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[leratotheot]

OT’s the friend we ALL need!

Primary Health care has been established as a sector that addresses a large majority of personal health needs. This sector is the largest in health science that deals with the immediate health needs that people may present with.This sector presents with people who have acute injuries,conditions and diagnosis are seen in this sector.The Multiple Disciplinary Team(MDT) is a team of people who work together to achieve optimal performance in a patient. The cohesion and effective collaboration amongst the members of this team is greatly impacts the recovery of patients.Occupational Therapy in my own opinion is a “Jack of All Trades” and is a vital member in this team.OT’s add life to the days that a patient may be spending in hospital recovering(acute phase).

A patient that is at an acute phase of recovery faces many challenges such as losing functioning of certain client factors.This dysfunction is easily reversed through the effective remedial therapy that come through OT. This therapy is special in the sense that it allows for remedial recovery through engaging the client in daily occupations that have been adapted with the aim of the client being able to experience remedial recovery. This role is very important because by the time discharge day comes and the client returns to their homes and previous context they would experience difficulties because they have not been taught how to still do things but in an adapted way that allows for them to participate despite their disabilities/conditions. In the primary health care patients family members are made known about the damage of the injury/condition of their loved on and how to live life with them and how they can make their lives easier.

Care giver training is something that is unique to the OT professional because family members get involved and are educated about the now limitations or difference in function of their loved ones.In these sessions family members are informed about the Do’s & Dont’s when it comes to caring for their loved ones.They are empowered with information about how they can continue with recovery recommendations at home to ensure the maximum treatment outcome of their loved one so that they can return to normal state of function prior to injury if possible.

Media is used to convey a message to a large audience if people to ensure that the same messages reaches a multitude of people.Media has developed along the years and has seemingly taken over how the world shares information and communicates. Media has been greatly used in the health care system to share information about diagnosis,conditions and injuries as a method of informing people about different medical conditions.These media forms have been used to get a message that is health related across to a large amount of people for example a community.The are many media forms that work well for different groups of people.

A medais form that is greatly used in the health system is the brochure.This media form comes in a compact folded paper that has information on either side about a certain condition,how to identify it,tios and warning signs and where people can seek help. This media form educates people about certain conditions in a very short and concise way.The reader leaves having learnt something practical that they can do or share the information with other relevant people.Brochures usually have pictures and a catchy title that draws the reader in and they are inspired by the pictures that are found on that brochure.What helps the most is for the information to be used and carried over by providing contact details that the public can use if they know of someone who might have the condition of they themselves have it.This media form works well in communities because the members have something tangible that they can take home and pass on to the relevant people and makes health promotion sustainable and continuous because of the possible amount of people that will read that brochure

Another media form that is beneficial to the community particularly in the community that I am placed in (Inanda) at the clinic there are long lines and a method that is used to give health promotional talks is the use of a speaker where a pre-recorded clip plays informing community members about the role of OT’s what we can assists with and how they can get a screening/session with us.This media form helps to inform the community members of conditions and how OT’s play a role in the recovery phase of that condition or even just general information about that condition. The speaker will be placed outside and on loud so that all that are in the line can hear what is being said.

Another media form that is largely used not only in the community of in the hospitals but everywhere,it is the most traditional media form used.It is a poster. A poster can vary depending on the information that is wanted to be conveyed. In a heath setting these posters will feature information either about the hospital,certain protocols, conditions,educational posters on roles of health professionals and even how a clinic or hospital works. The information shared on posters is concise and straight to the point which is very helpful for when wanting to do health promotion so that the information stays in the observers mind.Posters can be placed almost everywhere as long as there is a large flow of people passing that specific area for maximum exposure to people.These posters are largely used for prevention information about a condition that is greatly avoidable through preventative measures these diseases include HIV/AIDS,STI/STD,COVID-19 etc.These are largely seen in clinics in communities that have a large percentage of people living with these or other conditions/diseases

Ways that OT can fulfil their role in primary health care can be aided by media to inform people about their role and conditions/diagnosis.They assist in presenting information in an attractive,eye catching and concise way.

[leratotheot]

Goal setting from the grassroots

The pledge made by the United Nations of “Leave No-one Behind” ensured countries' commitment to fast track progress for those furthest behind first(www.za.undp.org) The rate that this has happened is questionable and one can say that not much has been achieved. With the community of Inanda which can be classified as a marginalized population, their hope has solely rested on the affirmative action that would be put in place since the day of glory of the first democratic elections the country has ever seen. But this has become nothing but wishful thinking to the many that have lost hope in the government changing their narrative. Measures that should’ve have been put in place to combat poverty and ensure equality in the economic sector ensuring the creation of jobs has been a tale that the government tells the population to get votes and remain in power. As a health professional, it is in my scope to advocate for my clients' health and optimal wellbeing, making efforts to ensure that sustainable development goals are achievable to some extent in my clients' realities and also what is achievable within my profession. This advocacy will ensure optimal treatment outcomes for my clients. Out of the 17 SDG’s that the UN has formulated, I have identified 5 that I can work towards within the community I am in (Inanda)

The first sustainable development that I would work towards would be climate action. This goal would be achieved by educating the community about the effects of pollution and global warming. The community has evidence of dumping, littering, and overcrowding this is mainly because of the lack of housing structures in the community because it is largely populated by informal settlements. Climate change is already adversely affecting human health and health systems and projected climate change is expected to alter the geographic range and burden off of a variety of climate-sensitive health outcomes and to affect the functioning of public health and mental health care systems(Haines,2019). This is already evident in the Inanda community, many community members are presenting with climate-related health issues that are avoidable if the community takes the necessary measures to lessen pollution and their carbon footprint. The Inanda Wilderness park is situated at the heart of the Inanda community and one of its aims is to raise awareness about nature conservation and sustainability. This is seen through the many upcycled structures that are found at the park, I would show the motive of programs that raise awareness of eco-friendly living could be done by showing the community that upcycling can be turned into an entrepreneurial venture by using recyclable material to create crafts/functional objects that could be sold to the community at large(this is working towards some decrease in the low socio-economic status of the community). Community members would be equipped with skills and knowledge that will increase their knowledge of pollution and the impacts of it with the hopes that they would spread the word and increase awareness for people to start making eco-friendly choices.

