage, with article searches expected to begin in November 2025 and data extraction anticipated to be completed by January 2026. ETHICS AND DISSEMINATION : No ethical approval is required as this review uses existing published data. Findings will be disseminated through a peer-reviewed journal and presented at academic conferences. PROSPERO registration : CRD420251151897.
Effectiveness of mindful breathing exercises on symptom reduction and quality of life in individuals with major depressive disorder : a systematic review
Bin Muaythir, Saad; Mshunqane, Nombeko; Ramano, Enos Morankoana; Bello, Bashir; Magida, Nontembiso (AOSIS, 2026-05-22)
BACKGROUND : Major depressive disorder (MDD) is a global cause of disability, with many patients experiencing suboptimal response to conventional treatments. Mindful breathing exercises, a simple and scalable technique, have emerged as a promising non-pharmacological intervention for alleviating depressive symptoms and improving quality of life. Objectives : To evaluate the effectiveness of mindful breathing exercises on symptom reduction and quality of life in individuals diagnosed with MDD. METHOD : A systematic search of Cochrane Library, MEDLINE (PubMed), PEDro, Index to Nursing and Allied Health Literature (CINAHL), Scopus, Web of Science and BioMed Central databases was conducted from inception to September 2025. Our review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible criteria were intervention studies examining the effects of mindful breathing on depressive symptoms and quality of life in individuals diagnosed with MDD. Two reviewers independently screened the studies, extracted the data and assessed the methodological quality using the Cochrane risk of bias tool. A narrative synthesis was conducted because of heterogeneity in outcome measures and intervention protocols. RESULTS : Two studies involving 179 participants met the inclusion criteria. One study combined cognitive behavioural therapy with breathing exercises, demonstrating improvements in sleep quality, psychiatric symptoms and heart rate variability. Another study demonstrated a significant reduction in anxiety. CONCLUSION : Mindful breathing exercises are beneficial in alleviating symptoms of depression and anxiety, as well as enhancing physiological indicators in people with MDD. CLINICAL IMPLICATIONS : Our review highlights breathing techniques as an affordable, non-pharmaceutical option to conventional treatment; however, more research with rigorous outcomes is needed.
Motor Vehicle Accident Fund Botswana loss of income claimants’experiences returning to work after road traffic accidents
Modise, Gofaone Lady; Uys, Kitty; Du Plooy, Eileen (Taylor and Francis, 2026-02-04)
PURPOSE: Return-to-work (RTW) following road traffic accidents (RTAs) is essential for better health and financial outcomes. The Motor Vehicle Accident Fund (MVAF) Botswana assists loss-of-income (LOI) claimants with medical assistance, LOI compensation and facilitates RTW. Claimants’ experiences affect RTW. This qualitative study investigated barriers to and facilitators of RTW for LOI claimants at the MVAF Botswana. MATERIALS AND METHODS: Eleven LOI claimants were purposively sampled and participated in two focus group discussions. They benefited from LOI compensation between 2015 and 2020. Thematic analysis and a hybrid inductive and deductive approach were used to analyze the data via the ecological case management model. RESULTS: The main themes were health care, personal, workplace and legislation and insurance systems, which were further classified into eight subthemes related to barriers and facilitators. The combined top facilitators were (1) vocational rehabilitation, (2)medical assistance, and (3) effective case management, whilst top barriers were (1)severe injuries, (2) insufficient LOI funds, and (3) ineffective RTW case management. CONCLUSION: Effective medical case management and coordinated RTW processes are vital for RTW; equally, the severity of injury affects RTW success. CONTRIBUTION: Understanding barriers and facilitators of RTW can inform personalized RTW interventions.
