Master of Public Health - MPH / Background: The Western Cape's Comprehensive Service Plan (CSP) is committed to "treating the right patient at the right level right, with the right skills and at the right cost" (Page 1, Tygerberg Hospital Annual Report, 2007). Occupational therapy (OT) Managers in the Metro District, Western Cape Province are in the process of aligning the OT services to the new CSP document. A major problem is the high default rate (non attendance) and irregular attendance (patient attends but skips sessions) amongst paediatric out-patients. In order to properly improve the OT paediatric services, it is vital for the OT managers to know the reasons for the poor utilisation of the OT services at the paediatric out-patient units. Purpose of study: The irregular attendance and high default rates (where patients stop attending the OT sessions completely) among children are a major problem at three OT out-patient units in Cape Town, Western Cape Province. The occupational therapists who work at these units are adamant that this impacts negatively on the child's progress. This study sought to explore the factors influencing the utilisation of the OT service in these three OT paediatric out-patient units in the hope of providing relevant information to the OT managers of these units in order to rethink the current service and make appropriate changes to improve adherence and treatment progress. Study design: This was an exploratory study using qualitative research methods. In-depth interviews were conducted with ten parents of children who have to attend the OT out-patient services. One group discussion was conducted with the occupational therapists that provide the services at the out-patient units. Sampling: Purposive sampling methods were employed to select four occupational therapists (at least one from each unit) and ten parents (at least three from each unit, with at least two who attended poorly and one that attended regularly). Analysis: Thematic analysis was used to interpret the data. The data was coded and categorised according to themes that emerged during data analysis. Results: The results of this study revealed that the factors that impact the utilisation of the OT service at the three OT units is complex. Factors that influenced the utilisation of the OT services in this study were related to the OT service such as staff attitude, relationship between the occupational therapist and the mothers as well as their child, communication between the mother and the occupational therapist, treatment progress, parent involvement in the OT programme and access to the OT service. Other factors such as the mothers' perception of the severity of the child's health condition, family support, work factors and family support were important factors related to the mother. The findings also revealed that environmental factors namely stigma, discrimination and travelling to the OT units impacted utilisation of the OT service. The participants made recommendations on how to improve the service. Conclusion: This study describes the complexity of what impacted the utilisation of the OT services and how closely interlinked these different factors are. It is evident from the findings of this study that a comprehensive, client centred approach is required to properly deal with the factors that negatively impact the utilisation of this service. Recommendations: A multi-faceted approach is required. Important issues to address are the shortage of occupational therapists across the levels of health care in the Western Cape Province; improving on the client centred approach in OT intervention programmes; advancing advocacy against stigma and discrimination against children with disabilities; and making public transport more accessible to children and their mothers.

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Tikslas: Nustatyti Kauno miesto pirmų klasių mokinių fizinio aktyvumo ir mitybos ypatumus bei jų sąsajas su tėvų sveikatos būkle. Uždaviniai: Įvertinti pirmokų fizinį aktyvumą; Išanalizuoti pirmokų mitybos ypatumus; Įvertinti subjektyvią tėvų sveikatos būklę; Nustatyti vaikų mitybos ir fizinio aktyvumo ypatumų sąsajas su suaugusių šeimos narių sveikatos būkle. Tyrimo metodika: šis magistro darbas parengtas atlikus Lietuvos vaikų augimo stebėsenos tyrimą, kuris buvo vykdomas vadovaujantis PSO Europos vaikų nutukimo stebėsenos iniciatyvos (angl. WHO European Childhood Obesity Surveillance Initiative – COSI) protokolo. Magistro darbe buvo atliktas mitybos įpročių, fizinio aktyvumo ir tėvų subjektyvios sveikatos vertinimas. Magistrinio darbo tikslinė grupė – Kauno miesto pirmų klasių mokiniai ir jų tėvai. Tiriamąjį kontingentą sudarė 6–8 metų vaikai (n=407; 51,1 proc. berniukų ir 48,9 proc. mergaičių) ir jų tėvai (n=407). Rezultatai: nustatyta, kad beveik du trečdaliai berniukų ir mergaičių (atitinkamai 60,1 proc. ir 61,8 proc.) lanko sporto ir /ar šokių būrelius. Du penktadaliai berniukų ir mergaičių (40 proc.) būrelius lanko 2 dienas per savaitę. Nustatyta, kad savaitgaliais ilgai (>2 val.) televizorių žiūri beveik visi pirmokai (93,6 proc.). Vertinant mokinių mitybą nustatyta, kad du trečdaliai (67 proc.) pirmokų pusryčiauja kasdien. Dažniausiai pirmų klasių mokiniai varotoja šviežių vaisių (62,4 proc.), virtų daržovių (58,7 proc.). Tėčių ir mamų turinčių antsvorio ar... [toliau žr. visą tekstą] / The goal of the thesis: to identify the relations between pecularities of first-graders‘ nutrition and physical activity and health status of their parents in Kaunas city. Objectives:To evaluate the first-graders’ physical activity; To analyse the peculiarities of first-graders’ nutrition; To evaluate the health status of parents of first-graders; To find relations between pecularities of first-graders‘ nutrition and physical activity and health status of their parents. Methods: This master thesis is based on Lithuanian children's growth monitoring study, which was carried out in accordance with the WHO European Childhood Obesity Surveillance Initiative - COSI protocol. Master thesis analyses habits of nutrition, physical activity and subjetive evaluation of parents‘ health. Target group of the research is first grade students and their parents in Kaunas city. Generally, the research study consists of 6-8 year old children and their parents. A total number of participants of the survey is 407 first-graders (51.1 percent boys and 48.9 per cent girls) and 407 parents. Results: The survey shows that almost two thirds of boys and girls (60.1 per cent and 61.8 percent) attend sports and/or dance clubs. The largest proportion (two fifths) of boys and girls attends clubs two times a week. The research shows that almost all of first-graders (93,6 per cent) spend a lot time (more than two hours) watching television on weekends. The nutrition survey shows that 67 per cent of children... [to full text]