Returning individuals with mild to moderate brain injury back to work: A systematic client centered approach

Book chapterAn increase in the numbers of individuals who sustained brain injuries due to motor vehicle accidents, trauma induced by violence and substance abuse, has resulted in more disabled individuals becoming non-productive members in society and inactive in the workplace. Research in the field of brain injury rehabilitation internationally is limited, with the majority of research focusing on the medical model of intervention. In the medical model, the disabled or injured individual is regarded as having problems that require medicalbiological intervention mainly, with little or no attention given to the difficult process of reintegrating the disabled individual back into society, for example, in resuming their worker roles. The medical approach may result in feelings of disempowerment on behalf of the disabled with regard to the rehabilitation process. The lack of success of current rehabilitation interventions could be seen as a result of an inability to generalize outcomes of rehabilitation in a clinical setting to the skills needed to return to work or re-integrate into the community

Adaptation to the worker role: The vocational experience of South African male ex offenders

Objectives: The study is aimed at exploring, describing and understanding the experiences and perceptions of male ex-offenders with regard to adapting to their worker roles after they have been released from prison. Methods: The research methodology utilised was positioned in the qualitative research paradigm, specifically using the tradition of interpretivism. To gather data from the participants, focus groups and face to face interviews were conducted, consisting of broad questions followed by probes to gain an in-depth description of participants’ experiences and perceptions. Participants: Five males who were classified as being ex-offenders participated in the focus groups and one female (key informant) participated in two semi structured interviews. Results: Four themes emerged that reflected the vocational experience of male ex- offenders: 1) A sense of distrust, 2) A sense of support: Giving back to the community through learning and doing, 3) A change in lifestyle and 4) Working towards change through capacity building. For the purpose of this article, Theme 3- A change in lifestyle, will be discussed in depth as it explored the adaptive process that male ex- offenders experienced when adapting to their worker roles post release from prison. Conclusions: The findings of the study suggest that occupational therapy practitioners as well as correctional service personnel should utilise context specific vocational rehabilitation programmes that enhance the exoffender’s ability to find employment once they have been released from prison. Practitioners should be aware of both the internal and external adaptation strategies when planning vocational rehabilitation and community reintegration strategies.Web of Scienc

The influence of divorce on the occupations of primary school going children in the Western Cape, South Africa: The perspective of the child and a relevant counsellor

There have been a number of studies over the years that propose that divorce could create turmoil in children’s lives. Many theorists agree that divorce is a stressful life transition needing adjustment for both the parent and/or child. This study determined how divorce influence childrens` participation in scholastic and leisure activities. The study was positioned in the qualitative research paradigm, specifically using focus groups and face to face interviews to collect data. The participants consisted of one male and three females (aged 8-12 years) and one adult female (key informant). Four themes emerged viz. 1) Listening but not hearing, 2) Adapting by doing, 3) Helping hands and 4) In the ideal world. The findings of the study indicate that children could benefit from family centred treatment programmes and should be involved in counceling post divorce. The barriers or challenges include feelings of sadness and hopelessness, inability to communicate and express feelings to parents and a change in social interaction and leisure activities. The facilitatory factors included having closer family networks, having a parental figure at home to assist with occupational needs, having positive peers support groups and counseling as a form of support.Unknow

Occupational therapy students’ perceptions of the challenges they experience in adapting to a psychiatric fieldwork placement.

Author post-printBackground: Mental health in Occupational Therapy is experiencing a decline in preference for practice. Aim: This study explored occupational therapy students’ perceptions of the challenges they experience in psychiatric fieldwork. Methods: The researcher used a qualitative research design and collected data by means of focus groups with 8 final year occupational therapy students and 1 interview with a key informant. Findings: Five themes emerged: 1) Listening but not hearing, 2) Boxed thinking 3) Helping hands, 4) Losing the training wheels: Gaining independence and 5) An ideal psych programme. Implications: The barriers to learning identified in this study should be eliminated and the facilitators encouraged. The study highlighted that all theory be taught in the class lectures before the students enter their fieldwork placement. It was also recommended that multimedia sources such a video clips or recorded treatment sessions be used in formal lectures in order to familiarise students to the reality of psychiatry

Occupational self efficacy : an occupational therapy practice model to facilitate returning to work after a brain injury

Philosophiae Doctor - PhDThis qualitative study explored and described the lived experience of people with brain injuries with regard to resuming their worker roles. Based on the results, an occupational therapy practice model to facilitate return to work was developed. The theoretical framework of occupational science with emphasis on occupational risk factors informed the study. The research design was a theory generative design based on a qualitative, phenomenological, explorative and descriptive research approach utilizing the methods of theory generation as advocated by Chinn and Kramer (1999), Walker and Avant (2005) and Dickoff, James and Wiedenbach (1968).South Afric

The experiences of women with traumatic brain injury about the barriers and facilitators experienced after vocational rehabilitation in the Western Cape Metropole, South Africa