The second sustainable development goal that I would work towards in the community of Inanda would be quality education by educating parents that have children with special needs more about the disabilities their children have and handling principles that they can learn when with their children. The programs developed towards achieving this SDG would consist of activities that parents can try at home with their children to facilitate continued learning even at home other than what they are taught at home. This ensures active engagement of parents in the children's lives as there is a lack of interest amongst these parents within the community of Inanda, this could be because they are unaware of how to deal/handle a child with a learning disability and lack of understanding of the actual disability. This shows a lack of quality education even from the health sector of not fully informing parents of the developmental delays that would take place in their children's lives and how to prepare for them on how to handle those delays. Hubert Humphrey allegedly said, “A society is ultimately judged by how it treats its weakest and most vulnerable members.” In this case, Inanda has stereotyped children with learning disabilities as well as their parents, They outcast these group of community members and this causes a further division within the community. These programs will be aimed at empowering these parents and challenging these stereotypes and for the parents to embrace learning so that they can assist their child in the best way possible.

The third SDG that I would work towards in the Inanda community would be health and wellbeing. The main focus would be on health promotional strategies to increase the community’s awareness and understanding of the role of occupational therapists within the community. Community members would be made aware that occupational based practice is focused on supporting their active and meaningful participation in life. The strategies to ensure this is done would be through collaborating with community stakeholders as well as other community-based services to increase involvement and awareness of the role of Occupational therapy in the community. This will fulfill one of the core values of OT within the community which is community immersion, home visits along with community caregivers ensure that home programs are carried out and that caregivers are trained on how to care for their loved ones. Creating occupation-based community programs that are specific to the community will further increase our involvement and awareness in the community. These programs ensure that occupational therapists are seen as equal partners with community members. They are aimed at bringing changes in human connection and fostering occupational engagement.

The fourth SDG that I would work towards in the Inanda community would be decent work and economic growth. The Inanda community has a low economic status with the majority of the youth is unemployed. The community is largely populated by a youth that is unskilled and uneducated. This goal would be achievable by developing programs that focus on prevocational, vocational, and work hardening skills. Some of the programs will consist of sessions where the youth will be taught about how to compile a C.V, interview skills, computer literacy, entrepreneurial training, and skills. The program will be aimed at getting the youth to identify niches or opportunities of potential income gain within the community through entrepreneurial skills. This will ensure that the youth can engage in economic decisions that take place within the community and for them to participate in the financial decisions that are made in their households. Collaboration with community businesses can be negotiated where internship programs are set up for the youth to learn skills at their establishment.

The fifth SDG that I would work towards the community of Inanda would be reducing inequalities. Awareness around the rights of disabled people would be done because this community is not only environmentally challenging for disabled people but there are stereotypes, myths, and social constructs that have been established by the community members that are associated with people that have disabilities. Advocacy would be the driving force of this goal being achievable and getting the majority of the community to be pro-disabled people.group sessions would help as a safe place for disabled people to express their frustrations of living in a community that is ignorant of their disabilities.

The sustainability of these goals will face many challenges that may arise from a macro level which is uncontrollable political changes or a Pandemic like the one we are currently facing and even at the micro-level(the community). Occupational therapists have the skill of adapting to any given situation ensuring interventions are carried out regardless of the state of the department of health, economy, or even the state of the country. OT always finds a silver lining in the grey clouds that could be hovering over the community

Reference List:

Ashwini,C.(2011) .Vulnerability before adaptation: Towards transformative climate action. Elsevier: Global Environmental Change(21)1160-1162

Haines.A.Ebi.K.(2019).The Importance for Climate Action to Protect Health. New England Journal of Medicine(380) 263-273.

[leratotheot]

Life is like a game of chess..we’re all being played

(https://qph.fs.quoracdn.net/main-qimg-b92fbf5eaf429820ef9f381223243e75-c)

Positionality is the notion that personal values, views, and location in time and space influence how one understands the world. In this context, gender, race, class, and other aspects of identities are indicators of social and spatial positions and are not fixed, given qualities.(sk.sagepub.com). This is evident that there are numerous factors that influence a person’s positionality,I would like to suggests that a person’s positionality can change from time to time in their lifetime giving the notion that in life we are being played by factors such as our government,media,laws,upbringing even the careers that we find ourselves in. A significant change in one of these factors can automatically cause a change in one’s position,just like a game of chess your opponents move will always impact the position(move) you make all in the quest to “win in life” but very few people understand that life isn’t just about winning but about learning.Changing your position in life can bring about a new perspective even a strategy to greater impact your society or even to understand it a bit more.This what I will be delving into this post..shall we.

Now I’ve turned the magnifying glass onto myself to really see what factors have created my current positionality.First of all I am able bodied and this has afforded me certain privileges in society and I am largely free from any form of discrimination in society.Looking through the media lense I am at a greater privilege to have more variety in terms of clothing,activities,careers all because of my weight and size(petite). There are certain stereotypes(model figure,more attractive to the opposite sex,”popular girl”) that put me at the top of the social hierarchy because of my size and height, but if I were to bring it into the South African context even globally my race does exclude me from certain activities and puts me in a position where I can be discriminated against because of the colour of my skin  as a result of the history of racism that has happened globally and Apartheid that has happened in South Africa.This speaks into the factor of ethnicity and how that further impacts my positionality, I come from a Zulu culture and IsiZulu is my mother tongue this affords me the privilege to communicate with the majority population in South Africa. The Zulu culture is one of South Africa’s most authentic cultures and adds to the diversity of the country,but if you were to ask me it’s one of the most respected cultures within the country.

Patriarchy states that because I am a woman I am obligated to become submissive but through the years this has been challenged by feminists suggesting equality of all genders.This has influenced my positionality because I do agree with the case to some extent because I do follow what my religion says about gender roles.My religion is Christianity and my position is greatly influenced by it, my outlook on life is governed by the values and rituals of my religion. My educational level is also a factor that influences my positionality.I am in my 4th year of occupational therapy,they say knowledge is power and I am mindful of the power whether real or perceived that stems from my education.This degree puts me at a level to impact people’s lives who find themselves experiencing occupational imbalance.I come from a family where my mother is a widow taking care of myself and my younger brother.This family structure does not fall under the nuclear family structure but it is nothing short of unconditional love and support.With a female heading the household this challenges the patriarchal structure and feeds more into the driving forces of feminism this also further impacts my positionality in the world.

