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Cultural Studies, Health Care Sciences & Services, and Social Issues

BACKGROUND: Primary healthcare (PHC) is central to increased access and transformation in South African healthcare. There is limited literature about services required by occupational therapists in PHC. Despite policy being in place, the implementation of services at grassroots level does not always occur adequately. OBJECTIVES: This study aimed at gaining an understanding of the challenges of being disabled and the services required by occupational therapists (OTs) in rural communities in order to better inform the occupational therapy (OT) training curriculum. METHOD: An exploratory, descriptive qualitative design was implemented using purposive sampling to recruit 23 community healthcare workers from the uGu district. Snowball sampling was used to recruit 37 members of the uGu community, which included people with disability (PWD) and caregivers of PWDs. Audio-recorded focus groups and semi-structured interviews were used to collect data, which were thematically analysed. Ethical approval was obtained from the Biomedical and Research Ethics Committee of the University of KwaZulu-Natal (BE248/14) RESULTS: Two main themes emerged namely: firstly, the challenges faced by the disabled community and secondly appropriate opportunities for intervention in PHC. A snapshot of the social and physical inaccessibility challenges experienced by the community was created. Challenges included physical and sexual abuse, discrimination and marginalisation. Community-based rehabilitation and ideas for health promotion and prevention were identified as possible strategies for OT intervention. CONCLUSION: The understanding of the intervention required by OT in PHC was enhanced through obtaining the views of various stakeholders' on the role. This study highlighted the gaps in community-based services that OTs should offer in this context.

Biology, Health Care Sciences & Services, and Medicine, General & Internal

BACKGROUND: Re-engineering of primary healthcare (PHC) was initiated nationally in 2009. There is, however, little information on the role expected of occupational therapists (OTs) in PHC. OBJECTIVES: This research aimed to understand how stakeholders of the Department of Health (DOH) perceived the role of OT in PHC service. METHOD: This exploratory, qualitative study used purposive sampling to recruit community health-care workers (CHW; n = 23), primary healthcare nurses (PHC; n = 5), DOH management (n = 5), experienced (n = 14) and novice OTs (n = 37) who graduated from the University of KwaZulu-Natal. The PHC nurses and the CHW represented PHC clinics in one district in KwaZulu-Natal. Data were collected through semi-structured interviews and focus groups. Interviews with CHWs were conducted in isiZulu. These were transcribed and translated prior to data analysis. Audio recordings of English interviews and focus groups were transcribed. Data for each participant group were inductively and thematically analysed to identify the themes. RESULTS: The findings provided an indication of the role of OTs in PHC settings. All participants perceived the role of OTs as predominantly curative/rehabilitation-based and individualised. Participants had a limited understanding of the key principles of PHC. They identified a need for adult and paediatric rehabilitation and early childhood intervention. Limited mention was made of population-based approaches, collaborative, and health promotion and prevention programmes. CONCLUSION: The study has highlighted that neither management nor OTs seemed to align practice and planning according to PHC principles. A review of the theory and experiential learning in the OT programme is required.

Health Care Sciences & Services, Clinical competence, clinical supervisors, and occupational therapy students

This study explores the perceptions offinal year occupational therapy students at the University of KwaZulu Natal and their supervisors, regarding their preparedness to practice as well as their views about the efficacy of the undergraduate curriculum in accomplishing adequate levels of preparedness. METHOD: A qualitative design using focus groups and semi-structured interviews with students and clinical supervisors to obtain their views and backed up by an analysis of relevant documents of the Health Professions Council of SA and the World Federation of Occupational Therapists, the outcome of which formed the conceptual framework guiding analysis of the data from the interviews and focus groups RESULTS/FINDINGS: Both students and their supervisors felt they possessed adequate graduate competencies to prepare them for practice. Some concerns related to curriculum content, teaching methods, and relationships with lecturers and clinical supervisors emerged. Students' level of professional confidence was directly influenced by their degree of enjoyment of the fieldwork practical and positive experiences related to this. Supervisors also reported that students display high levels of ethical awareness. CONCLUSIONS: the findings provide insights into understanding the relevance of current occupational therapy training specifically at UKZN but also of relevance to the rest of South Africa