Occupational therapists' and educators' experiences of the school-to-work transition for learners with mild intellectual disability
Dzhugudzha, Ntsieni Teresia; Uys, Kitty; Ramano, Enos Morankoana (SSBFNET (Center for Strategic Studies in Business & Finance), 2025-07)
Intellectual disability is a developmental disorder that markedly affects cognitive and adaptive functioning. Learners with mild intellectual disability are capable of engaging in various occupations, including activities of daily living, leisure, social interactions, and employment. Employment is frequently regarded as a critical measure of successful outcomes following education. Nonetheless, individuals with mild intellectual disabilities often exit the educational system lacking the workforce readiness skills—such as communication, social skills, self-management, responsibility, problem-solving, decision-making, and job-specific competencies—essential for sustained employment in the open labour market. Low intelligence quotients restrict community engagement. The researcher noted that South Africa does not have adequate systems to facilitate the successful transition of these learners from school to the workplace. This research investigates the experiences of educators and occupational therapists to delineate concepts related to facilitating school-to-work transitions for learners with mild intellectual disabilities. A qualitative exploratory research design was utilised. Fifteen educators and eight occupational therapists from schools for learners with mild intellectual disabilities in the Gauteng province, Tshwane region, were selected through purposive sampling. Data were collected via five focus group discussions until saturation was achieved and analysed thematically. Five primary themes were identified: challenges associated with the Differentiated Curriculum and Assessment Policy Statement (DCAPS), accomplishments within the DCAPS framework, collaborative initiatives, resource deficiencies, and learnership placement. Educators and occupational therapists could support learners in specific domains; however, they encountered systemic challenges. This study generated significant data for policymakers, the Department of Education, occupational therapists, and vocational skills training educators in schools for Learners with Special Education Needs, aimed at facilitating a successful school-to-work transition for learners with mild intellectual disabilities.
Utilizing nominal group technique to achieve consensus on a clinical decision-making tool for vocational rehabilitation at a grassroots level in South Africa
Harmse, Suzanne; Casteleijn, Daleen; Jacobs, Karen (Sage, 2026-03)
BACKGROUND : Barriers to the delivery of vocational rehabilitation have been reported as a lack of knowledge, skills and confidence in occupational therapists who deliver these services. A program aimed at overcoming these barriers was developed to provide training in the delivery of vocational rehabilitation services. The program includes three decision-making tools to facilitate not only knowledge translation but also practice changes. The tools are (1) Return-to-Work Decision Tree, (2) Performance-based Assessment Tool, (3) Job Match Tool. OBJECTIVE : The objective of the research was to obtain consensus on the acceptability and utility of the developed tools to facilitate clinical reasoning in the delivery of vocational rehabilitation services. METHODS : A nominal group technique was used to obtain consensus on the developed tools. During a second phase, participants were sent revised versions of the tools and asked to comment on the tools’ clinical utility using a four-point Likert scale. RESULTS : The Return-to-Work Decision Tree and the Performance-based Assessment Tool received a 100% agreement in terms of clinical utility with the Job Match Tool receiving a 90% agreement for clinical utility. Participants made valuable recommendations such as adding a user manual and a training workshop to facilitate implementation of the tools. CONCLUSION : The three tools developed to support clinical reasoning and decision making during the vocational rehabilitation process were reported to be acceptable by the expert participants. Further development of the Job Match Tool is recommended.
An occupational therapy programme for a psychiatric day hospital : voice of occupational therapy practitioners and patients
Masango, July; Van der Merwe, Tania Rauch; Casteleijn, Daleen; Adams, Fasloen (Wiley, 2025-09)
Occupational therapy (OT) practitioners play a critical role in supporting recovery from disruptions in occupational performance caused by mental illness, particularly within psychiatric day hospital settings. Despite this, there remains a notable absence of published evidence-based guidelines to inform the development and implementation of OT programmes in private psychiatric day hospitals in South Africa. This study aimed to evaluate an existing OT programme in such a setting, with the goal of informing the development of context-specific, evidence-based practice guidelines. A qualitative research design was employed to explore the perspectives of both OT practitioners and patients who participated in the programme. Data were collected through in-depth interviews and analysed using reflexive thematic analysis. Four key themes emerged: (1) the competent facilitator with expertise in group dynamics; (2) the therapeutic group as a cohesive and healing entity; (3) the patient as a unique individual within the recovery process; and (4) the integration of evaluation, intervention and outcomes within a coherent therapeutic process. Findings demonstrated the therapeutic potential of group-based OT led by skilled facilitators, underscoring the importance of integrating clinical reasoning, patient-centred care and group dynamics expertise into programme delivery. The study contributes to the body of knowledge advocating for structured, evidence-based OT programmes in psychiatric day hospitals, tailored to both the therapeutic goals of practitioners and the recovery needs of patients. This research provides a foundation for the formulation of evidence-based guidelines that can strengthen OT practice in private psychiatric day hospital contexts, thereby promoting mental health recovery through structured and purposeful occupation.
