Meanings of quality of life among people living with epilepsy in Ghana; a qualitative exploratory study.

PURPOSE: The purpose of this study was to explore the meanings of quality of life among people living with epilepsy (PLWE) in Ghana. METHODS: An exploratory-qualitative study design was adopted. Face-to-face in-depth interviews, using a semi-structured interview guide, were conducted on 15 PLWE who were purposively selected for the study. The interviews were audio recorded and transcribed verbatim. The content analysis approach was then used to analyze the data. RESULTS: Four themes - "acceptance", "support", "seizure control", and "self-reliance" emerged from the study as meanings of Quality of life (QoL). Quality of life meant unconditional acceptance from family, friends, acquaintances at home, school, and work, and by the public despite epilepsy. Receiving support in the form of protection from injury during a seizure, financial assistance to meet individual and family demands, emotional warmth, and spiritual support through prayers and encouragement, was QoL for PLWE. Achievement of control over seizures and being self-reliant in terms of selfcare and daily activities in addition to having some form of financial independence meant QoL. CONCLUSION: Meanings of quality of life among PLWE is associated with being accepted and supported by family and friends as well as being in control of seizures and attaining a status of independence.

A Reflexive Lens on Preparing and Conducting Semi-structured Interviews with Academic Colleagues.

In qualitative research, researchers often conduct semi-structured interviews with people familiar to them, but there are limited guidelines for researchers who conduct interviews to obtain curriculum-related information with academic colleagues who work in the same area of practice but at different higher education institutions. Using a pragmatic constructivist stance, we address the practicalities of conducting semi-structured interviews with fellow educators who work in the same area of professional practice, where the researcher has to address the dual roles of "insider" and "outsider" as well as that of researcher and participant. Interviewing academic colleagues offers a unique opportunity for rich data collection, but researchers should adopt a flexible conversational style during interviewing within research parameters and be acutely aware of their positionality and fluidity of roles. This article contributes to existing knowledge by drawing on the work of previous scholars in various areas of research and research methodology thereby offering a practical and theoretical perspective on conducting qualitative research interviewing in higher education institutions where the role of researcher and participant can become blurred. These guidelines and insights will also benefit researchers who conduct research with peers who work together in the same area of expertise, in similar contexts and with whom there are varying levels of working relationships.

Use of the logic model to develop and implement an interprofessional module for undergraduate healthcare students at a University in South Africa: A study protocol.

Interprofessional education and collaborative practice, supported by the World Health Organisation and the local Health Professions Council is not fully established at all universities and for all health professions in South Africa (HPCSA, 2014). In this study protocol, the logic model is proposed as a framework for the development of a module for final year healthcare students. The logic model will guide planning and implementation following the steps of situational analysis, input and processes, output and outcome. A community of practice will develop the module. Large-scale buy-in from management, faculty and students is required for successful implementation and sustainability.

Patient perceptions of nurses' cultural competence in public sector hospitals in Gauteng.

Background: Healthcare institutions are increasingly receiving patients from diverse cultural backgrounds because of migration, rapid urbanisation, and easier access to healthcare. Because the satisfaction of these patients is linked to their perceptions of appropriate cultural care, understanding patient perspectives about cultural competence is imperative. Additionally, patient perceptions about nurses' cultural competence are largely unexplored in South Africa. Aim: This study explored how the concept of cultural competence is perceived by patients. Setting: Three public sector hospitals in Gauteng, one from each of the three different levels of public sector hospitals - district (level one), regional (level two), and academic (tertiary, level three). Methods: This study derives from the qualitative phase of a larger sequential exploratory mixed methods study. The study population was patients in public sector hospitals. A total of 21 interviews were conducted after purposive stratified sampling was done. Data analysis followed Tesch's eight steps of data analysis. Results: Patients in public sector hospitals in Gauteng believe consideration of culture is important in nursing. They identified the cultural needs they would like nurses to acknowledge, such as being asked about their food preferences and mentioned the need to evaluate nurses' level of cultural competence. Conclusion: Patient perceptions about cultural competence and their cultural needs can assist nurses in gauging how culturally competent they are and improving care to patients. Contribution: Patients' perceptions revealed that nurses must be competent to acknowledge their specific cultural needs such as food, language preferences, and religious practices.

Strategies to Alleviate the Burden Experienced by Informal Caregivers of Persons With Severe Mental Disorders in Low- and Middle-Income Countries: Scoping Review.

