The current democratic climate in South Africa, along with current educational reform has called for a re-consideration of assessment and intervention procedures in the education and psychology context. Historical procedures of assessment and intervention programmes have been seen to be culturally biased, unfair, and unethical to children. These methods have been further regarded as too simplistic. A call for an approach to assessing and supporting children, which takes into consideration many factors of the child’s environment, has been placed. This study aimed to investigate the effectiveness of the constructivist ecosystemic approach to assessment and intervention used with a case study, Matthew, who was assessed and supported in this approach prior to the onset of this study. A constructivist, ecosystemic assessment process, The Initial Assessment and Consultation (IAC) was used in understanding the child’s development. Such an assessment process called for an ecosystemic intervention programme, including, learning support through the application of the Cognitive Approach to Literacy Instruction (CATLI) as well as play therapy for the child and parent counselling for the parents. Methods of qualitative data collection were used, such as surveys completed by all the participants and extant data, such as learning support exams, lesson plans and a journal as well as counselling process notes. Thematic content analysis was employed to analyse the data. The findings of this study suggest that a holistic constructivist ecosystemic approach to assessment and interventions is a viable process in understanding and supporting an underachieving anxious child. However, it is acknowledged that a considerable body of research needs to be achieved before this finding can be considered conclusive. In addition, certain constraints to using this approach were acknowledged, such as time and expertise.

Hintergrund: Triage und Ersteinschätzung von Patienten in der Krankenhaus-Notaufnahme als Instrument der Prozeßgestaltung. Übersicht: In den vergangenen Jahren zeigte sich deutschlandweit ein Trend. Die Versorgung von Patienten in den Notaufnahmen der Krankenhäuser erlangt eine immer größere Bedeutung. Bedeutendste Ressource in der Notaufnahme ist die ärztliche Arbeit. Diagnosestellung und Festlegung der Therapie sind die wesentlichen Leistungen. Es ist entscheidend, die Prozessqualität am Punkt des Erstkontaktes des Notfallpatienten mit dem Krankenhaus zu verbessern. Das Universitätsklinikum Dresden eröffnete 2012 mit der Konservativen Notaufnahme (KNA-S1) eine neue, interdisziplinäre Funktionsstelle. Organisatorische Intervention war die Entlastung und Steuerung der Ressource „Arbeitszeit Arzt“. Es wurde das Manchester Triage System als Steuerungsinstrument implementiert mit den Zielen: • Optimale Nutzung der Infrastruktur • Neu definierter und verbesserter Ablauf der Integration von Notfallpatienten in den Behandlungsprozeß und den Geschäftsprozeß des UKD. • Entwicklung von Handlungsempfehlungen für das Pflegepersonal für Maßnahmen am Patienten vor Arztkontakt Schlussfolgerungen: Die strukturierte Ersteinschätzung von Patienten ist ein zielführendes Instrument, um den organisatorischen Reifegrad des Workflows in der Notaufnahme zu erhöhen. Auf dieser Grundlage entwickelte Handlungsempfehlungen für das Pflegepersonal schaffen für Patienten, Ärzte und Pflegepersonal ein optimiertes, Risiko-reduziertes Umfeld. / Background: Triage and initial assessment of patients in Emergency Departments as organizational tool for process improvement. Summary: A trend occurred throughout Germany during the past years. Hospital Emergency Departments achieve increasing importance in patient care. Crucial resource in the ED is physician´s work and authority for diagnosis and therapy. It is important to improve process quality at the point of emergency patient´s first contact to hospital. In 2012 University Hospital Dresden established a new interdisciplinary infrastructure in emergency care for medical and neurological patients (KNA-S1). Organizational intervention has been to relieve and control workload and schedule of the physicians. The Manchester Triage System was implemented as instrument for process control aiming: • Optimized utilization of resources • improved workflow of how emergency patients are introduced into treatment and hospital workflow • Development of guidelines for nursing staff to accomplish appropriate procedures on patients before seeing the physician first Conclusion: Operating an initial assessment on emergency patients leads to improvement of quality and proficiency throughout the operating procedures of an Emergency Department. Guidelines for nursing staff on this foundation will create an optimized and risk reduced environment for patients, physicians and all medical professionals in the ED.

