During occupational therapy training in South Africa, students are expected to consider cultural differences when working with patients. This study considered the training offered to students in terms of cultural diversity and the perceptions of 47 novice community service occupational therapists about their cultural competence as well as how these perceptions had changed after three years of clinical practice. Results indicate that all six participating universities offer training in cultural diversity although university respondents feel this is affected by time, students’ attitudes and their inability to reflect. Most newly qualified occupational therapists felt the training was adequate, although they reported difficulty in working with patients from other cultures in clinical practice. The perceived cultural competency level of the newly qualified respondents varied with some respondents still needing to develop awareness and knowledge and others already extending themselves in terms of cultural skill, encounters and cultural desire. Some used rules and knowledge to guide their intervention and language was seen as a major barrier to practicing culturally appropriate occupational therapy, Three years later three respondents, who could be considered competent occupational therapists, reported using reflection in practice enabled them to consider culture from their clients’ unique perspective. They felt personal experience, opportunities from classroom experiences, fieldwork exposure and professional development activities should be used to strive toward becoming culturally competent. The importance of having relevant resources available was highlighted. Recommendations for occupational therapy curriculum development in terms of cultural competence in South Africa are therefore suggested.

M.Sc. (Occupational Therapy), Faculty of Health Sciences, University of the Witwatersrand, 2011 / Aim: To compile an assessment protocol, comprising of appropriate assessment methods, which can be used to assess activity participation in those suffering from mental illness. Research methods: An audit of existing performance-based instruments was carried out, and thereafter focus groups with clinicians were conducted. The methods of assessment were collected through review of existing performance-based assessments and by means of discussion groups with occupational therapists in mental health care. Following this the Activity Participation Assessment protocol was compiled. The content validity was then investigated through expert review. Results: Assessment methods for the domains of the Activity Participation Assessment were determined. Common methods of assessment included interviewing, activities, collateral information and standardised assessments. The content validity indices for all domains of assessment were above the 0.80 recommendation for new instruments. Conclusion: The Activity Participation Assessment has good content validity and can be used in the clinical setting.

A RESEARCH REPORT SUBMITTED TO THE FACULTY OF HEALTH SCIENCES, SCHOOL OF THERAPEUTIC SCIENCES, UNIVERSITY OF THE WITWATERSRAND, JOHANNESBURG, IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE IN OCCUPATIONAL THERAPY JOHANNESBURG, APRIL 2015 / Studies to determine which underlying motor deficits have the greatest impact on improvement in functioning within activities of daily living in stroke patients are nonexistent with regard to the South African context. Effective stroke rehabilitation is essential due to rapid discharge rates and therefore it is important to focus on the motor deficit that will contribute most significantly to function. Patients from the ages of 35 to 85, who had suffered a stroke and were admitted to a private, neurological, rehabilitation facility in Johannesburg gave consent to participate in three outcome measures determining adequacy of balance (Berg Balance Scale), upper limb movement (Frenchay Arm Test) and gait (Timed Up-and-go Test) as well as one outcome measure determining level of functioning within activities of daily living (Functional Independence Measure). Results from the pre- and post-tests indicated that all participants improved during the time of rehabilitation. The findings of the outcome measures for each of the three different motor components were correlated with functioning in ADLs for each patient. The results showed that balance had the strongest correlation with functioning in ADLs, followed by upper limb movement, and then gait. The use of the FIM as a functional measure appeared to have some limitations and is not standardised to be used within the South African context.