BACKGROUND: There is considerable evidence of the burden of care encountered by informal caregivers of persons with severe and enduring mental health conditions in low- and middle-income countries. Previous studies have highlighted the need to support these informal caregivers as key players in the care of these patients. To date, limited evidence exists on the extent and types of strategies for supporting these informal caregivers in low- and middle-income countries. OBJECTIVE: This scoping review aims to identify and describe the extent and type of evidence on the existing strategies for alleviating the burden of care among informal caregivers of persons with severe and enduring mental health conditions in low- and middle-income countries. METHODS: A systematic literature search was completed following the Joanna Briggs Institute methodology for scoping reviews. The participants, concept, and context framework was used to guide the search for literature sources across 5 databases: PubMed, MEDLINE, CINAHL, and PsycINFO for published literature and ProQuest for unpublished literature. This review included studies that reported on strategies for alleviating the burden of care among informal caregivers of persons with severe and enduring mental health conditions, with a focus on studies that evaluated or recommended caregiver interventions and support strategies in low- and middle-income countries. The search was limited to studies conducted between 2001 and 2021, and only papers written in English were considered for inclusion. Using the Covidence software (Veritas Health Innovation), 2 reviewers independently screened the papers, applied the inclusion and exclusion criteria, and met biweekly to discuss and resolve conflicts. The relevant studies and reported outcomes were summarized, organized, and analyzed descriptively using numeric summary analysis and deductive content analysis. RESULTS: Of the 18,342 studies identified, 44 (0.24%) met the inclusion criteria. The included studies were from 16 low- and middle-income countries in Asia, Africa, Europe, and South and North America. Most studies (21/44, 48%) were randomized controlled trials conducted in Asian countries. The identified strategies were grouped into 2 categories: implemented and recommended intervention strategies. Identified strategies included community-based interventions, psychoeducation interventions, support groups, cognitive behavioral therapy, spirituality-based interventions, and smartphone-based interventions. In addition, mindfulness and empowerment, collaborative interventions, standard care, financial and social support, counseling, occupation-based interventions, policy and legislature, and access to mental health care were identified. Psychoeducation and support group interventions were identified as common strategies for alleviating the burden of care among informal caregivers of persons with severe and enduring mental health conditions. CONCLUSIONS: This review provides evidence on the types of implemented and recommended strategies for alleviating the burden of care among informal caregivers in low- and middle-income countries. Although psychoeducational interventions were the most preferred strategy for alleviating burden, their benefits were short-lived when compared with peer-led support groups. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/44268.

Perceptions of students and educators regarding a once-off pre-clinical ICU simulation activity.

Background: Physiotherapy skills such as suction and manual hyperinflation (MHI) are used to manage patients in intensive care. Performing these skills effectively and safely requires a level of expertise. It is unknown whether a once-off preclinical high-fidelity simulation activity incorporating these skills would translate to clinical practice inclusion. Objectives: To determine students' perceptions of a simulation-based education (SBE) activity and clinical educators' opinions of students' implementation of skills into practice. Method: Our study consisted of two parts: a retrospective record review of students' feedback with the Simulation Effectiveness Tool - Modified (SET-M) and the Simulation Laboratory Questionnaire. A nominal group technique (NGT) with clinical educators provided information on students' skills implementation. Descriptive data analysis was undertaken. Results: Six SBE sessions, lasting 3 hours each, with 49 students (n = 8-9 students per session) were undertaken. Students perceived the teaching activity positively. Five (33.33%) of 15 clinical educators participated in the NGT. Participants had a mean age of 35.8 (± 8.9) years, were qualified for 13.9 (± 8.9) years and had been supervising students for 7.8 (± 6.7) years. The clinical educators' top five opinions regarding students' implementation of the intensive care unit (ICU) skills were: handling skills improved, students had greater confidence performing these skills, students were more observant of a patient's response to the skill being performed, students had better theoretical knowledge and students had more accurate recall for precautions. Conclusion: Clinical educators reported a change in students' clinical practice with regard to skills implementation. Clinical implications: A once-off preclinical SBE activity influences students' ICU practice.

Employee perceptions of non-communicable diseases health risks, absenteeism and the role of organisational support in a South African pharmaceutical manufacturing company.

BACKGROUND: The growing prevalence of non-communicable diseases (NCDs) in South African workers has been shown to be associated with absenteeism and increased risk of morbidity. Low-income workers living in urban settings are particularly vulnerable. Consultation with workers is crucial for understanding risks and identifying opportunities for intervention to promote health in the workplace. The purpose of this study was to examine South African pharmaceutical manufacturing workers' perspectives of health risk factors and absenteeism, and to identify how they perceived a role for the organisation to initiate interventions to improve their health. MATERIALS AND METHODS: Five focus groups were conducted to capture 27 employees' perspectives. The semi-structured focus group discussions were recorded and analysed using a thematic content analysis approach. RESULTS: Participants indicated that they were aware of behavioural health risks such as prolonged sitting. They showed insight into strategies to prevent injuries and stay healthy, but also expressed dissatisfaction about the lack of organisational support, leading to stress and consequently absenteeism. Participants emphasized the responsibility of the organisation to support a range of health promoting strategies. CONCLUSIONS: The findings of this study are important for cultivating a tailored workplace intervention to reduce NCD risk factors in the pharmaceutical manufacturing workforce. It is vital that these be supported by leadership of the company through the provision of funding and the development of internal healthcare services.

