Healthcare Stakeholders' Perspectives on Challenges in the Provision of Quality Primary Healthcare for People with Disabilities in Three Regions of Guatemala: A Qualitative Study.

It is estimated that 3.75 billion people worldwide lack access to healthcare services. Marginalized populations, such as people with disabilities, are at greater risk of exclusion. People with disabilities not only face the same barriers as people without disabilities, but also experience a range of additional barriers in accessing healthcare due to a variety of discriminatory and inaccessible environments. These extra barriers exist despite their greater need for general healthcare, as well as specialized healthcare related to their impairment. Few studies have focused on healthcare providers and the challenges they face in caring for this group. This paper describes the perspectives of healthcare stakeholders and reported challenges to the provision of quality primary healthcare for people with disabilities. In-depth interviews with 11 healthcare stakeholders were conducted in three regions of Guatemala. Data were analyzed using thematic analysis. Five sub-themes emerged from the above theme: infrastructure and availability of resources, impairment-based challenges, need for special attention and empathy, opportunity to provide services to people with disabilities, and gaps in training. The results could contribute to the development and implementation of strategies that can improve primary care provision and ultimately access to services for people with disabilities in low- and middle-income countries.

Vocational evaluation and vocational guidance for young people with a history of drug abuse.

BACKGROUND: Young people recovering from drug addiction often face challenges in returning to the job market and in maintaining their jobs. Many of them feel they have no choice but to do entry-level work, and they are often unsure about their work ability and vocational choice. OBJECTIVE: In collaboration with a youth outreach service, this study aims to provide a package of vocational assessment, guidance, and support for these clients. METHODS: Using a strength-based case management framework, we conducted a comprehensive vocational evaluation for each participant (N = 17), which covered self-perception of abilities, work and occupational interests, work readiness, work-related self-efficacy, and work aptitudes. We presented assessment results to each client and provided guidance on their education, training, or vocational choice. RESULTS: The results of aptitude tests indicate that most participants can cope with an entry-level job. Many participants are strong in jobs that require quick decision-making, sorting, assembly, and clerical tasks, but many are weak in fine manual dexterity and eye-hand-foot coordination. Many participants preferred jobs that are creative, indefinite, and autonomous in nature. CONCLUSION: Longer-term vocational counseling and coaching is needed to help clients make vocational choices and extend their job tenure. Many clients will also need training in job seeking and job maintenance skills.

Engagement in Play Activities as a Means for Youth in Detention to Acquire Life Skills.

This study describes how occupational therapists in a community-based programme, Occupational Therapy Training Program (OTTP), use play activities to facilitate the acquisition of life skills by youth in detention. This pilot study explored the extent of engagement of male and female inmates aged 14 to 18 years old in structured play activities on topics such as interpersonal relationships, self-awareness, cultural celebrations and the transition to community. Retrospective analysis of data collected from surveys using the Engagement in OTTP Activities Questionnaire (EOAQ), completed by youth participants at the end of each group session, was used to measure the extent of occupational engagement. Worksheets and artworks produced by OTTP participants during those group sessions were also analysed. The participants reported very high engagement in OTTP. Engagement scores for male participants were higher than those for female participants, and male and female participants had higher engagement scores for different activities. Over 90% of the worksheets and artworks were found to be complete and relevant to the topic of the session. Play activities could be an appropriate way for occupational therapists to encourage youth in detention to acquire life skills. Demographic information and the actual number of participants are unknown because of how the existing data were collected. Future studies examining the potential gender-related preferences for specific topics deserve further investigation as well as research comparing the youth's engagement in OTTP interventions using play activities to other group interventions. Copyright © 2016 John Wiley & Sons, Ltd.

Client perception of a client-centered and occupation-based intervention for at-risk youth.

BACKGROUND: A community-based occupational therapy program aims to provide client-centered and occupation-based interventions to at-risk youth. OBJECTIVE: This pilot study explores how at-risk youth experiencing psychosocial and environmental barriers to occupation respond to client-centered and occupation-based occupational therapy in the community. METHOD: One-on-one semi-structured interviews were conducted with five youth participants receiving individual therapy interventions through a community-based occupational therapy program. The transcript data were analyzed qualitatively. RESULTS: Three themes emerged: (i) client-centered and occupation-based OT interventions, (ii) the youths' increased self-advocacy, and (iii) the enhancement of youths' perception of their future. CONCLUSION AND SIGNIFICANCE: The youth in this study described OT interventions exemplifying client-centered and occupation-based therapy, a non-prescriptive approach that validates the individual and may prove especially effective in serving the at-risk youth population.