Made available in DSpace on 2016-06-02T20:44:11Z (GMT). No. of bitstreams: 1 4833.pdf: 1672486 bytes, checksum: 97e30e776da258d285f60832bd38e819 (MD5) Previous issue date: 2012-12-18 / Occupational therapy is constituted as a field of knowledge and service that makes use of human activities, such as a differentiated technology and public policy consistent with recent mental health. Currently, occupational therapy in the mental health field makes use of different benchmarks for the development of their practice, for which the main objectives are to broaden health care and the possibility of redemption citizenship rights of people with a mental disorder. Note the importance of verifying how occupational therapists that are inserted into the network of mental health services perform the assessment of user demands on their performance scenarios. The present study aimed to understand the forms of assessment used by occupational therapists in different equipment that make up the network of mental health services and to identify the admission criteria used by occupational therapists to users of mental health services. This is a descriptive cross-sectional case study, which made use of a qualitative approach. Data collection was through interviews with occupational therapists inserted in mental health services in a health region of a Regional Health Department of the State of São Paulo. Data analysis was performed using the method of thematic analysis, which allowed the identification of categories of analysis. The results showed that, in its entirety, the respondents are women, with service time between nine months and eighteen years. The network of services in the area chosen for the data collection relied on equipment ranging from basic care, such as the Center for Support Family Health (NASF) and minimum teams entered in basic health units, up clinics, psychosocial care center (CAPS) and psychiatric hospital. With respect to performing the initial assessment, the respondents include this point in the process of work as important to meet the user's needs and that the same demand. In most cases, the initial evaluation is conducted in informal format, with tools built by professionals in their own practices. People with chronic mental illnesses are admitted to occupational therapy services, mostly. It is expected that the study will help in the construction of technical criteria for admission from users of occupational therapy services in mental health, the expansion of knowledge and ideas about the practice of occupational therapists in mental health, as well as contributions to bring about forms initial assessment of the occupational therapist who works in the area of mental health. / A terapia ocupacional se constitui como área do conhecimento e de assistência que faz uso das atividades humanas, como uma tecnologia diferenciada e coerente com as políticas públicas de saúde mental recentes. Na atualidade, a terapia ocupacional no campo da saúde mental faz uso de diferentes referenciais para o desenvolvimento de sua prática, para os quais os principais objetivos são a ampliação do cuidado e a possibilidade de resgate dos direitos de cidadania de pessoas com algum transtorno mental. Observa-se a importância de se verificar como os terapeutas ocupacionais inseridos na rede de serviços de saúde mental realizam a avaliação das demandas dos usuários em seus cenários de atuação. O presente estudo teve como objetivos compreender as formas de avaliação utilizadas pelos terapeutas ocupacionais nos diferentes equipamentos que compõem a rede de serviços de saúde mental e identificar os critérios de admissão utilizados pelos terapeutas ocupacionais para acolher os usuários de serviços de saúde mental. Trata-se de um estudo de caso transversal descritivo, que fez uso da abordagem qualitativa. A coleta de dados se deu por meio de entrevista com terapeutas ocupacionais inseridos nos equipamentos de saúde mental em uma região de saúde de um Departamento Regional de Saúde do Estado de São Paulo. A análise dos dados foi realizada por meio do método de análise temática, que possibilitou a identificação de categorias de análise. Os resultados mostraram que, em sua totalidade, os profissionais entrevistados são mulheres, com tempo de serviço entre nove meses e dezoito anos. A rede de serviços da região escolhida para a coleta de dados contou com equipamentos que vão desde a atenção básica, como Núcleo de Apoio a Saúde da Família (NASF) e equipes mínimas inseridas em Unidades Básicas de Saúde (UBS), até ambulatórios, Centros de Atenção Psicossocial (CAPS) e hospital psiquiátrico. Com relação à realização da avaliação inicial, as entrevistadas compreendem esse momento do processo de trabalho como importante para conhecer o usuário e as necessidades que o mesmo demanda. Em sua maioria, a avaliação inicial é realizada em formato informal, contando com instrumentos construídos pelas próprias profissionais em suas práticas. São admitidos nos serviços de terapia ocupacional, pessoas com transtornos mentais crônicos, em sua maioria. É esperado que o estudo contribua para a construção de critérios técnicos de entrada dos usuários nos serviços de terapia ocupacional em saúde mental, para a ampliação do conhecimento e suscite reflexões acerca da prática dos terapeutas ocupacionais na área da saúde mental, assim como possa trazer contribuições acerca das formas de avaliação inicial do terapeuta ocupacional atuante na área de saúde mental.