Undergraduate students’ experience regarding wellness support services at universities offering health sciences programmes
Lesunyane, Ramadimetja Annah; Ramano, Enos Morankoana; Van Niekerk, Karin (Springer, 2025-11-29)
Students experience academic stress when confronted with high academic workloads while adapting to university life. Studies have found that health science programmes place additional academic stress on students. Student support is an important measure implemented by universities to minimise student dropouts, reduce failure rates and enable success in academic departments in health science universities. The purpose of this study was to explore and describe the experiences of undergraduate students regarding student wellness support services implemented by universities as an intervention measure to assist students in health sciences to cope with academic demands and stress. An explorative descriptive qualitative design was employed to explore and describe the experiences of undergraduate students regarding academic student support services. Students studying towards a health science undergraduate degree at three universities in the Gauteng Province, South Africa, were recruited by email to participate in the study. Purposive sampling was used, and nineteen students consented to participate in the study. The data were collected between November 2023 and April 2024 through synchronous online focus groups that followed a semi-structured interview. Thematic analysis was used for qualitative data analysis, where transcribed data were coded, and units of meaning were grouped to formulate themes. Three themes emerged, namely: (1) support service indicators, (2) student support challenges and (3) holistic wellness support provision. The study revealed that students experience academic stress, thus signaling a need for academic support. However, students face barriers when accessing support, as universities also face limitations in providing adequate support. Universities should enhance holistic wellness support provision to foster a supportive environment that boosts the accessibility of services to meet the diverse needs of the students.
Life history : exploring the lives of women living with HIV and disability in vulnerable contexts regarding their food security
Lister, Helga Elke; Mahlangu, Judith; Pillay, Mershen (Taylor and Francis, 2024)
Multiple disadvantages can heighten the risk of food insecurity for people. Unfortunately, when we do not interrogate the cycles that arise, they remain poorly understood and, thus, inadequately addressed. Through life history methodology, we investigated the lives of two women living with human immunodeficiency virus (HIV) and disability to obtain a deeper understanding of their food security. The researchers were intermittently embedded within the community over four years and experienced many key events with the households. During this time, the lives of these women changed significantly, both because of the voluntary community intervention provided, and the shocks and stressors that impacted their lives. Three important themes developed in the analysis. Firstly, the women displayed resilience, which contributed to their food security. Notably, both women did not view their disabilities as disabling. Secondly, systemic failures not only limited food access but also compounded these women’s food insecurity. Thirdly, the international measures taken to derive population statistics of food and nutrition security (FNS) can be wholly inadequate or incorrect. This can lead to traditional food security programmes not providing a sustainable solution. Therefore, statistical information needs to be supplemented by lived realities to ensure that the community and policy response can make a meaningful difference.
The experiences of community partners on working with occupational therapy students during work-integrated learning in Gauteng, South Africa
Kwena, B.; Fourie, K.; Volpi, M.; Groenewald, R.; Maila, S.; Kritzinger, S.; Phalatse, Nthabiseng; Moosa Tayob, S. (South African Medical Association, 2025-09)
BACKGROUND : Work-integrated learning (WIL) is an essential part of the occupational therapy (OT) degree; it expands students’ knowledge and skills, and adds value to the community through the provision of primary healthcare (PHC) services. It has been noted that there is a lack of feedback from community partners working with students in the communities. Feedback from community partners is integral as it serves as a guide for training institutions and students. OBJECTIVES . To explore the experiences, and opportunities for change and growth from the community partners in Gauteng, South Africa, regarding OT final-year students during their WIL in PHC settings. METHOD : A descriptive qualitative study was conducted with participants (n=14) recruited through the purposive sampling method. Open-ended interviews were used for data collection conducted with community partners who had worked with final-year OT students. Data were analysed using a hybrid approach. Trustworthiness and rigour of the study were ensured through reflexivity, credibility, confirmability and transferability. RESULTS : The study revealed three themes as per the Kawa model representing experiences of community partners when working with OT students: (i) barriers (rocks); (ii) facilitators (driftwood); and (iii) opportunities for change and growth (spaces). CONCLUSION : This study provided insight into aspects that may be built on for further curriculum development for OT students’ WIL. Consultation with community partners is essential to ensure optimal service provision for the population with whom students work. Further studies are recommended to enhance the experiential learning paradigm in PHC settings.
