Occupational therapists' views and perceptions of functional capacity evaluations of employees suffering from major depressive disorders

INTRODUCTION : Major depressive disorders (MDD) cause work disability and work loss, often resulting in unemployment. Employees with MDD are often referred to occupational therapists (OTs) to assist with functional capacity evaluation (FCE). Functional Capacity Evaluation forms a part of the return-to-work decision making process. This study describes the views and perceptions of occupational therapists regarding the requirements needed to conduct reliable FCEs of employees suffering from MDD. METHODS : This study employed a descriptive, qualitative study design. Data were collected in three phases using open-ended questions, focus groups and member checking groups. Thematic content data analysis was used. FINDINGS : In total, 78 occupational therapists were recruited and 39 participated, with response rates of (28) 47%, (11) 61% and (9) 82% respectively across the three phases. Nine participants took part in the focus groups and member checking groups. Three themes emerged, namely: (1) occupational therapists’ competencies in performing functional capacity evaluations (2) the process of functional capacity evaluation and (3) comprehensive functional capacity evaluation. CONCLUSION : The views and perceptions of occupational therapists of performing FCEs is to formulate return-to-work decisions. Occupational therapists should be competent in the use of standardised measurement tools, non-standardised assessment and clinical reasoning.http://www.sajot.co.za/index.php/sajotam2019Occupational Therap

‘There’s a lot on my shoulders’ – occupational therapists’ experience of stress and burnout in mental healthcare settings in Gauteng, South Africa

DATA AVAILABILITY STATEMENT : During the development, progress, and reporting of the submitted research, Patient and Public Involvement in the research was: • Included in planning and progress of the research • Included in the conduct of the researchINTRODUCTION : South African occupational therapists, working in mental healthcare, are exposed to chronic stress; this can lead to their experiencing symptoms of burnout. There has been a call for research to explore the experiences of stress and burnout that occupational therapists encounter whilst working in different contexts, and this article presents findings from a study focused on the field of mental healthcare in Gauteng, South Africa. METHODS : Thirteen occupational therapists participated in the study using qualitative and descriptive methods. The study sample was selected using purposive and snowball sampling. Data were collected via online focus group discussions and underwent thematic analysis according to open coding. FINDINGS : This article presents the findings of theme one, as part of a greater dissemination of findings, where the participants described their stress and burnout as a personal psychological experience. This involved the experience of emotional burden, strained interpersonal relationships and feelings of failure. The participants perceived their stress as a fluctuating experience and, a portion of the participants, felt that they had experienced burnout. CONCLUSION : The negative personal psychological impact of stress and burnout on occupational therapists working in South Africa, in the field of mental healthcare, has been well indicated in the study.https://journals.sagepub.com/home/BJOhj2024Occupational TherapySDG-03:Good heatlh and well-bein

Formulating a return-to-work decision for employees with major depressive disorders : occupational therapists’ experiences

Background: Major depressive disorder (MDD) is worldwide one of the most concerning health problems as it is associated with reduced work productivity and permanent disability. Occupational therapists are often called upon to make a return-to-work decision on employees with MDD in order to facilitate continued employment. Sustaining employment is in alignment with achieving the Millennium Development Goal 1: Eradicating extreme poverty, as it is known that people suffering from mental health disorders are frequently denied employment opportunities leading to reduced financial resources and therefore possible poverty. Aim: This study described occupational therapists’ experiences of formulating a return-towork decision on employees with MDD. It formed part of a larger study. Setting: Occupational therapists working in vocational rehabilitation or mental health in South Africa with a postgraduate qualification in vocational rehabilitation or mental health participated in the study. Method: A qualitative research design was used. Two separate focus groups explored 11 occupational therapists’ experiences of formulating a return-to-work decision on employees with MDD. Ethics clearance number: S34/2007. Results: Seven themes emerged, which were, (1) the biographical profile of the employee, (2) point of view of employer, (3) point of view of employee, (4) point of view of occupational therapist, (5) declaring the employee as temporary incapacitated, (6) declaring the employee as permanently incapacitated and (7) employee’s level of motivation. Conclusion: Occupational therapists ought to have sound knowledge, skill, experience and the ability to collaborate with employees and employers in formulating a return-to-work decision.http://www.phcfm.orgam2016Occupational Therap

The perceptions of adult psychiatric inpatients with major depressive disorder towards occupational therapy activity-based groups