Traumatic Brain Injury (TBI) is a serious global public health problem. Globally and annually, at least 10 million individuals live with TBI that is serious enough to result in death or hospitalization. This study aimed to explore and describe the experiences of women with traumatic brain injury, in their work environments utilising the Model of Occupational Self-efficacy as a vocational rehabilitation approac

Individuals with traumatic brain injuries perceptions and experiences of returning to work in South Africa

Objective: The aim of this study was to identify the central concepts of a model that would facilitate the return to work process of individuals with brain injury. However for the purpose of this paper there will be a focus only on the barriers and facilitators that influence the return to work process. Participants: Ten individuals who were diagnosed with a mild to moderate brain injury participated in this study. Methods: Qualitative research methods were used in order to explore the research question. The participants were selected by means of purposive sampling and the data was collected by means of in depth interviews. Results: The results of the study revealed that the participants experienced a sense of loss of function after the brain injury, a fear of the future and loss of confidence in their worker roles. The participants also indicated that by means of adapting occupational routines and actively engaging in rehabilitation they developed confidence in their worker roles. Conclusion: Occupational therapists have to use a client centred holistic work integrative approach in order to successfully rehabilitate as well as facilitate the return to work process with people who have suffered a traumatic brain injury.IS

The development of a return to work intervention programme for stroke survivor (SReTWIP): A Delphi survey

Even though clearly defined pathways for vocational re-entry are well recognized for conditions such as mental health, musculoskeletal dysfunction (MSD) and traumatic brain injury (TBI), none has been identified for stroke. There has been a lack of consensus regarding such clear pathways to vocational re-entry and the essential contents of return to work (RTW) interventions for stroke survivors. As part of a larger study aimed to design a RTW programme for stroke survivors, this study describes the concluding process through which Stroke Return to Work Intervention Programme (SReTWIP) was developed

Predictors of return to work among stroke survivors in south-west Nigeria

Introduction: Stroke is acknowledged globally and among Nigerian rehabilitation researchers as a public health problem that leaves half of its survivors with significant neurological deficits and inability to re-establish pre-existing roles. Consequent to the dearth of country specific data on return to work and its determinants for stroke survivors in Nigeria, this study investigated the predictors of return to work among stroke survivors in south-west Nigeria. Method: Two hundred and ten stroke survivors from five tertiary health facilities in Osun state, Nigeria responded to a validated three-section questionnaire assessing return to work rates and its determinants after stroke in this study. Collected data were analysed using descriptive statistics and inferential statistic of chi-square, t-test and multiple logistic regression. Result: The mean age of the respondents was 52.90 ± 7.92 years. Over 60% of the respondents returned to work with about half of them in full time employment (32.9%). Majority of the respondents noted that travel to and from work (43.8%) and access at work (43.3%) had an impact on their ability to work. The symptoms of stroke (odds ratio (OR) = 0.87), the environment (OR = 0.83), body function impairments (OR = 0.86) as well as activity and participation problems (OR = 0.80) were the significant predictors of return to work. Hemiplegia or paresis of the non-dominant side of the body was associated with a higher chance of return to work (OR = 7.64). Conclusion: Body function impairments, activity and participation problems were independent predictors of return to work after stroke. Similarly, side of hemiplegia plays a prominent role in resumption of the worker role of stroke survivors in south-west Nigeria. © The Author(s) 2021

An African perspective

Background. In the South African context, there are no specific guidelines regarding how to prepare and support adolescents for the transition from a health care to a high school setting post TBI. This raises questions about the relevance and responsiveness of the current transition practices in occupational therapy in terms of adequately preparing and supporting these adolescents toparticipate in school and hence exercise their right to a quality education. Method. This study explored adolescents and otherkey role players’ perspectives on and experiences of the high school transition (i.e., school reentry and continued school participation) post TBI. It was anticipated that this would provide an increased understanding of the enablers and barriers to high school reentry and participation post TBI. This served as a basis to explore the main aim of this study which was to help occupational therapists identify where efforts in terms of service delivery are needed. This study was situated in the interpretivist qualitative paradigm and used a multicase study design, which included semistructured interviews with eight adolescent learners with TBI, their primary caregivers, teachers, and principals as well as observations and documentation review. Results. This paper will focus on a central theme in the research, namely, the nature and extent of support needed to facilitate the high school transition of adolescents with TBI within a developing context. Similar to the findings of studies conducted in developed contexts, participants highlighted that they felt that adolescents need support at various stages of the school transition. Participants further alluded to support that should be collaborative, coordinated, flexible, and monitored to ensure it is relevant and responsive to these adolescents’ changing needs. Conclusion. The study findings conclude that occupational therapists have a crucial role in fostering an enabling environment (directly and indirectly) through fulfilling various roles including that of a facilitator, intermediary, coach, collaborator, supporter, and advocator