I live in Durban which is the heart of South Africa’s harbour trade having the largest habour in the country.This city is booming with many job opportunities and has it’s own cultural significance.This city is historic in South Africa and is home to many of the liberation fighters.This impacts my positionality in the sense that I look at the country from the historic lenses of my city. They call Durban” The boiling pot of cultural diversity” because of the many cultures that are found here.This gives me a diverse outlook on life.I live in suburban residential area where all basic needs are met,there is effective service delivery and there are infrastructure that promote growth and sustainability within my community.I come from a working class and it has been engraved within me that in order to get what I want I need to work hard for it.These factors impact my positionality in the sense that my approach towards achieving anything in life has to be hard work and determination,when I do start my own family I would like to be in an area that is safe, economically empowered, opportunistic and where all service deliveries are met

Positionality is something that is usually spoken about when one is about to embark on a research topic.The importance of this is to ensure that the researcher is not found to be biased or having their positionality influence the method and direction of their research.In the case of the community that I am in being Inanda it is always wise to put aside my positionality as this may cloud my judgement when it comes to assessing conditions of the community and its members;creating programmes for the people of the community as well as working in the community. My positionality of the environment that a child should be raised in which is having two parents if not at least one and in a household that provides unconditional love and support;the parents of the children need to be financially stable to care for the child’s needs.Now when it comes to planning interventions for the community and its members(Inanda) I need to constantly take into consideration how their socio-economic position is different from mine therefore I cannot assume that every child comes from a home that my positionality supports/is influenced by.Many children from this community come from households where there is no financial freedom,broken family dynamics where the main caregiver is the grandparents and the parents are nowhere to be found or even the children are heading that houdsehold.These factors have an impact on intervention and which programs I need to focus on/introduce to the community ensuring that I provide real life therapy and not just one that would fulfil my positional thoughts.The factors mentioned above also speak to the patriarchal state of my positionality in that women are generally the breadwinners and have to go to work,that alone has to be considered when planning a program for children who have learning or physical disabilities considering that the mother may not have time to carry out these activities and I would have to work my way around that situation to ensure the child still gets the therapy they need.

Living conditions of the Inanda community is very informal most households do not have running water or electricity and the community is largely populated with RDP houses and shacks.All the conditions that come with this type of living such as inadequate sanitation,lack of recreational space,lack of privacy,increased crime have to be assessed when working with the community in terms of planning programmes that bring about optimal performance despite the living conditions that they are in.The Inanda Wilderness Park allows for these opportunities by being centred in the heart of the community to allow for therapeutic engagement with nature.

The socio-economic-legislative and cultural influence of South Africa as a whole impacts different communities in different ways.We may all be facing the same challenges but to some the impact is far greater than others.All of this impacts one’s positionality of which has to be guided when working in a space that is outside the walls of your positionality.This community block has challenged me to think outside the walls of my positionality and either find the differences or similarities that I may come across in the community of Inanda.Doing this will result in a greater relation to the people of the community meaning that I will beable to work with them at the same level of their understanding,I will be able to assess conditions of the community better and ultimately create programmes that are specific to them and that are beneficial.This will ensure effective therapeutic outcomes and opening the university to the streets-Gada Kadoda

[leratotheot]

It takes more than a village to raise a child

(http://goblackcentral.com/wp-content/uploads/2013/05/Dear-Mama.jpg )

The very controversial, thought provoking and gifted rapper Tupac Shakur blessed us with this very famous track where he tells his story about the relationship he had with his mother. He expresses the hardships that they went through bringing to light the many social ills that were present in their society that had an impact on his upbringing such as inadequate housing, welfare as well as unemployment and inadequate employment wages. This track is over 10 years old but still resonates in the hearts of many around the world including myself as it shines the light on all mothers who soldier on to raise their children despite all the difficulties of poor health systems and economic constraints. Maternal and child health is what we do together as a society to ensure the conditions in which all women, children, and families can be healthy(Lu,2019). It  has been a constant struggle to achieve this  in our very diverse rainbow nation where it is evident that our health systems does not give way for this goal to be achieved because of  many factors and this all entirely contributes to our very high mortality rates.

Maternal and child health (MCH) programs focus on health issues concerning women, children and families, such as access to recommended prenatal and well-child care, infant and maternal mortality prevention, maternal and child mental health, newborn screening, child immunizations, child nutrition and services for children with special health care needs. States invest in healthy children and families to strengthen communities and avoid unnecessary health care costs.(NCSL.2020). With this in mind it is evident that no matter which society in the world the health of women and children is very important to ensure there is stability in society and continuation in terms of societal culture being passed down and practiced. The general health of women and children has a great impact on the population of any country because if there are high rates of mortality and diseases from maternal care then the population of that country is at risk and is not making maternal and child care a priority.It shows the flawed structure of that countries health system giving bad light to the country as a whole and this could impact the economy of that country as investors would not want to invest in a country that has flawed health systems,this would ultimately impact the economy of that country and increase poverty rates within that country deeming the country as one that is unable to take care of its own people.

In South Africa we have been named the most unequal country in the world by CNN.This is evident even in our health system where our maternal and child care procedures are not taken seriously and this contributes to the very high mortality rates.The Amensty International has reported that South Africa has unacceptably high rates of maternal mortality. Although the country is seeing improvements since 2011, the number of women and girls who are dying during pregnancy or shortly after giving birth has increased dramatically since 2000. Today, the maternal mortality rate stands at 269 deaths per 100,000 live births, far higher than the rate of 38 which the government committed to achieve by 2015. Experts suggest 60% of maternal deaths in South Africa are avoidable.(Amnesty Int.2014).