BACKGROUND: Occupational therapists have been using group therapy as their preferred treatment modality in mental healthcare since the origin of the profession. In private mental healthcare units, major depressive disorder (MDD) is the most common psychiatric disease. Occupational therapists use individual and group therapy to treat adult inpatients with MDD. Little is known about the perceptions and experiences of adult inpatients with MDD regarding occupational therapy activity-based groups. AIM: To describe the perceptions and experiences of adult psychiatric inpatients with MDD towards occupational therapy activity-based groups. This article reports on the perceptions of adult psychiatric inpatients with MDD, which formed part of a larger study. SETTING: The study took place at two private general hospitals in Gauteng province, South Africa, each with a psychiatric ward. METHODS: The researcher used a qualitative explorative descriptive design. Accessible participants were selected using convenience sampling. Only consenting participants took part in the study. Data were collected during focus group discussions. Data were thematically analysed. RESULTS: Participants’ perceptions could be placed into one of four themes: (1) experience improved mood, (2) learned coping skills, (3) regained self-esteem and (4) becoming part of the solution to face life challenges. CONCLUSION: Activities that are unique to occupational therapy profession can benefit inpatients with MDD. This supports the profession’s historical beliefs, assumptions and foundations regarding therapeutic use of activities. According to these inpatients, group activities improved their overall mental health.http://www.sajpsychiatry.orgOccupational TherapyPsychiatr

Early multi-wavelength emission from Gamma-ray Bursts: from Gamma-ray to X-ray

The study of the early high-energy emission from both long and short Gamma-ray bursts has been revolutionized by the Swift mission. The rapid response of Swift shows that the non-thermal X-ray emission transitions smoothly from the prompt phase into a decaying phase whatever the details of the light curve. The decay is often categorized by a steep-to-shallow transition suggesting that the prompt emission and the afterglow are two distinct emission components. In those GRBs with an initially steeply-decaying X-ray light curve we are probably seeing off-axis emission due to termination of intense central engine activity. This phase is usually followed, within the first hour, by a shallow decay, giving the appearance of a late emission hump. The late emission hump can last for up to a day, and hence, although faint, is energetically very significant. The energy emitted during the late emission hump is very likely due to the forward shock being constantly refreshed by either late central engine activity or less relativistic material emitted during the prompt phase. In other GRBs the early X-ray emission decays gradually following the prompt emission with no evidence for early temporal breaks, and in these bursts the emission may be dominated by classical afterglow emission from the external shock as the relativistic jet is slowed by interaction with the surrounding circum-burst medium. At least half of the GRBs observed by Swift also show erratic X-ray flaring behaviour, usually within the first few hours. The properties of the X-ray flares suggest that they are due to central engine activity. Overall, the observed wide variety of early high-energy phenomena pose a major challenge to GRB models.Comment: Accepted for publication in the New Journal of Physics focus issue on Gamma Ray Burst

Polymorphisms of −174G>C and −572G>C in the Interleukin 6 (IL-6) Gene and Coronary Heart Disease Risk: A Meta-Analysis of 27 Research Studies

OBJECTIVE: Elevated serum IL-6 level is a risk factor for coronary heart disease (CHD). The -174 G>C and -572 G>C polymorphisms in the IL-6 gene have previously been shown to modulate IL-6 levels. But the association between the -174 G>C and -572 G>C polymorphisms and the risk of CHD is still unclear. A meta-analysis of all eligible studies was carried out to clarify the role of IL-6 gene polymorphisms in CHD. METHODS AND RESULTS: PubMed, EMBASE, Vip, CNKI and CBM-disc were searched for eligible articles in English and Chinese that were published before October 2010. 27 studies involving 11580 patients with CHD and 17103 controls were included. A meta-analysis was performed for the included articles using the RevMan 5.0 and Stata 10.0 softwares. Overall, the -174 C allele was not significantly associated with CHD risk (ORs = 1.04, 95%CI = 0.98 to 1.10) when compared with the -174 G allele in the additive model, and meta-analysis under other genetic models (dominant, recessive, CC versus GG, and GC versus GG) also did not reveal any significant association. On the contrary, the -572 C allele was associated with a decreased risk of CHD when compared with the -572 G allele (ORs = 0.79, 95%CI = 0.68 to 0.93). Furthermore, analyses under the recessive model (ORs = 0.69, 95% = 0.59 to 0.80) and the allele contrast model (genotype of CC versus GG, ORs = 0.49, 95% = 0.35 to 0.70) yielded similar results. However, statistical significance was not found when the meta-analysis was restricted to studies focusing on European populations, studies with large sample size, and cohort studies by using subgroup analysis. CONCLUSIONS: The -174 G>C polymorphism in the IL-6 gene is not significantly associated with increased risks of CHD. However, The -572 G>C polymorphism may contribute to CHD development. Future investigations with better study design and large number of subjects are needed

