This three-stage study led to the development of a delineation model of occupational therapy practice for children with Attention Deficit Hyperactivity Disorder (ADHD). Stage one explored the current practice of occupational therapy in the United Kingdom (UK) by conducting a national survey of 282 paediatric occupational therapists. Results indicated that there were only a small number of occupational therapists (8.5%) working in a designated service for children with ADBD. This result suggested that occupational therapy for children with ADHD is a small field of practice. Stage two involved the consensus development on the role of occupational therapy for children with ADHD. Seventy-two paediatric occupational therapists participated in the study. The therapists' top six priorities of assessment and five priorities of intervention were identified. An occupational therapy delineation model of practice was developed by integrating data generated from this research, information from the literature review, and the author's clinical experience. In order to apply the model to clinical practice, a family-centred occupational therapy care package was developed. The third stage evaluated the process and outcome of the devised care package by conducting a multi-centred efficacy study. Twenty occupational therapists from the four countries in the UK attended a 3-day course to learn to implement the care package. Following their training, they submitted data on a sample of 20 children with ADHD. The majority of these children (85%) showed improvement in their behavioural patterns after the implementation of the care package. Over half of the cases (65%) had statistically significant changes of scores in the ADHD Rating Scales. Parents also reported experiencing good family-centred care delivered by the research therapists. The whole study makes a significant contribution to occupational therapy knowledge by creating a new delineation model of practice for which the research undertaken offers some validation.

In this study, a user-centred design approach was used to develop a mobile health application designed to support adult T1DM patients with their self-management routine. In the requirements gathering phase, an observational study of a diabetes clinic and patient interviews were conducted. An analysis of the data collected from this phase helped identify the functional design requirements used to guide the design. Using a rapid prototyping approach, data visualizations, game-based elements, carb-counting and social networking features were explored. The final prototype developed in this research was evaluated for its ease of use and perceived usefulness. The design was found to be generally easy to use. With respect to data visualizations, participants preferred the scatter plot view of their blood glucose readings to a bar chart. In addition, it was found that all participants wanted a way to track their HbA1c on a regular basis.

This exploratory research investigates students’ responses to innovative instructional methods, focusing primarily on identifying the barriers that discourage students from engaging with methods that are new or not expected. The instructional methods explored are examples of learning-centred teaching and assessment methods, and are considered to be innovative since they are not yet widely used in higher education. To investigate this issue, literature from organizational change management, resistance to change, and higher education is reviewed. Gaps from the higher education literature suggest that no comprehensive framework or model exists regarding students’ barriers to engaging with innovative, learning-centred instructional methods. Additionally, few studies compare faculty member and student perceptions, clarify whether the instructional methods studied are innovative for the students, or apply theories and concepts from the change management literature. This research attempts to address these gaps. Case study methodology is selected to enable a detailed study of a course that employs innovative instructional methods. A modified grounded theory approach is used to inform both research instrument design and data analyses. Data are collected from multiple sources and via multiple methods, and both thematic and comparative analyses are presented. Overall, support is found for the four research propositions posed. The students’ barriers fall into eight key themes, and comprise various codes and properties to provide further understanding. The saliency of the codes appears to vary by time of term and type of instructional method. Other relevant factors include: the students’ year of study and amount of instructional variety, the academic discipline and culture of the innovative course, and misalignments between the students’ and instructor’s perceptions of the barriers to change. The value of course evaluation data as feedback about innovative courses is also questioned. Finally, connections are made between the findings and the Reasoned Action Approach theory for future possible research. The findings provide a new comprehensive barrier framework, analytic fishbone tool, and testable theory to help guide the development of future research projects. Additionally, future practitioners – both faculty members and educational developers – can benefit from knowing what factors to consider when planning for and confronting student resistance to innovative instructional methods.