I would like to take this report further by focusing on the procedures that form part of maternal care and shed light on prenatal care and child birth.These are just some of the factors but they are very important as they are needed  before(prenatal care) and after the birth of a child(immunization). Prenatal care is any intervention taken to ensure a health pregnancy and methods to ensure the health of the growing baby during gestation some interventions include group prenatal care sessions where women who are around the same gestation period form a support group as a means to share experiences and troubles that they may be facing during their pregnancy as well as to educate women about the gestation period and what to expect at childbirth  this is facilitated by either a midwife or a nurse, these sessions would usually take place at a local clinic or at a hospital. These sessions are for both low-risk and high-risk moms(moms with diabetes or any other comorbid conditions) and lowers the chances of preterm birth.

Taking into consideration the South African context many mothers prefer the traditional prenatal route of practicing methods that have been passed down from generations before.Very few public health clinics and hospitals offer these services which could be the reason why most women resort to traditional prenatal care another factor is that SA has high teenage pregnancy rates and high prevalence of women infected with HIV/AIDS putting them in the high risk population for complications such as preterm birth,mother child transmission just to name a few.Due to the lack of information amongst this population many young girls go throughout their pregnancy not knowing the state of their health or of their unborn child these form contributing factors to the high mortality rates in SA. Its very important for a society like this one is well informed and receives interventions such as prenatal groups that are provided by organizations that touch on this topic to ensure that the rate of mother to child transmission of HIV/AIDS is decreased as well as premature births are avoided as much as possible.

Poor health care facilities that have inadequate equipment,shortage of staff,negligence of staff and shortage of resources and infrastructure all contribute to the high rates of maternal and child mortality rates in SA.The implications of complications during child birth consist of delayed developmental milestones which will have a great impact when the child reaches school going age and the child presents with learning difficulties. Lack of information around leaning disabilities within the society negatively impacts the child receiving the correct intervention and the society is uneducated on how to handle children that have learning disabilities.The implications of this in OT is that the therapist would to screen the child and the mother(mental health) to compile a problem list and treatment would be based on trying to correct or treat what has gone wrong as a result in complications in child birth.Interventions such as home programs would be every beneficial especially in poverty stricken societies such as the one that I have been placed in Inanda. This society has quite a few special schools which shows that there is a high prevalence of children with learning disabilities but society is unaware of the programs that have been put in place like the Inanda Wilderness that address learning disabilities through engaging children through outdoor and nature play.

The community is most informal and there are a lot of informal settlements and is dominated by RDP houses,this environment is not condusive for successful maternal and child health because of the social ills that are present within this community such as lack of water and electricity,informal housing and crowding,substance abuse,lack of hygiene and sanitation structures,poor infrastructure as well as poor service delivery.If government took maternal and child health seriously most if not all these issueus would be addressed as an effort to provide a safe and healthy environment for mothers and children to grow in which will ultimately contribute greatly to the overall atmosphere and sustainability of the society(community).

In conclusion, while science, technology and big data will undoubtedly advance MCH in the coming decade, the biggest gains will still come from improving social conditions for all women,children and families. We should not forget that some of the greatest improvements in MCH over the past 150 years were achieved with better sanitation and hygiene, cleaner water and a safer food supply, enactment of child labor laws and women’s suffrage, and overall improvements in educational attainment, economic opportunities, and social status of women and children in our nation and around the world (Brosco 2012). This forms part of the leading factors that would ensure that maternal and child health is implemented in South African societies,without these changes coming from government then it makes it difficult for society to have a positive participation in maternal and child care as much as they want to because they are restricted by situations that they have no power to change themselves but it is a governmental change and intervention that has to be taken to change this unfortunate narrative.It doesn’t bring a good light upon any country when maternal  mortality rates are so high it gives a bad impression that the country does not care about its people and the future generations.

  References:

Brosco, J. P. (2012). Navigating the future through the past: The enduring historical legacy of federal children’s health programs in the United States. American Journal of Public Health, 102(10),1848–1857.

NCL:Maternal and child health. Retreived from http://www.ncsl.org/research/health/maternal-and-child-health-overveiw

Amnesty international:Struggles for maternal health:barriers to antenatal care in SA.Retreived from  https://www.amnestyusa.org/reports/struggles-for-maternal-health-barriers-to-antenatal-care-in-south-africa

Lu,M.C(2019) .The Future of Maternal and Child Health. Maternal and child health journal(2019)(23:1-17)

[leratotheot]

And then the curtains close,for now!

Here I was at the amusement park called “OT year 3” as I was about to board the “Psych terminator” ride. As I took steps closer with determination and anticipation for what this ride was going to be like. Little did I know that this ride would have ups and downs with loops that came out of nowhere. On the ride I had my fellow colleagues and in front was my supervisor repeatedly letting us know that “we will be fine once it’s all over,you will make it”

There were so many things I learnt about myself during this ride. Firstly to hold onto the rails of my knowledge,confidence and passion. There were a few moments where I had my hands up and was controlled by the wind and with that I didn’t know what to do. But I had the best team who were continually shouting “Don’t let go!!” and that made me go back to my roots and the passion that pushed me over the edge.

There will be many rides that I will be on throughout the course of my life that will teach me a lot about myself and my capabilities.This will be my attitude moving forward that I’m never alone and every learning curve is for my own benefit!

[leratotheot]

Research Day 2019

This picture is a clear representation of what I got to witness on Research Day 2019. Its showcases how people’s views,opinions and perspectives were all represented in various ways. Research Day gave me a new outlook on research and how it empowers people to think about their surroundings.

This picture also puts into perspective how “team work makes the dream work” and that a good team is needed to make the research a success this was evident at this years research day. It also shows that people’s thinking may be different but sort of are similar in the sense that they are able to link to come up with a hypotheses of which the research will try to prove.

Research Day was an eventful day filled with pride and accomplishments. A year and a half ‘s work was all summed down into a 20 minute presentation in front of adjudicators,supervisors and fellow peers. All of the researchers were nervous to say the least but all came out victorious in the end. This was just a glimpse of what I was about to get into and the sight of it was scary but the tips the researchers have calmed my nerves a bit.

The research topics (questions)that were explored were relevant and intriguing! Some hit home more than others but all were worthy. The topics varied from student riots and their impacts to training of caregivers of pediatrics who had psychological impairments.