The outcome of two occupational therapy group programs on the social functioning of individuals with major depressive disorder

Individuals with major depressive disorder (MDD) frequently experience interpersonal difficulties. This study compared two occupational therapy group programs, an existing discussion/activity program and a new activity-based group program, on the social functioning of individuals with MDD. A concurrent embedded mixed methods intervention advanced design was employed. One hundred voluntary individuals, 50 in each group, were pre- and post-tested with the Social Interaction Scale and participants’ experiences were documented with self-report questionnaires and focus group interviews. The new activity-based program showed significant (p < 0.004) improvement on the total outcome compared to the existing program. Participants of both programs experienced improved social interaction.http://www.tandf.co.uk/journals/titles/0164212X.asphj2021Occupational Therap

Reducing psychosocial disability for persons with severe mental illness in South Africa

Severe mental illness, which includes disorders such as schizophrenia, bipolar disorder and major depressive disorder, is associated with significant impairment, but the severity of the impairment and the associated psychosocial disability varies significantly within each disorder. While South African legislation and policies support interventions aimed at reducing psychosocial disability and promoting recovery, implementation remains a challenge.http://www.journals.co.za/content/journal/healthrhj2021Occupational Therap

Mental health care users with major depressive disorders: Initial outcomes of an occupational therapy group programme

Treating mental health care users (MHCUs) with major depressive disorders (MDD) require an inter-professional health team approach that includes occupational therapy. The MHCUs with MDD in psychiatric wards at two private general hospitals followed a standard occupational therapy group programme as part of a treatment plan. The efficacy of this occupational therapy group programme in hospital settings has hardly been previously investigated. This study measured the outcome of a standard occupational therapy group programme on the cognitive, performance and affective functioning components of MHCUs with MDD. The study was conducted in the Occupational Therapy Department at the University of Pretoria. Thirty- five MHCUs with MDD voluntarily participated in nine 90-minute occupational therapy group sessions over a two-week period. A quantitative one group pre-test-post-test study design was employed. The 35 participants were evaluated using The Bay Area Functional Performance Evaluation-Revised (BaFPE-R) prior to and following on a two-week occupational therapy group programme. T-test analysis revealed significant improvements in the pre- to post-testing mean score (p&lt;0.001), in the following variables: cognitive (10.0), performance (7.6) and affective (6.3) functioning component scores. The standard occupational therapy group programme had a positive outcome on MHCUs with MDD’s cognitive, performance and affective functioning components. It was concluded that occupational therapy group programmes could improve longterm recovery from MHCUs with MDD. Future studies with larger samples sizes and control groups are needed to accurately assess the benefits of occupational therapy programmes in South African psychiatric settings.Keywords: Major depressive disorder, occupational therapy groups, cognitive functioning,performance functioning, affective functioning

A comparison of two occupational therapy group programs on the functioning of patients with major depressive disorders

BACKGROUND ː Occupational therapists, as part of the multi-disciplinary psychiatric team, regularly include activities and or discussion groups to reduce symptoms of patients with major depressive disorders (MDD), and to improve their functional ability. This study set out to compare two occupational therapy group programs. A Standard Care Plus (SCO) program, which includes tangible activities in each of the nine group sessions, was compared with the usual Standard Care (SCN) program, which excludes tangible activities in four of the nine group sessions. METHODS ː A comparative two-group parallel-study design was employed. One hundred participants, 50 from each occupational therapy group program, were pre- and post-treatment tested by means of the Patient Health Questionnaire (PHQ-9). The study took place at the psychiatric wards of two private general hospitals in South Africa. RESULTS ː The SCO had a significant improved total outcome (P<0.0071) compared to the SCN. Five items measured in the SCO, showed a statistically significant improvement. These items were the following: interest or pleasure in doing things (P<0.0145), trouble falling or staying asleep, or sleeping too much (P<0.0103), feeling tired or having little energy (P<0.0365), moving or speaking slowly or fidgeting and/or restless (P<0.0114) and thoughts that you would be better off dead, or of hurting yourself (P<0.0123). CONCLUSIONS ː The results indicated that the SCO, which included tangible activities in every occupational therapy group session in the treatment of patients with MDD, was superior to the SCN which excluded tangible activities in four of the nine group sessions.https://www.minervamedica.it/it/riviste/minerva-psichiatrica/index.php2018-09-30hj2018Occupational TherapyPsychiatr