Occupational therapists form part of the vocational rehabilitation multidisciplinary team, in returning patients back to work after any form of injury or illness. Among the services that they provide is work intervention procedures, which is comprised of different components that are implemented to rehabilitate patients’ work occupation, in order to ensure entry into, and/or return to the open labour market. The right of South African citizens’ opportunity to work is protected by specific legislation. When this right is affected by illness, injury or disability, the National Health Insurance system intervenes and ensures adequate healthcare services that are delivered equitably. The public healthcare services are delivered to over 84% of the South African population, of which a majority is dependent on public healthcare for medical intervention, including rehabilitation from different professions such as occupational therapists. To rehabilitate patients’ work occupation, occupational therapists follow different procedures as part of intervention. When researched, however, it was found that when this intervention was executed, it occurred haphazardly. The aim of the study was to explore the occupational therapy work intervention procedures that should be implemented by occupational therapists in the Gauteng public healthcare sector. A qualitative, explorative and descriptive research design was used. Data was collected through a workshop, working from an appreciative stance. Purposive sampling was used. Seventeen occupational therapists who practised in vocational rehabilitation and implemented work intervention procedures in the Gauteng public healthcare sector attended the workshop. Data was analysed using the creative hermeneutic data analysis method. The work intervention procedures for occupational therapists were generated. Client-centredness was identified to be at the heart of work intervention procedures, which entail different components, such as legislation, empowerment, assessment, planning, prevocational and vocational skills, work visit, job analysis, work hardening and conditioning, placement and follow-up. Occupational Therapy work intervention procedures for the public healthcare sector in the Gauteng province, were successfully explored and generated. The results showed that although there are procedures that can be followed in work intervention, the implementation process is not linear, and the procedures should be customised to individual patients. / Dissertation (MOccTher)--University of Pretoria, 2019. / Occupational Therapy / MOccTher / Unrestricted

Made available in DSpace on 2016-04-29T13:17:52Z (GMT). No. of bitstreams: 1 Luciana Di Domizio Amaral.pdf: 1066199 bytes, checksum: 15d7d49ef3a0dc3c35b17affd444f1d1 (MD5) Previous issue date: 2014-03-14 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The occurrence of stereotypy is one of the criteria for Autism Spectrum Disorder diagnosis. The stereotypy is frequent and intense in autistic individuals and may cause academic and social damage. Various areas of knowledge, including behavior analysis, have tried to develop strategies to weaken stereotypy of autistic individuals. This study aimed to develop a systematic review and methodological evaluation of studies that used analytical-behavioral interventions for weakening motor and vocal stereotypy in autistic individuals published between 1999 and 2013. The studies from this period were selected by PubMed, Medline, PsycINFO and Lilacs bibliographic indexes. It were analyzed 36 articles. The results indicated that 106 authors developed procedures applied with 73 participants between 03 and 49 years old. The use of single subject design was unanimous in the different studies analyzed. Studies evaluating the agreement between observers had high levels of concordance. The procedures most used to weaken stereotypy were environmental enrichment matched stimulation and procedure of interruption and redirection of response (RIRD), however, several procedures were used, for example, procedures of self-management, self-recording, the response blocking, response cost, overcorrection, visual cues, differential reinforcement, verbal reprimands, replacement of edible consequences, functional communication training, verbal operant training, and others. Although results varied between participants, it was shown that weakening the stereotypy is possible by most of the procedures used in the studies reviewed. The 28 studies that evaluated the function of stereotypy and the 03 studies that did not made the functional analysis assessment considered that stereotypy was automatically reinforced. The authors of 03 studies considered that stereotypy was maintained by socially mediated consequences, beyond the sensory consequences. This review pointed methodological weaknesses in the reviewed studies: lack of stability of the measurements made, and lack of generalization and follow-up tests / A ocorrência de estereotipia é um dos critérios para o diagnóstico de Transtorno do Espectro Autista. A estereotipia é frequente e intensa em indivíduos autistas e pode acarretar prejuízos acadêmicos e sociais. Diversas áreas do conhecimento, entre elas a análise do comportamento, têm buscado desenvolver estratégias para enfraquecer a estereotipia apresentada por indivíduos autistas. O presente estudo teve o objetivo de realizar uma revisão sistemática e uma avaliação metodológica dos estudos que empregaram intervenções analítico-comportamentais para o enfraquecimento de estereotipia motora e vocal em indivíduos autistas publicados entre 1999 e 2013. Os estudos desse período foram selecionados por meio dos indexadores bibliográficos PubMed, Medline, PsycINFO e Lilacs. Foram analisados 36 artigos. Os resultados indicaram que 106 autores desenvolveram procedimentos aplicados em 73 participantes entre 03 e 49 anos de idade. Foi unânime o uso do delineamento de sujeito único nas diferentes pesquisas analisadas. Os estudos que avaliaram o acordo entre observadores obtiveram índices altos de concordância. Os procedimentos mais frequentemente empregados para enfraquecer a estereotipia foram o enriquecimento ambiental do tipo estimulação equivalente e o procedimento de interrupção e redirecionamento da resposta (RIRD), entretanto, foram utilizados diversos procedimentos, como os procedimentos de auto-monitoramento, de auto-registro, de bloqueio de resposta, de custo de resposta, de hipercorreção, de pistas visuais, de reforçamento diferencial, de reprimendas verbais, de sobreposição de consequências comestíveis, de treinamento de comunicação funcional, de treino de operantes verbais, entre outros. A maioria dos procedimentos empregados nos estudos revistos mostrou-se capaz de enfraquecer a estereotipia embora os resultados tenham variado entre participantes. Os 28 estudos que avaliaram a função da estereotipia e 03 dos estudos que não fizeram a avaliação funcional consideraram que a estereotipia era reforçada automaticamente. Os autores de 03 estudos consideraram que a estereotipia era mantida por consequências mediadas socialmente, além das consequências sensoriais. A presente revisão apontou como fraquezas metodológicas nos estudos revistos falta de estabilidade das medidas efetuadas e escassez de testes de generalização e de follow-up