The researchers really broadened our thinking and really displayed good critical thinking.

In terms of the scope of OT. Research really expands the profession as a whole because we deal with the most researched specimen that being human beings. Humans are complex and explanations behind behaviors and thinking are always being pondered upon.

OT is heavily based on literature and encourages all professionals to advance the profession through sound,reliable and valid research. This will give the profession the the exposure and recognition that It deserves.

Research Day was a day that inspired greatness. Seeing the delivery and confidence that the researchers had was a ray of hope to what was to come. They were passing on the beacon to continue where they left off to break boundaries and inspire others with research!

[leratotheot]

The worlds got a lot to say about mental health!?

Article 1:https://moodle.ukzn.ac.za/pluginfile.php/413740/mod_resource/content/1/is%20spirituality%20relevant%20to%20OT%20practice.pdf

Spirituality in occupational therapy practice was found to be associated with a holistic, person-centred approach to care. It aimed to restore a sense of wellbeing and to recognise individual coping strategies.(Jones,2016)

The article that I have chosen points out that as Meyer advocated and many current occupational therapists reiterate (Friedland, 1998; Molineux 2001; Wilcock, 1999), occupation is considered to be the core business of occupational therapy. Thus factors influencing occupational performance and facilitation of occupational functioning, by implication, are important to occupational therapy. Spiritually is a key component that influences occupation especially in the multicultural country that we live in. Clients often relate their illnesses to a spiritual problem that they have to solve using rituals.

This article points out how occupational theorists are acknowledging the importance of spiritually to occupation and have even developed models that are centered around spirituality such as the Canadian Model of Occupational Performance (CMOP).There is some evidence from research (Do Rozario, 1997b; The Mental Health Foundation, 1997), personal accounts (Thibeault, 1997) and clinical experience (Algado et al., 1997) that demonstrates that spirituality can be health-enhancing within the healing process. I partially agree with this statement as in South Africa there are “rituals” that do not promote health for example a schizophrenic patient might stop taking medication because they believe that their ancestors will help them in their own way that docents allow for pharmaceutical intervention. This negatively impacts the clients functional and medical prognosis.

The article touches on a core value called holism (Egan&Delaat,1997) This aims at looking at the client in a holistic way which will guide therapy and help the therapist to understand the complexities of the human system.The article touches on the contrast to the reasons already presented explaining the relevance of spirituality to occupational therapy, there are also arguments that speak against this proposal, such as lack of knowledge about spirituality, lack of understanding about how to consider spirituality in practice and lack of education about spirituality. I agree with this especially in this multicultural country therapists have ensure that they educate themselves about the various spiritual activities and spiritual aspects of each religion represented in this country. Therapists have to always consider the culture and spiritual beliefs of their client when planning intervention for example a Muslim client will not eat any food that is not Halaal etc. If the therapist doesn’t consider this there will be potential barriers in applying spirituality in occupational therapy.

The article touches on the lack of knowledge of spiritual amongst the community of occupational therapist in a sense that they do not see the need to look at spirituality because they simply don’t understand it. This makes them adequately unprepared to attend to spiritual aspects of the client which will result in,ineffective therapy.However, it is this author’s belief that these potential barriers of lack of knowledge, understanding and training can be overcome by engaging in research that aims to determine the many ways in which spirituality relates to occupation, and how occupational therapy practitioners may address spiritual issues with clients.

This article touches on potential boundary violation and suggests that as spirituality also affects occupation, there is likely to be a place for both spiritual experts and occupational therapists to work in collabora- tion in meeting the spiritual needs of clients. Each professional brings their particular understanding to bear upon the situation the client is facing.

Article 2:https://moodle.ukzn.ac.za/pluginfile.php/413743/mod_resource/content/1/moho%20in%20mental%20health.pdf

To date, the Model of Human Occupation (MOHO) is the most widely used model internationally. I agree with this statement as I have used the model countless times before and I found it to cover my clients holistically and gives a clear picture of my client.The article highlights that therapists reported using MOHO moderately to greatly improve their assessment, goal setting, and conduct of relevant interventions as well as professional identity as an OT in their mental health occupational therapy practice. I relate with these reports as this model guided me as to what I should focus on when applying the model and it’s guidelines are client centered covering all aspects of the client.

MOHO, allows for therapists to explain how their clients’ occupations are motivated, transformed into routines and habits, and performed capably within given social and physical environments.These are the core guidelines of this model that make it so distinct from other models.

The article points out that reasons for why MOHO is the most commonly used model in occupational therapy. This model is extensively evidence based which proves its reliability and assurance. This has been the main drive in theories and research in that the evidence proves its validity and use.Studies also indicate that OTs value the holistic approach of MOHO, its client-centered focus, and the ease with which other practice models can be incorporated along with this model.

Additionally, there has been a constant emphasis on linking this model’s development with current and future practice needs and with the pressure for more standardized pathways of care (19). MOHO has sub- stantial resources to guide its use. Research indicates that therapists find this model and its resources useful for practice (5,6). In a national sample survey study in the United States, Lee, Taylor, and Kielhofner (5,6) found that therapists perceived that MOHO influ- enced their practice in three aspects. These included client-centered practice, treatment planning and monitoring, and professional identity and practice. An overwhelmingly high percentage of therapists reported that MOHO facilitates client-centered prac- tice by providing a holistic view of clients, enhancing their ability to relate to clients and prioritize needs, and enhancing clients’ satisfaction with OT services. Therapists reported that MOHO influenced their practice by providing a strong base for generating treatment goals and helping them identify a rationale for intervention. Also, therapists indicated that using MOHO enhanced more occupation-focused practice, gave them confidence as an OT, and provided better ways of communicating with clients.

The article focuses on the therapists perception and experience of applying the model. Most practitioners expressed that this model was useful for practice as it facilitates client-centered prac- tice by providing a holistic view of clients, enhancing their ability to relate to clients and prioritize needs, and enhancing clients’ satisfaction with OT services. Therapists reported that MOHO influenced their practice by providing a strong base for generating treatment goals and helping them identify a rationale for intervention. Also, therapists indicated that using MOHO enhanced more occupation-focused practice, gave them confidence as an OT, and provided better ways of communicating with clients.