The occupation of self-employment in South African informal microenterprises
Monareng, Luther Lebogang; Casteleijin, Daleen; Franzsen, Denise (Occupational Therapy Association of South Africa, 2024-04)
INTRODUCTION : Self-employment, in which individuals work for themselves in a small business or microenterprise to earn an income or generate a salary, has been encouraged to facilitate employment opportunities in South Africa. However, participation in self-employment within the community served by professionals such as occupational therapists is limited by many factors, including effective government initiatives, such as implementing the Small Enterprise Development Agency (SEDA) policies. To enable individuals and community participation in this type of work for those with occupational dysfunction, mainly persons with disabilities, professionals such as occupational therapists need to understand the structural, contextual and occupational outcomes related to self-employment. Based on the Framework for Occupational Justice, this study explored the occupation of self-employment in microenterprises in the low-resourced urban community of Alexandra Township. METHOD : A quantitative descriptive non-experimental design study was used to identify informal microenterprises in the community using a transect walk and community mapping. Structured interviews were conducted to complete a questionnaire with key informants (service providers and business owners) who provided perceptions on factors that impacted the occupational outcomes of microenterprises. RESULTS : Structural and contextual factors from the participants' experience resulted in unjust occupational outcomes, which indicates that occupational rights, particularly participation, choice and balance, were negatively affected by the lack of opportunities, such as jobs. Occupational marginalisation and imbalance were reported since many businesses lacked adequate and appropriate space for trade. Some business owners, however, reported just occupational outcomes related to the occupational right for meaningful occupation in providing a service to the community and financial income to support themselves and their families. CONCLUSION : Occupational therapists need to play various active roles in raising the consciousness of unjust occupational outcomes and support for just occupational outcomes that are achieved in engagement in self-employment in informal microenterprises. IMPLICATIONS FOR PRACTICE : Occupational therapists should take note of the factors and occupational outcomes of being self-employed identified in this study and consider the roles they could play in expediting success in this occupation for clients. Occupational therapists could assume: • A collaborative role, such as referring and working with various key role players or sectors in the interest of sourcing and providing opportunities for skills development for those entering self-employment, particularly in entrepreneurial training. This may include working with the government (e.g., Department of Labour and Small Enterprise Development Agency), private sector (e.g., yes4youth), other professions (social workers and industrial psychologists) and organisations for persons with disabilities (e.g., Disabled People South Africa). • A researcher role by conducting further research in this field, e.g., the development of an evidence-based framework on self-employment for occupational therapists. More research is still needed on, e.g., domains such as performance patterns, performance skills and client factors related to self-employment for persons with disabilities. • An educator's role by incorporating and teaching content on self-employment as an occupation when training occupational therapy students. • A clinical role, where they could assist with adaptations to the skills, tasks or environment to facilitate engagement in self-employment. Essential aspects to consider by the occupational therapist together with their clients during the collaborative occupational therapy process include, but are not limited to, o The client's motivation, dedication and whether self-employment is the client's primary choice. o The client's potential to be self-employed and their level of resilience in dealing with factors affecting self-employment in the informal labour sector.
Occupational therapy practice in psychiatric day hospitals : a scoping review
Masango, July; Casteleijin, Daleen; Adams, Fasloen; Van der Merwe, Tania Rauch (Occupational Therapy Association of South Africa, 2024-11)
INTRODUCTION : The aim of this scoping review was to explore whether clear guidelines for the practice of occupational therapists in psychiatric day hospitals exist, both locally and globally. METHODOLOGY : Searches were conducted in January 2024; 38 articles were screened and 22 were identified for data extraction. Articles were imported onto Covidence software. Data charting was done, and data were exported into a Microsoft Excel sheet, where content analysis was performed based on the review's objectives. Synthesis of the results was done through discussion and reported according to the PRISMA for Scoping Reviews guidelines. RESULTS : Thirty-eight articles were included but only 22 were relevant. Group therapy, individualised therapy, vocational and community workshops were identified as common modes of intervention in psychiatric day hospitals. Occupation-based activities are integral to intervention. However, there was no explicit definition regarding the role of occupational therapy and practice guidelines for psychiatric day hospitals. CONCLUSION : The general scope of occupational therapy remains the same for overnight hospitals, day hospitals and community-based centres. It is mainly occupation-centred, function-orientated, and patient-centred. However, there remains ambiguity on specific practice principles and guidelines that clearly define the role of occupational therapists in day hospitals. There is a need for occupational therapy practice guidelines specific for psychiatric day hospitals. IMPLICATIONS FOR PRACTICE : • The study provides valuable insights into the current knowledge and availability regarding the role and scope of practice for occupational therapy in the rapidly expanding psychiatric day hospital setting, emphasising areas for further development. • Tangible evidence was identified on therapeutic principles, practice approaches, program content, and guidance for resource allocation in psychiatric day hospitals, which can be translated into practical guidelines. • Ultimately, the results inform occupational therapy service delivery, solidify the profession's role in psychiatric care, and contribute towards National Health Insurance (NHI) policy development.