Syfte: Syftet med studien var att beskriva omvårdnadspersonalens erfarenhet av handledning från arbetsterapeuter inom gruppboende för vuxna personer med neuropsykiatriska funktionsvariationer och/eller intellektuella funktionsvariationer. Metod: Studien är baserad på en kvalitativ ansats med semistrukturerade intervjuer för att undersöka deltagarnas erfarenheter. Tio deltagare från sex olika kommuner i spridda delar av Sverige medverkade i studien. Vid bearbetning av det insamlade materialet användes kvalitativ innehållsanalys där materialet transkriberades, kondenserades, kodades och kategoriserades. Resultat: Analysen av intervjumaterialet resulterade i tre kategorier; handledningens struktur, behov och tillgänglighet av arbetsterapeut samt betydelsen av handledning. Resultatet från studien visar att handledningen bidrog till trygghet hos omvårdnadspersonalen i utförandet av arbetsterapeutiska insatser samt utgjorde ett värdefullt tillfälle för nya idéer och synsätt att utvecklas. Vid bristfällig handledning och andrahandsinformation upplevde omvårdnadspersonalen en osäkerhet vid utförandet av arbetsterapeutiska insatser. Resultatet visade även att deltagarna önskade att arbetsterapeuten var mer lyhörd gällande omvårdnadspersonalens åsikter och erfarenheter. Slutsats: Studien har bidragit till ökad insikt i omvårdnadspersonalens erfarenhet av arbetsterapeutisk handledning och områden inom handledning som kan utvecklas. / Purpose: The aim of this study was to describe healthcare workers experience of supervision from occupational therapists within group homes for adult people with neurodevelopmental disorders and/or intellectual disabilities. Methods: The study is based on a qualitative method with semi-structured interviews to examine the participants experience. Ten participants from six municipalities from different parts of Sweden participated in the study. When processing the collected material, a qualitative content analysis was used where the material was transcribed, condensed, coded and categorized. Results: The analysis of the interview material resulted in three categories; the structure of the supervision, the needs and availability of the occupational therapist and the importance of supervision. The results of the study show that the supervision contributed to the feeling of safety for the healthcare workers in the performance of occupational therapy interventions and constituted a valuable occasion for new ideas and viewpoints to be developed. In case of insufficient supervision and second-hand information, the healthcare workers experienced an uncertainty in the performance of occupational therapy interventions. The result also showed that the participants wanted the occupational therapist to be more perceptive to the healthcare workers opinions and experiences. Conclusion: The study has contributed to increased insight into the healthcare workers experience of occupational therapy supervision and areas within supervision that should be developed.

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Syfte Syftet med denna uppsats är att undersöka hur bildterapeutiskt arbete, både bedömning och behandling, beskrivs utifrån anknytning och anknytningsskador för att ge en översikt om kunskapsläget kring detta område. Metod En allmän litteraturstudie som bygger på ett antal tematiserande forskningsfrågor av ett urval artiklar som beskriver bildterapeutiskt bedömnings- och behandlingsarbete kopplat till anknytning och anknytningsskador. Resultat Anknytningen mellan barnet och dess förälder kan utvidgas till att omfatta andra anknytningsrelationer som till exempel terapeut-klient och mellan individer i parrelationer. Beroende på om anknytningen är trygg eller otrygg leder detta till olika förhållningssätt hos individerna i de olika konstellationerna. Bird´s Nest Drawing – BND och Bird´s Nest Sculpture – BNS har visat sig vara användbara bildterapeutiska bedömningsredskap för att urskilja anknytning och anknytningsmönster hos olika klientgrupper tillsammans med familjeteckning, Person Picking an Apple from a Tree – PPAT, samt en gemensam teckningsuppgift. Då det gäller bildterapeutiska behandlingsmetoder som är inriktade på anknytning och anknytningsskador så visar inte forskningen på några tydliga exempel på praktisk tillämpning. Slutsats Uppsatsens resultat visar vikten av att bedöma anknytning och anknytningsmönster hos klienter innan den terapeutiska behandlingen påbörjas för att få en uppfattning och prognos om klientens förhållningssätt och fortsatta utvecklingsmöjligheter samt då det gäller det terapeutiska bemötandet för att på bästa möjliga sätt skapa en trygg allians. Hur det fortsatta behandlingsarbetet sedan ska genomföras för att möjliggöra läkning av anknytningsskador är dock oklart. / Aim The aim of this work is to conduct research about how art therapy, including screening and treatment, is described in relation to attachment and attachment injuries. Method A general literature study built on a few thematical research questions which describes art therapy screening and treatment linked to attachment and attachment injuries. Results The attachment between parent-child might be expanded to other relationships, for example therapist-client and romantic partners. Depending on if the attachment is secure or insecure that could result in different individual behavior in the constellations. Bird´s Nest Drawing – BND and Bird´s Nest Sculpture – BNS are shown as valuable art therapeutic screening methods for identifying attachment and attachment patterns in different groups of clients with family drawing, Person Picking an Apple from a tree – PPAT and a joint drawing task. When it comes to art therapy focused on attachment and attachment injuries, contemporary research does not present any clear examples on practical treatment methods. Conclusion The result of the study illustrates the need for identifying the client’s attachment and attachment patterns before starting the therapeutic treatment in order to form an opinion and prognosis about the client’s behavior and potential for development, and the therapeutical reception to optimize the possibility for a secure alliance. In what way the following therapeutic work should be implemented in order to heal attachment injuries is yet unclear.

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