Pharmaceutical workers' perceptions of physical activity and healthy eating: a qualitative study.

OBJECTIVE: The public health message 'move for health' is relevant given the high prevalence of insufficient physical activity, particularly in African countries. The call for behaviour modification including limiting unhealthy dietary patterns in these settings is therefore critical; however, there is limited knowledge on the adoption of health promotion strategies in the workplace. This study aimed to investigate workers' perceptions of physical activity and healthy eating. RESULTS: Five focus groups were conducted with 28 participants employed in a South African pharmaceutical manufacturing company to explore perceptions of physical activity and healthy eating. Results showed that two categories emerged: physical activity and unhealthy behaviours. Participants recognised the importance of obtaining sufficient physical activity in various domains, however believed that contemporary lifestyle limited opportunities for movement. Likewise, participants viewed healthy eating as unrealistic due to financial constraints. There was however agreement that total physical activity time could be increased during recreational pursuits outside of vocational time and may include intermittent walking for travel. These findings are important for workplace interventions and provide a more robust understanding of workers' perceptions of physical activity and healthy eating.

Sensory Modulation Dysfunction in Child Victims of Trauma: a Scoping Review.

Due to the high level of violence globally, providing intervention for child victims of trauma has become a priority for various government departments and health professionals including occupational therapists. Child appropriate sensory modulation intervention, which has its theoretical origins within the occupational therapy profession, has been suggested as a suitable treatment approach for children who are victims of trauma, since the initial experience of trauma occurs on a somatosensory level. Advances in trauma care indicate that children may experience the effects of trauma as an inability to appropriately regulate and organize sensory responses. This results in sensory modulation dysfunction associated with emotional and behavior difficulties. This scoping review provides an overview of the extent to which sensory modulation dysfunction has been identified and treated in child victims of trauma. Using the Arksey and O'Malley (2005) framework, five databases and three manual hand searches were conducted. This scoping review confirmed the scarcity of research available. The 13 studies which met the inclusion criteria indicated that child victims of trauma (CVT) present with a sensory modulation disorder (SMD). Sensory modulation intervention, within the theoretical framework of Ayres Sensory Integration® (ASI®), alone and in combination with psychotherapy approaches was found to be valuable for CVT, in the studies chartered. Identification and treatment of sensory modulation dysfunction in CVT has been researched and is becoming an area of increasing need. Therefore, to remain relevant to the violent contexts within communities, there is a need to expand research in this field.

Strategies to strengthen the provision of mental health care at the primary care setting: An Evidence Map.

In a deinstitutionalised mental health care system, those with mental illness require complex, multidisciplinary and intersectoral care at the primary or community service setting. This paper describes an Evidence Map of different strategies to strengthen the provision of mental health care at the primary health care (PHC) setting, the quality of the evidence, and knowledge gaps. Electronic and reference searching yielded 2666 articles of which 306 qualified for data extraction. A systematic review methodology identified nine different strategies that strengthen the provision of mental healthcare and these strategies are mapped in line with the outcomes they affect. The top three strategies that were reported the most, included strategies to empower families, carers and patients; integration of care or collaborative interventions; and e-health interventions. The least reported strategy was task shifting. The Evidence Map further shows the amount and quality of evidence supporting each of the listed strategies, and this helps to inform policy design and research priorities around mental health. This is the first systematic Evidence Map to show the different strategies that strengthen the provision of mental healthcare at PHC setting and the impact these strategies have on patient, hospital and societal level indicators.

Preparing for work practice: Under- and postgraduate student training at the University of Pretoria (South Africa).

South Africa has experienced much new legislation since the restoration of democracy in 1994 which has had widespread influences on education. Past and current teaching strategies of occupational therapy training at the University of Pretoria have included the training of students in vocational rehabilitation (or work practice). The influence of these new laws on training is discussed. An outline of the undergraduate and postgraduate modules presented at the University of Pretoria is presented in this paper. The authors wish to share the training of vocational rehabilitation with other educators as this training program seems to be very successful in South Africa.

The Model of Creative Ability in vocational rehabilitation.

Occupational therapy literature has reported on the concept of motivation in great depth and it is evident that motivation has many constructs. Motivation is seen as a key indicator for success in rehabilitation. When assessing a client's vocational skills and performance, occupational therapists in South Africa have found the Model of Creative Ability to be a useful model to determine the quality and quantity of motivation. This article briefly describes the development of the Model of Creative Ability in South Africa and explains the fundamental concepts and terminology used in the model. Criticism of the model as well as the reasons for the popularity of this model are given. A case study is used as an example to illustrate the unique contribution of the levels of motivation and action to a medico-legal report.