Abstract The main difficulty in the usability evaluation of a product concept or a prototype is that it is very difficult to take reliably into account many different characteristics or attributes, which cannot be measured with the same unit, scale or instrument. Secondly, evaluation always involves some uncertainty. One can never be really sure that all the essential aspects that affect the final user emphasis are taken into consideration. This uncertainty can be decreased by involving diverse people in the evaluation process during R&D or, before the final decision, by elaborating the best ideas to a level at which they can be really used on a pilot scale in the field. Most often, though, the latter takes too much time and would result in many other problems. Evaluation can possibly be best enhanced by using enough involved people, i.e. various experts and especially end-users, who need or use the product in question. A key ingredient to the success of product development, in addition to ergonomic knowledge, is often thought to be active involvement of the intended product users by (1) measuring user-product interaction and (2) participation in design decisions. When a potential end-user experiments with the product, both quantitative and qualitative evaluation methods can be used. This thesis shows some methodological possibilities of evaluation, especially through simulation. It also describes in detail the practical phases of the experiments. For example, a lot of development was needed to find out how to communicate product alternatives and their concepts to (elderly) users. And most importantly, this thesis aims to give evidence of how the procedure called experimental ergonomic evaluation (EEE) should be feasibly implemented and statistically confirmed for significance and consistency. A special focus in the experiments was placed on elderly end-users. Since the number of elderly citizens is increasing, there is a need for products to help the elderly live independently at their homes. Studying and understanding how users accomplish their tasks helps to identify their needs and to formulate implications for the design of technology to satisfy those needs. Thus, user studies conducted before beginning to design a new technology provide a proactive way of involving users in the design process. The first prototypes then enable usability studies, such as user trials. With an emphasis on usability engineering, trials can be developed into more feasible EEE procedures for industrial companies. All the developed and applied EEE procedures were based on a user-centred approach with different user trial types (N = 15). The users as subjects (N = 264) performed as real tasks as possible and, based on their perceptions during the trials, gave their preferences or scored certain variables. The subjects were also observed and measured by the researcher. The products or other technologies in the trials comprised a total of 9 cases, ranging from "low-tech" steps and chairs to "high-tech" information and communication technology (ICT) applications. The perceived preference and observed performance measures were then combined. Different methods are needed simultaneously to make the results more accurate. The present EEE procedures proved to be cost-effective, efficient and sufficiently valid at least in a research context. The EEE procedures ranged from subjective estimations, such as rating and ranking, to more complex multi-criteria methods that can be used to facilitate decision-making, such as conjoint analysis, Mitchell's paired comparison and use-value analysis. Objective evaluation was also used, including measurement of products and users as well various observations. Both experts and end-users (subjects) had their own important roles in the experiment. Based on this study, EEE procedures are easy to implement in industry for routine usability testing in the course of product development. EEE with its wide coverage yields more universal and absolute usability values, not only ones based on direct benchmarking.

Older adults living with dementia are marginalized in society through the socially constructed binaries of old/young, able/disabled and ultimately us/them. These are manifested in a culture dominated by approaches towards illnesses that favor clinically inclined models of care which entail the search for cures rather than attention to the care required by and for individuals. To heighten their vulnerability, from an individual perspective, the cognitive nature of dementia often prevents people living with it from having a voice in their representation. Person-centered care is a philosophy that recognizes the importance of who the individual is and where they are situated in an effort to create a more holistic care experience. The Lodge at Broadmead is a residential care facility that has operationalized an explicitly person-centered philosophy of care. The main objectives of this project were to gain an understanding of the lived experience and implementation of person-centered dementia care from the many different perspectives contained within this facility as well as the methodological barriers associated with including people living with dementia in this type of research. To this end, one-on-one interviews and focus groups were conducted with a total of 16 staff members and leadership at The Lodge at Broadmead as well as one resident. These were informed by a 4 month period of observation in the form of volunteer work. Three main themes emerged around the implementation of person-centred care at The Lodge at Broadmead: identity maintenance, facilitating relationships, and aligning values. These themes represent the most important theoretical links between the physical and social aspects of the environment, and person-centred care’s ultimate goal of maintenance and enhancement of personhood for the residents. Drawing from my own research experience, there were several methodological challenges in undertaking the research as well which were: the institutional necessity of consent by proxy, a rigid interview approach, and not enough time spent with the residents. / Graduate / 0336 / 0351 / kyle.plumb@gmail.com