Occupational therapists' perceptions of a school-to-work transition programme for learners at a special educational needs school
Msimango, Henry; Phalatse, Nthabiseng; Germishuys, Rienie Marie; Jamieson, Megan; Avenant, Kay-Lee; Rameetse, Thabang (Occupational Therapy Association of South Africa, 2024-08)
INTRODUCTION : South Africa has a high unemployment rate and few post-school employment opportunities for learners with disabilities. School-to-work transition programmes in special educational needs schools prepare learners with disabilities for work in the open labour market, optimizing post-school employment opportunities. Occupational therapists are the main key role players in facilitating school-to-work transition programme in many contexts of education. AIM: This study explores the perceptions of occupational therapists of a school-to-work transition programme at the school for learners with special needs. METHODS : This study was a descriptive qualitative study. The researchers conducted semi-structured interviews with six occupational therapists involved in delivering the programme at the school. To ensure ethical compliance, we obtained clearance from the UP-Research Ethics Committee. The collected data underwent reflective thematic analysis for interpretation. FINDINGS : Three prominent themes emerged from the data analysis: (1) The Significance of the Programme: Participants highlighted the importance and benefits of the program. (2) Facilitators affecting school-to-work transition programme: Various factors that positively influenced the smooth transition from school to the workforce were identified and discussed. (3) Barriers to school-to-work transition programme: Participants also pointed out obstacles and challenges that hindered the successful transition from school to the workforce. CONCLUSION : The school-to-work transition programme was influenced by personal, environmental, and occupational barriers and facilitators. The findings highlighted that the benefits of the programme should be viewed in a broader context, as learners mature and develop self-confidence. The value of the programme thus extends beyond employment opportunities. IMPLICATIONS FOR PRACTICE : The research findings inform barriers that need to be focused on in order to have a successful and effective school-to-work transition programme. There are facilitators that show the perceived effectiveness of the school-to-work transition programme that could assist in motivating for more assistance from stakeholders of the school.
Clinical utility of MODAPTS during work assessment : perceptions of South African occupational therapists
Buys, Tania Lee; Harmse, Suzanne; Slawson, Caitlin Christina; Rapolai, Boitumelo Thamirah; Rapotu, Kwena Dorah; Furniss, Sian Gabrielle; Jordaan, Karma (Occupational Therapy Association of South Africa, 2024-04)
INTRODUCTION : Clinical utility is an important attribute in selecting an assessment tool. The study aimed to determine the perceptions of South African occupational therapists of the clinical utility of Modular Arrangement of Predetermined Time Standards (MODAPTS) work samples when assessing a client’s work ability. The research objectives were to determine whether MODAPTS is perceived to be credible, practical, useful, and easy to use. METHODOLOGY : A quantitative, cross-sectional, descriptive research design was used. Non-probability sampling with elements of voluntary response- and snowball sampling was used to recruit respondents. An electronic questionnaire was developed using Qualtrics, which was distributed electronically via the Occupational Therapy Association of South Africa, WhatsApp and Telegram. RESULTS : Data were based on 52 completed questionnaires, analysed through descriptive statistics. MODAPTS was perceived as practical, useful, credible, and asy to use in practice. Main barriers to the use of MODAPTS included the timeliness of developing work samples, lack of MODAPTS training, and having other more useful and reliable assessment tools. Experienced occupational therapists used MODAPTS more often than inexperienced occupational therapists. CONCLUSION : Clinical utility of work samples developed using MODAPTS has been confirmed. This supports the use of work samples developed using MODAPTS as part of work assessments as a cost-effective, practical tool. IMPLICATIONS FOR PRACTICE : • Development of contextually relevant work samples. • Use of MODAPTS work samples as an outcome measure during intervention. • Application during rehabilitation goal setting. • Cost effective application of MODAPTS work samples in a variety of settings.