In 1982, a new model of psycho-educational assessment, called the Initial Assessment and Consultation Approach (IAC), was introduced into the Education Clinic of the Division of Specialised Education at the University of the Witwatersrand (WITS). It has continued to be used in the new Emthonjeni Centre at WITS University. The IAC assessment model was developed in response to criticisms and limitations of existing assessment practices. It represents an approach that is client oriented, in that it encourages consultants and clients to arrive together at their own decisions. Key to the model is a joint problem-solving approach, where the concept of the client’s control, consent and commitment are imperative. The aim of this study was to explore student consultants’ perceptions of the IAC model of assessment. More specifically, the study explored the perceptions of the effectiveness of the IAC as a tool for psycho-educational assessment; the student consultants’ opinion regarding the model and lastly past students’ use of the IAC approach at internship sites or places of work. The results of the study were qualitatively examined through the use of thematic content analysis, which provided rich description participants’ opinions. The sample consisted of forty respondents. Information letters were distributed to all participants and data was gathered through the use of an online questionnaire. The questionnaire was structured specifically to elicit the participants’ perceptions of the IAC model of psycho-educational assessment. The results indicate that the IAC is perceived as an effective approach to psycho-educational assessment, by student consultants at WITS University, and many of the principles of the approach are continued to be adopted by past students at their internship sites or places of work.

Hintergrund: Triage und Ersteinschätzung von Patienten in der Krankenhaus-Notaufnahme als Instrument der Prozeßgestaltung. Übersicht: In den vergangenen Jahren zeigte sich deutschlandweit ein Trend. Die Versorgung von Patienten in den Notaufnahmen der Krankenhäuser erlangt eine immer größere Bedeutung. Bedeutendste Ressource in der Notaufnahme ist die ärztliche Arbeit. Diagnosestellung und Festlegung der Therapie sind die wesentlichen Leistungen. Es ist entscheidend, die Prozessqualität am Punkt des Erstkontaktes des Notfallpatienten mit dem Krankenhaus zu verbessern. Das Universitätsklinikum Dresden eröffnete 2012 mit der Konservativen Notaufnahme (KNA-S1) eine neue, interdisziplinäre Funktionsstelle. Organisatorische Intervention war die Entlastung und Steuerung der Ressource „Arbeitszeit Arzt“. Es wurde das Manchester Triage System als Steuerungsinstrument implementiert mit den Zielen: • Optimale Nutzung der Infrastruktur • Neu definierter und verbesserter Ablauf der Integration von Notfallpatienten in den Behandlungsprozeß und den Geschäftsprozeß des UKD. • Entwicklung von Handlungsempfehlungen für das Pflegepersonal für Maßnahmen am Patienten vor Arztkontakt Schlussfolgerungen: Die strukturierte Ersteinschätzung von Patienten ist ein zielführendes Instrument, um den organisatorischen Reifegrad des Workflows in der Notaufnahme zu erhöhen. Auf dieser Grundlage entwickelte Handlungsempfehlungen für das Pflegepersonal schaffen für Patienten, Ärzte und Pflegepersonal ein optimiertes, Risiko-reduziertes Umfeld. / Background: Triage and initial assessment of patients in Emergency Departments as organizational tool for process improvement. Summary: A trend occurred throughout Germany during the past years. Hospital Emergency Departments achieve increasing importance in patient care. Crucial resource in the ED is physician´s work and authority for diagnosis and therapy. It is important to improve process quality at the point of emergency patient´s first contact to hospital. In 2012 University Hospital Dresden established a new interdisciplinary infrastructure in emergency care for medical and neurological patients (KNA-S1). Organizational intervention has been to relieve and control workload and schedule of the physicians. The Manchester Triage System was implemented as instrument for process control aiming: • Optimized utilization of resources • improved workflow of how emergency patients are introduced into treatment and hospital workflow • Development of guidelines for nursing staff to accomplish appropriate procedures on patients before seeing the physician first Conclusion: Operating an initial assessment on emergency patients leads to improvement of quality and proficiency throughout the operating procedures of an Emergency Department. Guidelines for nursing staff on this foundation will create an optimized and risk reduced environment for patients, physicians and all medical professionals in the ED.