Masters Degrees (Occupational Therapy)

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Browsing Masters Degrees (Occupational Therapy) by browse.metadata.advisor "Cloete, Lizahn"

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    Exploring the value of mentorship programmes as a preventative strategy for prenatal alcohol use for at risk women in the South Africa
    (Stellenbosch : Stellenbosch University, 2021-03) Zietsman, Linda; Cloete, Lizahn; Fredericks, Jerome Peter; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health & Rehabilitation Sciences. Occupational Therapy.
    ENGLISH SUMMARY : Introduction: The high prevalence rate of FASD is well-known in South Africa, especially in certain areas in the rural Western Cape with an estimation of about 180-260 children in 1000 being affected. Literature confirms that there is poor recognition and response to the epidemic of FASD, and that a response from public health, which could include occupational therapy, could benefit many. Occupational therapy could be a valuable contributor to maternal health during the prenatal stages considering their holistic, client-centered approach. There have been many preventative strategies implemented to lower the prevalence of FASD, and one of them is by the means of mentorship programmes for at-risk mothers in high-risk communities. At-risk women face many barriers in accessing adequate healthcare services and mentorship programmes could potentially provide the necessary care and support at-risk mothers need to improve their maternal health. There is a need for exploring the value of these mentorship programmes to further assist with the development of successful prevention strategies for FASD. Methodology: A qualitative, explorative case study has been done on community-based mentorship programmes for at-risk mothers in South Africa, with a focus on the Western Cape. The study population has been field experts within the mentorship programmes, as well as mentors and mentees. Data has been collected by the means of an online focus group discussion of field experts (n=4), and SMS-journaling of mentors and mentees over a period of three weeks (n=6). An inductive analysis approach was used. The data was analysed according to themes, sub-themes and codes using content analysis. Ethical clearance has been obtained. Credibility has been ensured by member checking and peer examination. Data triangulation was ensured by using multiple data collection methods. Transferability has been ensured by thick description. Findings: There were four main themes that emerged from the collected data. These themes were (1) “It’s not just a generic programme”, (2) “Our pregnant women are struggling out there”, (3) “It has been a wonderful challenge to be a mentor” and (4) “What I will say that does not work”. Discussion: The most valuable components of a mentorship programme as studied is the client-centered, holistic approach while building empathetic, trustworthy relationships and supporting and empowering the at-risk mothers. This relationship between the above-mentioned components is transactional in nature, and one cannot function without the other. It is also important to consider the contextual challenges that at-risk mothers face in their daily lives, including unemployment, poverty, crime, violence, gangsterism and household abuse which often leads to poor coping mechanisms such alcohol and substance abuse. It is also important for the mentors themselves to feel supported and empowered throughout the mentorship programme to add to the success of a mentorship programme. It also became evident that prevention of FASD should not only start with at-risk mothers, but preventative strategies, such as education for primary school learners, should be implemented. The accessibility of mentorship programmes should also improve to reach more at-risk mothers. Conclusion: In conclusion, mentorship programmes should include a client-centered, holistic approach while building strong relationships between the mentor and the at-risk mother. It is also important to support and empower the at-risk mother as she experiences a range of adversities and challenges and focus should be given to her mental well-being. This requires a shift from the problems within the person, but rather to that of the environment. Occupational therapy can play a vital role in the fields of maternal health and can assist at-risk mothers to achieve client-centered goals and create supportive environments. This could assist in the success of these programmes, and success of these programme could benefit the public health system in decreasing the prevalence of FASD in those communities.
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    Female mental health care users perspectives of their occupational engagement at a tertiary psychiatric facility
    (Stellenbosch : Stellenbosch University, 2021-03) Sonday, Haseena; Cloete, Lizahn; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health & Rehabilitation Sciences. Occupational Therapy.
