Although quality management is used in occupational therapy in South Africa, no comprehensive description or standardisation of it exists. Literature in the context of this topic is scarce. As a consequence of this problem, the purpose of this study was to describe the extent of occupational therapists’ involvement in quality management. A quantitative study in the form of a survey was carried out. A convenience sample of 80 occupational therapists was surveyed, using a structured questionnaire. Results of the study indicate that most occupational therapists have some knowledge of quality frameworks. Standardisation on documentation and its auditing appears to be one of a number of problems. Another challenge is that occupational therapists may work in relative professional isolation making it problematic to implement quality management. Recommendations were made for occupational therapy practice and further research, as well as recommendations for a quality management framework for occupational therapy in South Africa. / Health Studies / M. A. (Public Health)

Thesis (MBA)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: The aim of this study was to investigate the management skills of occupational therapy business unit managers on Assistant Director Level in the Public Health Sector (PHS) of the Free State (FS). For the purpose of this study, management skills referred to the occupational therapy business unit manager’s perception of the importance and competency experienced while doing their work within the Free State Department of Health. Occupational therapy form an integral part of the Free State Department of Health, which is a provincial public sector entity and solely responsible for health services to the majority of the population. An inquiry was initiated based on the researchers’ observation of occupational therapy business unit manager’s challenges regarding knowledge and skill when exposed to management. The investigation was conducted by making use of a questionnaire for the quantitative typical descriptive study design and semi-structured telephonic interviews for the qualitative study design. Electronic self-administrative questionnaires were distributed to all the occupational therapy business unit managers in the service of the Free State Department of Health. Ten (n=10) questionnaires, a hundred percent of employed occupational therapy business unit managers, were used for the analysis of quantitative data. Subsequently to this base-line data gathered, semi-structured telephonic interviews with open-ended questions were conducted among the target population. In conclusion the results of the study showed that the occupational therapy business unit managers in the PHS of the FS perceive a gap between their current and desired performance management skill levels. This was found to be in accordance with studies worldwide as clinicians promoted to a managerial post would prefer to utilize gained qualifications and experiences as managers within their specialty field.

The aim of this study was to investigate which protocols Occupational Therapists (OT’s) use when rehabilitating clients after flexor tendon repairs, and to investigate the therapist’s knowledge regarding these protocols, to guide therapists and institutions in using effective methods within the South African context. A questionnaire was sent to OT’s in South Africa. Of the 32 responses, 50% had more than 10 years experience and 50%, less experience. 81.2% were private practitioners and 28% worked in government. The trend of protocol use was as follows: 18.8% used a Duran-type passive mobilization protocol, 25% used a Kleinert-type protocol - a passive flexion protocol (but labelled an active mobilization protocol in literature as it allows active extension of the fingers), 28.1% used Early Active Mobilization and 3.1% used an Immobilization-type protocol. 64.5% of the sample used static splints, 9.7% used dynamic splints and 25.8% used a combination. Most (83.3%) continued the splint at 4 weeks but only 26.6% were using the splint at 6 weeks. At week 1, 30% allowed active flexion of the fingers, whereas at week 4 and 5, 60% allowed active flexion. The referring doctor and confidence in one’s own skills were the main factors influencing protocol choice. Resources available influenced the protocol choice, which can be problematic in South Africa. Access to literature was mostly through textbooks (90.6%), although journal articles were accessed (internet - 50%, hard copy - 62.5%). More than half of the sample attended courses regularly. Most therapists were happy with their outcomes, regardless of which protocol used. Therapists need to build their confidence, realising the efficacy of various protocols is similar, according to research. Thus whatever factors influence protocol choice, they will likely not be critical to good outcomes. / Thesis (M.O.T.)-University of KwaZulu-Natal, Durban, 2012.

Although quality management is used in occupational therapy in South Africa, no comprehensive description or standardisation of it exists. Literature in the context of this topic is scarce. As a consequence of this problem, the purpose of this study was to describe the extent of occupational therapists’ involvement in quality management. A quantitative study in the form of a survey was carried out. A convenience sample of 80 occupational therapists was surveyed, using a structured questionnaire. Results of the study indicate that most occupational therapists have some knowledge of quality frameworks. Standardisation on documentation and its auditing appears to be one of a number of problems. Another challenge is that occupational therapists may work in relative professional isolation making it problematic to implement quality management. Recommendations were made for occupational therapy practice and further research, as well as recommendations for a quality management framework for occupational therapy in South Africa. / Health Studies / M. A. (Public Health)