Magister Scientiae (Occupational Therapy) - MSc(OT) / Stroke has been identified as a global cause of neurological disability with a resultant burden shared not only by the survivor but also by the society. The resumption of one’s role as a worker after having a stroke is an important rehabilitation goal. South-West, Nigeria has experienced high incidence and prevalence of stroke leaving a quarter of survivors with severe disability and difficulty in community integration after rehabilitation. As a disability resulting from a stroke could be viewed as being a dynamic interaction between the health condition and contextual factors, a client-centred approach should be focal to stroke management to facilitate return to work. Therefore, it became necessary to explore the return to work process from stroke survivors and stakeholder’s perspective in order to understand the challenges stroke survivors face while adapting to their worker roles, to improve service design and delivery as well as to facilitate the return to work after having a stroke. The study was aimed at exploring and describing the experiences of rehabilitated stroke survivors and perceptions of stakeholders about stroke survivors returning to work in South-West Nigeria. A qualitative research design was used to explore these experiences and perceptions from nineteen participants that comprised of nine stroke survivors, two key informants (rehabilitation specialists) and eight caregivers of the respective stroke survivor. Two methods of data collection were used by the researcher to access the perceptions and experiences of the participants. The researcher made use of focus groups with the caregivers while in-depth interviews were conducted with the stroke survivors and rehabilitation specialists. One pilot testing in-depth interview and eleven in-depth interviews were conducted with the stroke survivors and rehabilitation specialists while two focus group discussions were held with the eight caregivers consisting of four participants per group. The data from the study was analysed using thematic analysis. All data were managed manually. The study was further aimed at obtaining participants` perceptions and experiences of barriers and facilitators as well as adaptation processes that influenced the stroke survivors’ ability to resume their worker role. The findings were revealed in five themes. Theme one and two describes the barriers experienced by the stroke survivors while returning to work in the form of loss of former self and returning to work is a struggle. The resumption of the previous worker role by the stroke survivors was construed to be a contest which entails a struggle between the survivor, survivor’s job characteristics, rehabilitation intervention and stigma from the society. Poor access to rehabilitation interventions, inadequacy of treatment and poor insight of the stroke survivor regarding condition, job characteristics as well as social stigma related to the condition were observed as factors that posed great challenges to the participants. Theme three describes the factors that facilitated the resumption of the worker role for the stroke survivors. Engagement in rehabilitation as well as social support enabled the stroke survivors to overcome the barriers and returning to work. Theme four describes the adaptation strategies that enable the return to work for the stroke survivors. Theme four was described by an intrinsic adaptation process that involves the acceptance of the illness and being motivated to return to work and an extrinsic adaptation process that involves gradual work exposure, workplace and home adaptation. Theme five describes the participants’ perception of changes needed in the rehabilitation services and policies that would facilitate the quick return to work of the stroke survivor. Promoting participation of stroke survivors in work through government policies was observed to be a necessary recommendation for the study. These were seen to be achievable through the improvement of rehabilitation resources, enabling access to rehabilitation through financial assistance, change of the regulatory environment to accommodate for the disabled and the initiation of health promotion through public awareness campaigns in the community regarding stroke. The Person Environment Occupation model of occupational performance was used as a framework to interpret the findings of the study; the barriers, facilitators and adaptation process was placed into perspectives as they impacted on the experience of the stroke survivors ‘resumption of their worker role. The resumption of the worker role of the stroke survivors was observed not only to be influenced by the individual characteristics of the survivors but also by the environmental context within which the return to work process took place.

This thesis describes an interpretative, qualitative study of one person centred planning, circle of support. The eight people in the circle support a person with a learning disability, to help plan the life the person would like, utilising person centred planning techniques and tools. This study uses an ontological foundation of phenomenology, existentialism, and social psychology to examine the authenticity of the process of person centred planning for the circle of support members, and the person they have all chosen to support (focused person). A variety of data collection methods are employed, particularly those utilising ethnographic characteristics, and participatory approaches. These include video of a circle of support meeting, informal interviews using a video elicitation technique with circle members, and the use of photographs of the person’s plan. The data analysis is interpretative, and uses a two stage thematic analysis. Findings focus on the key concepts of individual agency, social inclusion, rights, choice and social emancipation. In addition the study attempts to examine the individual’s “truth” of current service experiences, and of person centred planning as a method of life planning, for people with learning disabilities. This study adds to understandings of learning disability, and disability generally, by providing new insights into how people should be supported in the future. It emphasises recognising the importance of individual experience both as participants in circles of support, but also as people involved in, or using learning disability services in the United Kingdom. This includes appreciating that human experience is shaped not only by what can be observed and measured, but that individual agency, imagination, feelings and thought are just as important in how individuals view and experience their world.