These two articles give two different aspects of mental health. Both with very informative concepts. Not only have I learnt from them but I am also looking forward to adding my two cents in the ever growing studies around mental illness in the future.

[leratotheot]

The journey continues...

These past weeks of prac have been nothing but a learning experience. One of the biggest aspects I learnt was effective intervention planning.If you asked me to draw up a subprogram five weeks ago, I would silently go into a panic mode in my head and answer with a shaky “okay” but with the help of aspects covered in prac prep and supervisors. I can confidently say that I’m finally getting the hang of intervention planning. It’s not that I didn’t understand it but it was the merging of my observations and giving clinical reasoning to them.

One of the highlights of what I’ve learnt on prac so far was evident on Casual Day. I got to see clients in a different setting which further emphasizes one of the core values of an OT which is to look at a person holistically. Clients portray different behaviors once placed in different settings and that is what intervention stems from. In order for intervention to be beneficial and effective for the client a person centered approach must be considered.

Another major aspect that I learnt on prac was treatment principles and how they have to be specific to my clients. The subprogram outlines the general principles but each session should have “general specific” principles. This is to ensure that each session is doable if it so happens that someone were to take over my session they will not get lost but the treatment principles will give them a clear picture of what to do and how to do it as well as what they need to watch out for when working with my client.

The past week we got to go over the goals that I had set out at the beginning of prac and sort of reflect on whether I had met them and what needed more improvement. One of my goals was identifying therapeutic opportunities which was something I have gotten better at doing over the prac period. Identityingbthis sort of gave me direction as to where my therapy will be headed and what to focus on next in therapy. This was of great help as I was able to focus on areas that impacted on my clients functioning.

Another one of my goals was Competence in the execution of my sessions. This goal I was able to achieve as I had all the tools and materials needed for the sessions and I was able to engage my client in creative ways that they also enjoyed. Activities took place indoors as well as as outdoor this allowed for me to observe my clients in different settings.

One of my goals that needed improvement in was time management. This was a goal that I carried over from physical. I have identified that a day plan helps to structure out my day and allows for me to plan my sessions in a way that I spend ample time with each of my clients doing assessments or therapy. Even in my case presentation time was a factor that needed improvement to make sure that I speak about all the important aspects of my client.

One weakness that had taken me a while to admit and identify was my lack in organization which would lead to me forgetting important things,missing out on dates etc. This weakness has affected my performance as it is a hindrance to the potential that I have. With better organizational skills and time management I can unlock the potential that is within.

[leratotheot]

It’s Time To Shine✨

Casual Day is a widely celebrated national campaign that occurs annually on the first Friday of September.The public’s contribution of R10 for a Casual Day sticker entitles them to express their individual interpretation of the annual theme through their outfits, which also allows them to show their support for the full inclusion and equity of persons with disabilities. The 2019 theme is Time to Shine with Persons with Disabilities.

This campaign has been round for 25 years this year and its aim is to advocate for the integration of people with disabilities into mainstream society and to be represented and accommodated in workplaces as well. This campaign urges the public to not give into the stigmatization that society places on people with disabilities.The NGO raises money to assist facilities that are situated in underprivileged areas with assistive devices,tools and materials that are needed as well as facility renovations.

This campaign is supported by more than 4000 companies in the country and is widely supported across the country.This NGO is an excellent example of advocacy for clients in the country.It was my first time celebrating casual day the way I did this year.For this years theme we decided to host a talent show for the clients at our prac facility.The reasons why we choose to do this was because we wanted clients to showcase their talents that they have to their peers and family members.This show was aimed at giving clients the opportunity to express themselves in the way they felt comfortable in.

Clients definitely surprised not only themselves but their peers and family members in that they were confident enough to go on stage in front of a large umber of people and to display their talent.The clients were reminded in advance that they had to prepare theyre item and to rehearse them as well of which the clients did do.

The planning aspect was done by the OT3 students.We engaged clients in group sessions before hand where they made decorations to decorate the stage such as stars and the sign”Time to Shine” the clients also made items that that hey would give to their peers and family members that came to watch them.The clients thoroughly enjoyed these sessions as it created an anticipation within them as well as an excitement about what was to come.

The OT3 students had to make sure that the other aspects of the event were sorted for example sponsoring for the food that was so graciously given by PicknPay but even that happening it taught me the challenges that might arises when asking for sponsoring.Another one of the aspects to tis event was coming up with a program,sourcing all the songs that the clients wanted to dance to and sing to.

Clients were encouraged to wear bright clothes that is in line with the theme of this year.They were also reminded to buy their casual day stickers at the end of the month as they were receiving their wages.

This event allowed for me to experience what its like to host events at facilities to raise awareness on the clients behalf.It was a great learning opportunity.



[leratotheot]

“ Depictions of ‘madness’ have been dominated by horror films revealing of the film industry’s historic insensitivity about mental health, You don’t have to be ‘mad’ to be in the movies – but the film industry has generally shown a shaky vision of mental health. It’s not that cinema evades ‘taboo’ themes here; it’s more that it tends to swing wildly from sentimentality to sensationalism.” - Arwa Haider

I agree with the above statement as I also believed this stigma about mentally ill people that has been displayed by the film industry.In this weeks blog I got to watch a movie that centers around the challenges and experiences of people with mental disabilities.The movie that I chose to watch is called “Awakening”

In the beginning of the movie I am introduced to an old age home that has been named by the staff there as the “garden” merely because the patients that lived there were at a criticl state of Parkinsons Diesease that they can no longer tak care of themselves in the most way.They can no longer engage in their ADLs.This clinical picture of these clients have put them in a vegetative state and the staff are merely “feeding and watering”the patients (flowers) of the “garden”.This depicts the negative effects of institutionalization.The patients seem to present themselves at catatonic and show symptoms of institutional neurosis.

The movie focuses on one peculiar patient called Leonard Lowe who has been frozen in the same position for 30 years, who neither moves nor speaks. Mr Lowe is at a critical stage of Parkinsons disease.The stigmatization that comes with this is that he is put into this facility to be left to die which is one of the factors that families think of when placing their loved ones in an old age home. He cannot make his body do what his mind desire. Sometimes that blockage is manifested through bizarre physical behavior, sometimes through apparent paralysis.