Thesis (MOccTher)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Introduction: This research was conducted to establish the assessment practices of occupational therapists working with clients with upper limb injuries and/or conditions. This was done to get an updated account of frequency and variation in the use of various assessment tools as well as reasons offered for infrequent use. Methodology: A quantitative cross-sectional survey design was used. A convenience sample of therapists attending courses was recruited for the study. A questionnaire was developed for the study and face and content validity established through pilot testing. The questionnaire consisted of three sections containing demographic information and questions about upper limb assessment practices. Descriptive statistics were calculated for numerical and categorical data to describe the demographic characteristics and to identify the measurement tools that were used most frequently. The Chi-Square test of associations was used to determine whether there were any associations between frequency of use and demographic factors. Results: Questionnaires were completed by 81 (71%) respondents. Twenty-two (27.2%) of the respondents had more than five years’ experience in the field of hand therapy while the remainder (n=52, 64.2%) had less than five years. The more experienced therapists worked in the private sector (n=49, 60.5%) with two (0.03%) experienced therapists being employed in the public sector. The diagnoses that were seen most commonly were nerve injuries (90.1%), fractures (88.8%) and tendon injuries (85.1%). Of the 81 respondents 15 (18.5%) held post graduate qualifications in the field of hand therapy. Goniometry (68 of 81, 84.0%), manual muscle testing (62 of 81, 76.5%) and testing for flexor digitorum profundus and superficialis function (61 of 81, 76.3%) were used most frequently. Performance tests were used infrequently or not at all. The most common reasons for non-use of performance tests were that they were not available in the practice setting or respondents were not familiar with them. Significant associations were found between frequency of using measurement tools and practice setting, years of experience and holding a post graduate qualification in the field of hand therapy. There was a significant association between working in the private sector and using a dynamometer (p < 0.001), and working in government settings and frequent use of the test for localisation (p = 0.021). Therapists with more than five years’ experience in the field of hand therapy were significantly more likely to use Semmes Weinstein monofilaments (p = 0.034) as were those holding a post graduate qualification in hand therapy (p <0.001). Conclusion: The results of this study have serious implications in terms of the upper limb assessment practices of occupational therapists, especially in the context of evidence-based practice which has become crucial not only for the credibility of the profession, but also for its survival. Information obtained through this research could aid to guide education and training at an undergraduate and post graduate level and assist to direct a research focus for hand therapy in the South African context. / AFRIKAANSE OPSOMMING: Inleiding: Hierdie navorsing is uitgevoer om die bepalingspraktyke van arbeidsterapeute wat werk met kliënte met boonste ledemaat beserings en/of toestande vas te stel om sodoende ‘n beeld te verkry van die frekwensie en variasie van die gebruik van bepalingsinstrumente. Redes aangebied vir ongereelde gebruik hiervan is ook ondersoek. Metode: 'n Kwantitatiewe deursnee-opname-ontwerp is gebruik. ’n Gerieflikheidssteekproef van terapeute wat kursusse bygewoon het, is gewerf vir die studie. ‘n Vraelys is ontwikkel vir die studie, en voorkoms- en inhoudsgeldigheid is bepaal deur ‘n loodstudie. Die vraelys het bestaan uit drie afdelings met demografiese inligting en vrae oor boonste ledemaat bepalingspraktyke. Beskrywende statistiek is bereken vir numeriese en kategoriese data ten einde die demografiese eienskappe te beskryf en die bepalingsmetodes wat die meeste gebruik is, te identifiseer. Die Chi-kwadraat toets is gebruik om te bepaal of daar enige assosiasies tussen die frekwensie van gebruik en demografiese faktore bestaan. Resultate: Vraelyste is deur 81 (71%) respondente voltooi. Twee-en-twintig (27,2%) van die respondente het meer as vyf jaar ondervinding in die veld van handterapie gehad, terwyl die res (n = 52, 64.2%) minder as vyf jaar gehad het. Die meer ervare terapeute het gewerk in die privaatsektor (n = 49, 60.5%) met twee (0,03%) ervare terapeute in diens van die staat. Senuweebeserings (90.1%), frakture (88,8%) en tendonbeserings (85.1%) was die meeste gesien. Van die 81 respondente het 15 (18,5%) ‘n nagraadse kwalifikasie in die veld van handterapie gehad. Goniometer (68 van 81, 84.0%), spiertoetsing (62 van 81, 76,5%) en die toetse vir fleksor digitorum profundus en superficialis funksie (61 van 81, 76,3%) is die meeste gebruik. Vaardigheidstoetse is selde of glad nie gebruik nie. Die mees algemene redes aangevoer vir die feit dat vaardigheidstoetse nie gebruik is nie, was dat dit óf nie beskikbaar is in die respondent se werksarea nie, óf dat respondente nie vertroud is met die toetse nie. Beduidende assosiasies is gevind tussen die frekwensie van die gebruik van bepalingsmetodes en werksarea, jare ervaring in handterapie en 'n nagraadse kwalifikasie in die veld van die handterapie. Daar was 'n beduidende assosiasie tussen terapeute werksaam in privaatpraktyk en die gebruik van 'n dinamometer (p < 0,001) en terapeute werksaam in die staat en gereelde gebruik van die lokalisasie toets (p = 0.021). Terapeute met meer as vyf jaar ondervinding, sowel as diegene met ’n nagraadse kwalifikasie in handterapie was beduidend meer geneig om Semmes Weinstein monofilaments te gebruik (p = 0,034 en p < 0,001 respektiewelik). Gevolgtrekking : Die bevindinge van hierdie studie het ernstige implikasies in terme van die arbeidsterapie bepalingspraktyke van die boonste ledemaat, veral in die konteks van bewys-gebaseerde praktykvoering (evidence based practice) wat noodsaaklik geword het nie net vir die geloofwaardigheid van die beroep nie, maar ook vir die oorlewing daarvan. Inligting wat verkry is deur middel van hierdie navorsing kan help met onderrig en opleiding op 'n voor-en nagraadse vlak. Dit kan ook help om navorsing in handterapie te rig binne die Suid- Afrikaanse konteks.