Appropriateness of the standard manual wheelchair for occupational performance by wheelchair users in the Thulamela Municipality of the Vhembe District, Limpopo, South Africa
Lister, Helga Elke; Nethathe, Khumbelo; Naidoo, Deshini; Govender, Pragashnie (Occupational Therapy Association of South Africa, 2024-08)
BACKGROUND : Wheelchairs are an essential assistive device that assists with the facilitation of engagement in occupation especially those that require mobility. Anecdotally, there have been identified gaps in implementation of areas of wheelchair service delivery which included the referral, assessments, prescription, user and provider training, follow up and maintenance. Therefore, there was a need to investigate the appropriateness of the standard manual wheelchair for occupational performance in Thulamela Municipality Vhembe District, Limpopo. METHODS : An observational cross-sectional descriptive design using simple random sampling was used to select n=60 wheelchair users who were issued with standard manual wheelchairs between 2014 and 2018. The Wheelchair Outcome Measure was used to investigate the participants' level of satisfaction in engagement in ADL and IADL and the suitability of the wheelchair in terms of the user’s comfort and satisfaction with positioning and prevention of skin breakdown. Descriptive statistics were used to analyse the data. RESULTS : The wheelchair users viewed activity participation in the home as important and were generally satisfied with their standard manual wheelchairs while performing occupational activities at home and outside the home. A total of (n=46; 78%) of the participants felt comfortable in their wheelchair. CONCLUSIONS : Wheelchair prescription should take into consideration the occupational choices of the user. Further qualitative studies to explore the factors that determined the participants' choices for their activity participation goals should be undertaken.
Identifying the gap in assessing activities of daily living in resource-constrained rural settings : an integrative review of existing frameworks and instruments
McAdam, Jennifer Claire; Casteleijn, Daleen; Franzsen, Denise (Occupational Therapy Association of South Africa, 2024-12)
INTRODUCTION : The non-availability of indoor piped water and electricity results in alternate forms of personal care and domestic tasks in resource-constrained rural settings. This article examines the applicability of existing measures for the contextual assessment of basic and instrumental Activities of Daily Living (bADLs and iADLs) in these settings. METHOD : An integrative review guided by the approach of Lübbe et al. (2020) was conducted. Structured database searches of CINAHL, Scopus and Sabinet identified published articles which were subjected to eligibility criteria. Microsoft Excel was used to synthesize data RESULTS : The search strategy yielded 591 articles that met the inclusion criteria, from which 187 ADL instruments were identified. Three instruments suited to resource-constrained rural settings were identified. CONCLUSION : Occupational therapists should consider that existing ADL frameworks and instruments appear silent on the impact of limited access to household amenities in resource-constrained settings. This constitutes epistemic injustice as many rural households globally do not have potable water or adequate household energy supply. Global South occupational therapy curricula must include contextually relevant ADL frameworks and development of contextually relevant instruments should be prioritised. IMPLICATIONS FOR PRACTICE : The findings suggest that existing ADL instruments have limitations when utilised in the Global South, particularly in resource-constrained rural settings. As such, occupational therapists practicing in such settings need to interpret instrument scores with caution and apply contextual clinical reasoning in the best interests of service users. Furthermore, training institutions in the Global South must ensure that the limitations of existing ADL frameworks, models and instruments are made overt within curricula and that research efforts are directed towards the development of contextually relevant ADL instruments.
Barriers and facilitators of return to work for loss of income claimants : healthcare workers’ perspectives
Modise, Gofaone Lady; Uys, Catharina Jacoba Elizabeth; Du Plooy, Eileen (AOSIS, 2025-06)
BACKGROUND : Road traffic accidents (RTAs) are a global and public health concern affecting a third of the world’s population mainly in low- to middle-income countries, particularly affecting young people. Returning to work (RTW) following an RTA is essential for better health and financial outcomes. The motor vehicle accident (MVA) Fund Botswana assists loss-of-income (LOI) claimants with medical assistance, compensates for loss, advocates and facilitates RTW. OBJECTIVES : The study aims to identify barriers to and facilitators of RTW for LOI claimants as experienced by health care workers (HCWs). METHOD : A qualitative explorative design included six healthcare workers who had worked with the MVA Fund on RTW for at least 5 years through purposive sampling. Data collection was done using a focus group discussion. Thematic analysis was conducted using Atlas.ti, with data interpretation guided by the ecological case management model. RESULTS : The main themes were healthcare systems, legislation and insurance systems, personal and workplace systems, which were further classified into eight subthemes relating to barriers and facilitators. Barriers included ineffective case management and how claimants perceived work. Facilitators included clear insurance RTW guidelines and workplace support and education level. CONCLUSION : Successful RTW can be achieved through multidisciplinary collaboration of HCWs. While legal and healthcare systems play vital roles in RTW, personal factors and workplace systems cannot be ignored. CONTRIBUTIONS : Understanding the barriers to and facilitators of RTW will assist in implementing RTW interventions to improve patient outcomes, health, livelihoods, quality of life and guide RTW operations to ensure a coordinated process in the insurance industry in Africa.

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