If I were to consider Mr Lowe’s state of mind I would conclude that he is probably not motivated to do anything,he has given up on lie and he is just waiting to die.But one of the aims of this movie is to reveal that all mentally ill people have an inner drive to beat the limitations of their diagnosis and although they may not show it out to the public they have some hope that they will be helped in order to help themselves and that is happens with the arrival of a new doctor who aims sets out to establish and prove a theory,where he taps into the unseen potential of the patients at the “garden”particularly MrLowe.

These opening scenes of the movie particularly when Dr Sayer arrives at the facility and discovers this phenomenon of the patients really sey the mood for the rest of the movie as from that discovery that was made I got to see that joy that it brought to the patients and brought about their awakening from their “frozen”state.With the clients being awakened they do although come to face realities and how much their diagnosis has affected their lives in that their liberation comes with its own cruel set of conditions.

The movie follows Leonard through the stages of his rebirth.As a therapist in the making I can relate to this because of the time I spend with my clients on field block and the progress that is made by my clients through the therapythey engage in which further emphasises the important of compliance in therapy.It portrays a client who is motivated to improve their level of functioning.

Dr Sayer represents the members of the MDT.He was able to build a rapport with MrLowe ad empathised with him and aimed to help in regain his function.His personality and drive to help encouraged me to ensure that my therapy is client centred at all times.

The disease is not an open-and-shut case. And as the movie unfolds,I was able to identify the challenges of implementing this theory and that patience and determination was key to getting the outcomes that would benefit MrLowe.This encourages me to have patience when dealing with clients who are mentally ill and that their progress is a lifetime journey that requires patience and determination from both the therapist and the client.





[leratotheot]

Good,better,best!

This quote right here hits the nail on its head! When you think about success in life it really is all about making the small steps that will make a difference in the end! Improving in areas where lacking is an act of closing the gaps!

With just one and a half years with the knowledge of assessments and interventions I get to look back at my progress and where I would place myself on the confidence scale.

In terms of assessments. They have been particularly difficult to understand let alone how they should be administered especially the MSE! But with practice I have come to the point where I can adapt and personalize the MSE to suit my client. One of the key assessments was the MOCA assessment as this helps you place your client on the correct level of function making it easy to look for activities that will bring about the best outcome from my client.

The “draw a man” test for me is by far the easiest assessment I was able to understand because it was simple for the client yet showed a lot about the cognitive aspects of the client based on what they drew.

The Barthell index provides a picture of what can the client do in their ADL’s and what they need assistance in. This type of assessment gives direction in the types of activities that will benefit the client

The activity analysis form assists in planning effective sessions with our clients it allows me to analyze all aspects of an activity ensuring that it is in line with the treatment plan set out for the client.

In terms of treatment. The main aspect which is AFR’s was something that I had struggled with before because I did not know how to implement these frames and how they impacted on the treatment principles of the treatment plan. Through practice and guidance of supervisors/lectures I would say that my skill in selecting the correct AFR is fair to good. And does need room for improvement.

Following models & AFR’s is treatment planning(subprograms) this is a skill that is still under construction. The one thing I’ve come to understand is that the treatment principles listed in the subprogram becomes the general treatment principles in the individual sessions. I’ve also learnt that these subprograms are subject to change.

Treatment principles is an area that needs improvement as they make up most of my session write up. Principles such as handling,presentation and structuring definitely have to be specific to my client and grading cannot be generic but specific as well.

The journey is never ending. There's always gonna be growth, improvement, adversity; you just gotta take it all in and do what's right, continue to grow, continue to live in the moment. This is what drives me every prac morning.

[leratotheot]

Reading articles =Better understanding

The more that you read, the more things you will know. The more that you learn, the more places you’ll go. – Dr Seuss

This quote gave me the encouragement to continually read articles that are OT related as they will not only better my knowledge but will ultimately result in a better therapist for my future patients. I believe these are the words of an OT who is experiencing a transition from the womb of her comfort zone to the big world of all things health related!

The opening paragraph in the introduction of this article gave me the most clearest definition of what OT is. The clearest one since I enrolled into this degree! Definitely using it the next time someone asks me what OT’s do!

In the introduction of the article it explores the different applied frames of references that are used in psych and give an example of cognitive-behavioural(CBT). It also goes on to explain how a subprogram(or as called in the article occupational profile) assists with setting goals,treatment planning and implementation of treatment is based on the evidence-based assessments and interventions.

The introduction stated that the aim of the study was to examine the effectiveness of OT in the intervention of psychiatric disorders and to provide evidence of OT’s contribution to mental and behavioral health. This is what interested me the most in this article because I was curious of the effectiveness of OT and how it benefits the client who have mental health issues.

The main body of the article went into the different OT interventions that could be used when treating in the psychiatric sector. One of the interventions which is regarded as an assessment was the interest checklist. This form of formal assessment aimed at determining the clients strength of interest and engagement and its main focus was from a leisure aspect. I find this assessment effective but it is not culturally sensitive as some of the activities may not be known by a client who is of a different culture other than the western culture.

The articles goes onto cognitive behavioral therapy where it states that it’s focus is on uncovering ineffective thinking and maladaptive behaviors and practicing alternative more positive cognitive and behavioral patterns. This frame of reference is relevant in psychiatry as most clients are unable to control their behaviors and require treatment/intervention to teach them appropriate behavior.

The article goes onto Interpersonal therapy. It’s my first time reading of an intervention like this one and I found it so significant as psychiatric client generally have poor IPR’s . The significant others of the client(family&friends) are also engaged in this as they also need understanding of how the mental disorder has affected their loved one. This form of intervention involve the client and the family which brings about a better outcome to therapy

The article goes onto modeling. This form of intervention is observation based. Where the client will observe the correct behavior as displayed by the therapist or the caregiver. This form of intervention is very effective as some patients tend to be aggressive and do not know any coping mechanisms to control their aggression.