    ENGLISH SUMMARY : Introduction: The prevalence of mental illness, burden of disease in South Africa is increasingly high, a global trend amongst other low-and middle-income countries, affecting more females than males. Poverty, crime, intimate partner violence and the existence and co-morbidities, such as HIV, make people in previously disadvantage areas, particularly females, more vulnerable to mental illness. South Africa’s legislation, and vision for mental health, outlined in Healthcare 2030 exemplified the improvement of tertiary psychiatric services and patient experience, in the face of decentralisation. Despite this, readmission rates remain high, a complex phenomenon, for which the reasons are multifaceted. One of the reasons cited is that the lack of meaningful occupational engagement for patients in mental health care leads to a deterioration of mental health and subsequent relapse and readmission. The aim of the study is to explore female mental health care users’ perspectives of their occupational engagement in the pre-discharge ward at a tertiary psychiatric facility. Methodology: The study is grounded in a constructivist paradigm. A qualitative method of inquiry investigates the subjective underpinnings of meaningful occupational engagement of mental health care users. The collective case study used data from interviews, the Activities Clock, participant observations and the programme in the pre-discharge ward. Five (n=5) participants were included in the collective case study. Inductive analysis was used to analyse data. A four phased analytical strategy, thematic, content, within-case and across-case analyses was performed. Credibility was ensured through member checking. Data triangulation was ensured by using multiple data sources. An audit trail and thick descriptions were used to ensure transferability. The findings of the study were verified amongst other researchers in the field, ensuring confirmability. Reflexive journaling was used to bracket the researcher’s thoughts and feelings. The study received ethical approval and adhered to sound ethical practices. Findings: Two themes emerged. The first theme, “this is not a prison, it’s a hospital”, demonstrated mental health care users’ experience of dehumanisation in the pre-discharge environment. Mental health care users experienced gross human rights violations in the number of restrictions they were subject to, the lack of privacy and freedom enforced by staff in the pre-discharge ward. The second theme, “we need to do more” highlights that mental health care users were unstimulated, bored, and frustrated in the pre-discharge ward. There were not enough opportunities for meaningful occupational engagement in the pre-discharge ward. Discussion: Tertiary psychiatric facilities situated in the medical model violated the occupational and human rights of mental health care users and creates an environment ill conductive for occupation-based practice. Navigating mental health care users’ rights to freedom and privacy, with the responsibility of healthcare providers to offer a safe and caring environment, that is supportive of the recovery of mental health care users in the pre-discharge ward, remains a challenge. Conclusion: Tertiary psychiatric services should embrace a shift in paradigm from a dominantly medical model towards an occupation-based practice and recovery approach, in an environment that is less restrictive, that creates opportunities for meaningful occupational engagement, within a human and occupational rights framework.
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    A transformation strategy for Protective Workshops : towards comprehensive services for adults with intellectual disability
    (Stellenbosch : Stellenbosch University, 2015-04) Terreblanche, Susan Elizabeth; Goliath, Charlyn; Cloete, Lizahn; Stellenbosch University. Faculty of Health Sciences. Interdisciplinary Health Sciences. Occupational Therapy.
    ENGLISH ABSTRACT: South African Protective Workshops struggle to transform to align to a developmental human rights approach and to increase sustainability in the absence of a uniform model and an implementation strategy. This study applied qualitative research methodology in the form of Action Research with Co-operative Inquiry to answer the research question of what could be a framework of best practice for and strategy of transformation for protective workshops (PWs) operated by the South African Federation for Mental Health (SAFMH) in South Africa. It included the development of a transformation strategy for 31 PWs for adults with intellectual disability operated by SAFMH member organisations across South Africa. Seven representatives from the managers and service users of PWs were selected trough convenient sampling. The participants formed a co-operative inquiry group to determine the nature of the service to be delivered and how it should be implemented. The purpose was to develop a framework for possible and relevant services for persons with intellectual disability. Such services should preferably be aligned to the human rights based legislation and funding requirements of the Department of Social Development as to increase the long-term sustainability of the PWs. Given that the study was funded by the SAFMH, the directors requested that the Co-operative Inquiry Group use the exisisting best practice model used by Cape Mental Health as a template and point of departure. The study was done over a 12-month period (February 2012 – February 2013) and included a research initiation meeting, four search conferences and a presentation of the findings to the SAFMH Directors. The study contributed new knowledge on the nature of service provision to persons with ID and the ideal process to transform services within the SAFMH context. Through inductive content analysis two themes emerged namely: 1) Comprehensive service provision and 2) Coordinated transformation of services. The first theme determined that comprehensive services to persons with ID should consist of inclusive, appropriate, enabling and empowering services. The second theme suggested a new way of coordinating the transformation of services through systematic implementation, suitable regulation, sufficient capacity and ensuring sustainability. A central management structure was suggested to ensure coordinated implementation, to secure funding and to monitor and evaluate the implementation. A mind-shift towards new thinking was identified as a prerequisite for stakeholders buy-in on transformed service delivery. This mind-shift relates to the status of the service users with ID as adults in training towards employment in the open labour market and maximum integration into society. This study contributed new knowledge that informs the development of a new service delivery framework of best practice. The proposed implementation strategy could offer persons with ID the opportunity to progress and develop towards their maximal level of integration into society. It further provided PWs with possibilities for conceptualising different models of practice in the form of an implementable framework and a strategy to transform services. The findings were presented to the SAFMH Directors who adopted the concept framework and implementaimplementation strategy in theory as a proposal for future transformation without amendments.