What are the long and short term effects of working with suicidal clients on the person-centred counsellor? As suicide remains a major public health issue with the latest figures for the UK of 5706, an increase from 5377 in 2007 (ONS, 2010), suicide prevention strategies remain high on the public health sector agenda. With this statement in mind, and financial resources and funding at a low, an increased demand on psychological therapies can be assumed. As a result, the impact on individual practitioners will most likely intensify, personally and professionally. This research aims to explore the extent the impact may have, personally and professionally on the person-centred counsellor. The study was structured using semi-structured interviews with a purposeful sample of ten person-centred counsellors. A constant comparative method was applied to analyse transcribed data, from which four main categories emerged: ‘Experiencing the Therapeutic Encounter’, ‘Experiencing the Self within the Therapeutic Encounter’, ‘Seeking Solace – finding understanding’ and ‘Counsellor’s Grounding through Knowledge’, each subsumed by several lower order categories, from which a core category ‘The Counsellor’s Resilience’ emerged. The findings propose that, although the participants in this study were at times deeply affected, both personally and professionally, by their clients’ stories, they were able to reclaim their strength through seeking and finding support from supervisors, peers, holistic self-care and tacit knowledge, gained through personal experience and understanding. Formal training was identified as lacking in counselling training courses. The implications of the findings and recommendations are discussed.

Establishing proficient practices for technology teaching and learning is an immense challenge, especially since technology is a new subject that was added as one of the new learning areas within the South African education curriculum. This happened when the South African education system was reviewed after the 1994 democratic elections and OBE was chosen as not only the hub, but the underpinning philosophy of education. As part of the challenges that followed implementing a new subject, when technology was first implemented, there were no qualified teachers to teach it, and there were no official academic programmes to train those who were inevitably selected to teach it. After a while, the government found out that all was not well with the national curriculum technology and that in many schools, it was not as well taught as other subjects. From ever since, institutions of higher learning and service providers across the country made efforts to develop programmes and offer formal training in technology education. This study intended to carefully examine how technology academic programmes are conceptualised, planned, and implemented; and how that contributes to efficient training and development of student-teachers in technology education. This it did by purposefully sampling the University of Pretoria (UP) and performing a case study on its technology education pre-service programme. The investigation necessitated the concept: "the essential features of an effective and comprehensive technology education programme", which the researcher believes are inescapable because they forms the core, effect and success of technology programmes' design features; and they have a propensity to guide educational practice to enhanced performances and yield. From literature, the essential features are centred on programme design, content, teaching methods, programme coordination, staffing, student assessment policies and practices and the context of study. The investigation at UP started with programme conceptualisation and planning, which the researcher performed by interviewing the developers, designers and the lecturing staff. She then performed document analysis on the study guides and university general programme to investigate programme content; and she did lecture observations to explore teaching methods. The results of the study indicated that UP technology education pre-service programme is conceptualised and planned based on problem-based learning, project-driven approach and standard-based design. The lecturing staff applies learner-centred, activity-based, and outcome-based approaches that provide student teachers with opportunities to engage in authentic, real-life problems. The programme content consists of modules that are made up of study units that engage various technology concepts and knowledge base. They have good resources and specialised venues for technology teaching and learning. UP-D&T is balanced and auspicious; students and lecturers are enthusiastic and positive about the activities of this programme. However there exist a few hiccups, which are resembled in the level at which certain essential features are engaged within UP-D&T. The designers and lecturing staff might want to conduct some impact studies of this programme, as well as evaluations of practice on student-teachers presently training and those who were trained under this programme in the past. The study reflected in-depth descriptions of how technology education programmes can be comprehensively designed; by providing a window, patterns, essential features and rubrics for enhanced planning, practice and implementation. Discussions thereof might serve to mobilise, critique and further the discourse on effective pre-service teacher education. / Dissertation (MEd (Science and Technology Education))--University of Pretoria, 2008. / Curriculum Studies / unrestricted

Magister Scientiae (Nutrition Management) - MSc(NM) / The provision of quality nutrition care services is needed to address the national burden of diseases, and to reduce under- and overnutrition in South Africa. Globally, there is a lack of information and data about the perceptions, experience of, and satisfaction with the quality of nutrition care services, both from patients and dietitians. Patients and dietitians are in the best position to provide useful information pertaining to their perception and experience of nutrition care service delivery. The aim of this study was to determine the perceptions of patients and dietitians on the quality of nutrition care service delivery in the Klipfontein/Mitchells Plain Sub-Structure (KMPSS).