The article also touches on the model of human occupation (MOHO). It explains how the principles and guidelines of this model help when therapist is evaluating and analyzing client as a wholistic being.

The article goes onto a table that shows OT interventions to specific problems/symptoms. For example a client who presents with indecisiveness & ambivalence the intervention would be providing with occupations & do not require too many choices. Another example was poor attention and concentration with the OT interventions of setting realistic,step-by-step goals &to do behavioral list.

I valued the study that was made in this article as it gave me a broader understanding of the role of an OT in mental health.

Reference: Hassan.IS(2018).Overview:Occupational Therapy for psychiatric disorders.(Vol9,issue5)

[leratotheot]

“We don’t learn from experience,we learn from reflecting on experience “-John Dewey

Most of us go through life viewing our experiences as isolated events. I’ve been guilty of having an episodic grasp of reality.

This semester’s prac prep our lecturer promoted reflection to engage us in the purpose of making meaning of our previous prac experiences and set up expectations of what we would like to achieve for this semesters prac block.She wanted to ensure that we as students become producers and not just consumers of knowledge.

At this years prac prep our lecturer wanted to encourage a new beginning,attitude and experience about this semesters practicals. She encouraged this notion through the atmosphere she created before prac. She added elements that would make a student feel less anxious like calming music and adding sweets to the tables.

Each prac venue had their own table and students were seated with their supervisors which brought about a sense of unity and encouraged familiarity amongst the students & supervisors.

Topics that needed to be touched on were revised at prac prep. These topics revolves around the basic rules and guidelines for practicals. This ensured that we all had the same understanding and knew what was expected from us in this next block field.

My first week at prac was okay. I was well orientated to the facility,clients and staff that worked there. I was placed at a sheltered workshop and got to see how people with psychological disabilities are also included in the working industry.

My first interview with my clients went well,although there were times where I was a bit overwhelmed & confused. I tried not to show it as much. I tried to remember all the topics that were covered in prac prep especially the topic of observations and deductions which is vital when planning for treatment. Building a rapport with the client was the main aim of this week and ensuring that they are comfortable around me.

I got the opportunity to work with 2 intellectually disabled clients who are complete opposites in terms of personalities but both experiences the same impairments. My focus moving forward in the following weeks is to ensure that they get to some level of independence than where they were before my arrival. I understand that in psych block it’s the little victories that contribute to progress and ensuring that the client is not at a state of regression.

Going to practicals always reminds of why I enrolled to this degree. Interacting with clients and seeing that impact therapy makes in their lives is a driving force to keep getting better so that more clients will be able to recognize the potential they still have to function even after an acquired injury/impairment

[leratotheot]

The final stretch

I would like to think that I made progress since the beginning of this block. I’ve progressed in my session write up’s handling of clients,intervention skills as well as communication with other health professionals in the MDT. I’ve learnt a lot about client centeredness and the importance of clinical reasoning. I got the opportunity to use applied frames of reference like the NDT and approaches like Bobath where I was able to use techniques that addressed tone etc. I had some successes as well faced difficulties but I learnt from all of this as we come to the end.

I think that my clients benefited from OT as some of their client factors improved such as balance,endurance,muscle strength,range of motion and what I’ve witnessed is improvement of the clients General mood.

Clients expressed how besides having family visit them they are hopeful when working with me. Some clients value the sessions that they have as they have an understanding that it will help improve their function and have a positive impact on their chances of getting discharged early. Clients are in compliance with treatment plans and are already witnessing results.

[leratotheot]

The final stretch

I would like to think that I made progress since the beginning of this block. I’ve progressed in my session write up’s handling of clients,intervention skills as well as communication with other health professionals in the MDT. I’ve learnt a lot about client centeredness and the importance of clinical reasoning. I got the opportunity to use applied frames of reference like the NDT and approaches like Bobath where I was able to use techniques that addressed tone etc. I had some successes as well faced difficulties but I learnt from all of this as we come to the end.

I think that my clients benefited from OT as some of their client factors improved such as balance,endurance,muscle strength,range of motion and what I’ve witnessed is improvement of the clients General mood.

Clients expressed how besides having family visit them they are hopeful when working with me. Some clients value the sessions that they have as they have an understanding that it will help improve their function and have a positive impact on their chances of getting discharged early. Clients are in compliance with treatment plans and are already witnessing results.

[leratotheot]

Do you feel you have grown as an OT?

At the beginning of my studying career I had a very superficial definition for OT. All I knew was that OT helped people and that was aligned with the feeling I had after matric. Seeking a career that helped people. Little did I know what I was getting myself into! “Helping people” took a whole new definition when I began studying and was redefined when I started prac blocks. The actual contact with people who need the OT expertise was need and I had to step up to the plate. At times I didn’t know what I was doing and wasn’t too sure whether I was of help to the client that I was dealing with. But as time went on I gained confidence in myself,the knowledge I knew and the degree I was studying. I got to see the impact OT has in peoples lives as it gave them a sense of independence and confidence in their ability to function after going through a traumatic injury. OT has given people hope and I got to see that first hand. This is the drive behind me wanting to be better at what I do to perform the best for those who are in need of my services.

[leratotheot]

A multidisciplinary team is a group of health care workers who are members of different disciplines (professions e.g. Psychiatrists, Social Workers, etc.), each providing specific services to the patient. The team members independently treat various issues a patient may have, focusing on the issues in which they specialise. The activities of the team are brought together using a care plan/intervention planning This co-ordinates their services and gets the team working together towards a specific set of goals.

The cohesiveness of this team is very important to ensure that the patient reaches their optimal recovery. It is very important that the client understands that their cooperation and full participation in all of the intervention that will take place as this will impact on recovery. It is also important for the family/caregiver of the patient to cooperate with the guidance and training that is given by the members of the MDT.

Regular meetings amongst the MDT should be held to ensure that all members are on track with the treatment plan and short term to medium goals as well as long term goals are met. The patient needs to to be orientated with each of the MDT members as well as their role.

My experience with working in a MDT has been insightful as I got the chance to interact with the physiotherapist as well as the social worker. With the social worker I got the chance to make a referral for my client.

References:

www.multipleserosisacademy.org

www.hse.ie/communityservices.org