Occupational therapy students' contribution towards enabling potential in a semi-rural community.

Occupational therapy students at the University of Pretoria engage in a 7-week service learning fieldwork in their fourth year. This fieldwork takes place in a semi-rural community. The article reports on a successful project where the students enabled adult learners with disabilities to improve their engagement in meaningful activities and trained the learners in selected prevocational skills. The students included a teacher from the center and she was given the opportunity to expand her skills in teaching as well. The ZOPP model of community project planning was used and proved to be a useful tool for students who have limited time for planning, implementation and evaluation of a project.

Digital technologies in occupational therapy and physiotherapy undergraduate and postgraduate education: a scoping review protocol.

REVIEW QUESTION AND OBJECTIVE: How have digital technologies been used in occupational therapy and physiotherapy undergraduate and postgraduate education?Specifically, the objective of this scoping review is to present an overview of research on the use of digital technologies in terms of type of digital technology used, pedagogy associated with the use of digital technology, subject/topic/area of application, experiences/perception of digital technology used, outcomes of the digital technology used and challenges to the use of digital technologies in occupational therapy and physiotherapy undergraduate and postgraduate education.

An Investigation into the Quality of Life of Cancer Patients in South Africa.

OBJECTIVE: Cancer patients in Africa face unique challenges such as poverty, access to health care and under-resourced health-care systems. Although quality of life (QoL) of cancer patients has been well researched, the perspectives of cancer patients living in Africa are unknown. The objective was to explore what constitutes QoL for cancer patients accessing public health care in South Africa. METHODS: A qualitative exploratory design was used, and data were gathered by means of in-depth interviews. Purposive sampling selected the participants, and the sample size was determined by saturation (n = 22). The data were analyzed using Patton's method of content analysis. RESULTS: The participants were aged between 20 and 79 years, with an average of 50 years. Most were female and represented seven cultural groups. Four themes that influence QoL arose from the data: psychosocial-, physical-, spiritual and financial factors. CONCLUSIONS: QoL remains a complex phenomenon, enhanced and diminished by various individual factors. Poverty was a major issue and influenced the physical aspects of QoL, as the participants had to be strong enough to work and earn a living. Support from family, friends, and church members enhanced QoL, as well as religion and religious practices. Measuring QoL would be the next step to enable nurses to implement measures to improve QoL. Whether existing QoL instruments would be suitable for this patient population is not known and should be investigated before implementation.

Exploring service delivery in occupational therapy: The use of convergent interviewing.

BACKGROUND: Occupational therapy clinicians working in South Africa's public healthcare had views on what patients thought about their vocational rehabilitation services that were based on anecdotal evidence. However evidence-based practice requires more than that. Reliable information is important in patient-centred practice and in the assessment of service quality. OBJECTIVE: Clinical occupational therapists used the convergent interviewing technique to explore patients' views of the vocational rehabilitation services on offer in public hospitals. METHOD: An Action Learning Action Research (ALAR) approach was used to explore the vocational rehabilitation services occupational therapy clinicians provided over a two week period in three settings. RESULTS: The majority (96%) of patients interviewed were not aware that occupational therapists offered vocational rehabilitation services. The convergent interview technique allowed continued unrestricted discussion of their vocational rehabilitation concerns and provided evidence that patients had significant concerns about work. Critical reflection on the interview experience and technique indicated that therapists were in favour of using convergent interviewing to obtain their patients views about the services offered. Therapists found the convergent interview technique easy to apply in clinical practice. CONCLUSION: Establishing patients' views of a clinical service have multiple values. However it is meaningless unless clinicians use the knowledge to improve service delivery to the patients who provided the views. Convergent interviewing was a valuable technique for occupational therapy clinicians to incorporate patients' views of their services into service development.

A comparison of two assessments of levels of functioning in clients with intellectual disability between occupational therapists and nursing staff within a long-term mental healthcare facility in South Africa.

BACKGROUND: The implementation of the South African Mental Health Care Act, which regulates care for clients with intellectual disabilities, impacted on the healthcare services provided to this population. Changes in the Act necessitated planning of new care packages, which resulted in the investigation of the current hospital client profile, as well as assessment data on patient abilities according to the occupational therapist and nursing staff as primary caregivers. METHODS: A retrospective, descriptive correlation study design was used as information was analysed from an existing database. Descriptive analysis of clients' demographic data, occupational performance and adaptive functioning were done, as well as a Spearman's rank correlation test and cluster analysis to describe the association between the levels of functioning as measured by the different professions. RESULTS: The results indicated low levels of abilities, as well as a good to excellent correlation between results of the Fairview self-help scale and Creative Participation Assessment. CONCLUSION: This study provided preliminary evidence that these two tools are valuable instruments for measuring occupational performance and adaptive functioning in institutions that provide care for this vulnerable and under-researched population.