A conceptual framework for return to work for clients with major depressive disorder.

BACKGROUND: Return to work (RTW) may be a lengthy and complex process for individuals with major depressive disorder (MDD) especially when not well managed. This increases the risk of isolation and loss of routine which negatively influences their mental health. However, for clients with MDD, a comprehensive overview of all the factors that influence RTW based on a model of occupation is lacking. OBJECTIVE: To develop a conceptual framework to guide an occupation-based process of RTW for clients with MDD, treated in the private sector in South Africa. METHODS: This paper describes the development of a conceptual framework using literature and thematic synthesis of a qualitative descriptive study based on interviews with eight participants diagnosed with MDD which were linked to constructs of Kielhofner's Model of Human Occupation (MOHO). RESULTS: Qualitative data from key informant interviews were deductively analysed according to the subsystems of MOHO for waiting to RTW and experience of RTW. The conceptual framework developed included the constructs of Person and Occupational Setting from MOHO as well as the components of Occupational Identity and Competence central to intervention to achieve successful RTW. CONCLUSION: A successful RTW process for clients with MDD is dependent on the person and the occupational setting. The role of the occupational therapist in the RTW can be facilitated by the occupation-based conceptual framework developed on MOHO.

Vocational rehabilitation for young stroke survivors in Gauteng public healthcare: Occupational therapists' perceptions1.

BACKGROUND: The prevalence of working-aged stroke survivors is increasing yearly. Stroke is an expensive disease, causing financial burden to the government, the family and caregivers of the patient, thus making it imperative for working-aged stroke survivors to work to remain financially independent. Survivors' need to work necessitates occupational therapists to shift their focus from basic activities of daily living, to rehabilitating work. OBJECTIVES: This study aimed to determine the perceptions of occupational therapists working with younger stroke survivors in public hospitals and clinics in Gauteng South Africa, about rehabilitating working-aged stroke survivors' work ability. METHODS: Ethical clearance was obtained. A qualitative research design was used to obtain narrative, descriptive data from six focus groups. Therapists from public healthcare settings, who had more than six months' experience and had worked in neurological rehabilitation within the six months preceding the focus group, were invited to participate. Focus groups were audio recorded and transcribed. Inductive content analysis was used to identify themes and categories. RESULTS: Few participants are involved in rehabilitating younger stroke survivors' work ability or facilitating return to work (RTW). The study identified perceived barriers and enablers to rendering OT services that meet working-aged stroke survivors' needs. CONCLUSIONS: Despite enabling employment equity laws in South Africa, OTs working in the public sector appear to experience a sense of futility when trying to rehabilitate young stoke survivors to RTW. Fragmentation of the public sector and limited resources impede successful RTW for working-aged stroke survivors. Survivors' employment status and motivation to RTW facilitated rehabilitating work ability.

Sensory processing of women diagnosed with genito-pelvic pain/penetration disorder: a research proposal.

OBJECTIVES: The study objectives are to describe the sensory processing patterns of women diagnosed with genito-pelvic pain/penetration disorder (GPPPD), to explore the level of anxiety when both GPPPD and sensory processing disorder (SPD) are present and to investigate participants' experience of participating in a sensory-based home programme. METHODS: A descriptive two-phased study design will be used. Phase one is a quantitative, cross sectional non-experimental descriptive study, using the Adolescent/Adult Sensory History (ASH) and Hospital Anxiety and Depression Scales (HADS) to obtain data from purposive sampling. Phase two is an exploratory qualitative study involving participants who were identified with SPD in phase one. They will participate in a sensory-based home programme and their experience thereof will be established during semi-structured interviews. OUTCOMES: Descriptive studies are known to be useful in planning health services and to develop hypotheses for future testing. This study could improve practitioners' understanding of GPPPD and SPD and make alternative, non-invasive, non-pharmacological treatment options available to better assist these patients. The study could further clarify the role of the occupational therapist in sexuality. Exploring participants' anxiety has important implications for treatment protocols in occupational therapy and assisting in describing the signs and symptoms of GPPPD.

A career exploration programme for learners with special educational needs.

Learners with disabilities lag far behind their peers without disabilities in achievement, graduation rates, post-school education and employment outcomes [4]. Against the current state of education affairs in South Africa, where curriculum models for learners with special educational needs (LSEN) are still under revision, therapists and teachers are finding it difficult to prepare these learners for appropriate employment after school. Even where systems in education are established, persons with learning disabilities face more challenges to enter employment [5]. This article reports on a unique career exploration programme for grade 11 learners at a school for learners with special educational needs in Gauteng, South Africa. It is a collaborative strategy between the learners, their parents, a teacher and the occupational therapists at the school. Two case studies are described to indicate the success of the program.