Thesis (MOccTher)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: Background: The high number of mental health care users requiring care, the quick turnover in psychiatric hospitals and the scarcity of community-based mental health services are some of the factors that have led to a dramatic increase in the number of high frequency users of in-patient psychiatric services. In an attempt to address these issues, an occupational therapy-led day treatment centre was established at Stikland Hospital in the Western Cape province of South Africa. The aim of this study was to determine whether attendance at an occupational therapy-led community day treatment centre for mental health care users affects the use of in-patient services in the Western Cape Province of South Africa. Methods: A pre-test/post-test quasi-experimental study design was used to determine the benefits of the occupational therapy-led day treatment centre. Total population sampling was used. Forty four mental health care users participated in the study. The number of admissions and number of days spent in hospital before and after occupational therapy intervention were compared using statistical analysis. Results: The analysis showed a significant difference in the number of admissions (p = .00) and the number of days spent in hospital (p = .00) before and after the occupational therapy intervention. There was a decrease in the number of admissions of 62.3% after intervention. Twenty-five participants (56.8%) had fewer admissions after intervention than before. Total days spent in hospital for the group showed a decrease of 74.6% after intervention. Days spent in hospital became shorter by up to 7 months after occupational therapy intervention. This indicated a medium effect size (r = .436) for number of admissions and a large effect size (r = .504) for number of days spent in hospital after intervention. The frequency of attending the day treatment centre had no influence on number of admissions (p = .410) or on the number of days spent in hospital (p = .579) after intervention. Conclusion: The findings suggest that an occupational therapy-led day treatment centre is effective in reducing the use of in-patient services within the Western Cape, South Africa. In addition providing a range of opportunities for meaningful participation may be more important than the intensity of treatment when promoting recovery. / AFRIKAANSE OPSOMMING: Agtergrond: Die groot hoeveelhied persone wat psigiatriese sorg benodig, die vinnige omset in psigiatriese hospitale asook die tekort aan gemeenskaps psigiatriese dienste is van die faktore wat lei tot ‘n toename in persone wat gereëlde heropname benodig. As moontlike oplossing vir die probleem is ‘n dagbehandelingsentrum geopen by Stikland Hospitaal in die Wes-Kaap provinsie van Suid Afrika. Die doel van die studie was om vas te stel of ‘n dagbehandelingsentrum, onder leiding van ‘n arbeidsterapeut, effektief is in die Wes-Kaap provinsie van Suid Afrika vir persone met psigiatriese siektes. Metode: ‘n Voortoets-natoets kwasi-eksperimentele studie metode is gebruik om die voordele van ’n arbeidsterapie gedrewe dagbehandelingsentrum te bepaal. Totale bevolking steekproef is gebruik. Vier en veertig persone met ‘n psigiatriese diagnose het deelgeneem aan die studie. Die hoeveelheid opnames asook hoeveelheid dae spandeer in die hospitaal voor en na die arbeidsterapie intervensie is vergelyk. Resultate: Resultate het getoon dat daar ‘n beduidende verskil was tussen die hoeveelheid opnames (p = .00) en die hoeveelheid dae in die hospital (p = .00) voor en na arbeidsterapie intervensie. Die groep se hoeveelheid opnames het met 62.3% gedaal na intervensie. Vyf en twintig deelnemers (56.8%) het minder opnames gehad na intervensie as voor intervensie. Data toon ‘n medium effekgrootte (r = .436). Die totale dae in die hospitaal vir die groep het met 74.6% afgeneem na intervensie. Dae spandeer in die hospitaal het met tot 7maande verkort na arbeidsterapie intervensie. Dit toon‘n groot effekgrootte (r = .504). Die frekwensie van bywoning het geen invloed getoon op die hoeveelheid opnames (p = .410) of hoeveelheid dae in die hospitaal (p = .579) nie. Gevolgtrekking: Die studie het gevind dat, in die Wes-Kaap, ‘n arbeidsterapie gedrewe dagbehandelingsentrum ‘n effektiewe en uitvoerbare opsie is om die druk op binne-pasiënt dienste te verlig. Die studie het verder getoon dat betekenisvolle deelname aan aktiwiteite moontlik belangriker is vir herstel na ‘n psigiatriese siekte as intensiteit van behandeling.