Abstract:
The restructuring of health services in South Africa was aimed at shifting the
emphasis of health provision from the urban hospitals to a primary health care
approach where selected health services, including rehabilitation services,
would be available in the community where their clients live. A result of this is
that the cultural background of the Health Care Worker frequently differs from
that of their clients
The concept of occupation is an integral part of the profession of occupational
therapy. The challenge facing the Health Care Worker is to render their
services in an appropriate manner to enable them to address occupation in a
manner that is relevant to the individual and his community, which makes up
that society. Occupational performance is viewed as a person's engagement
and implementation of occupations in the performance areas of self-care,
productivity and leisure in accordance with his role as an individual and his
role within his own unique community.
Any assessment model of occupational performance needs to express the
interaction between occupation and the factors that influence it. Following a
review of the literature, the researcher selected the Canadian Occupational
Performance Measure to determine the occupational performance priorities of
adults with physical disabilities in a developing community. The Canadian
Occupational Performance Measure is based on the client-centred approach
that allows the client to determine occupational performance priorities from his
own perspective and to rate his performance and satisfaction with these
priorities.
The research was conducted in Kwaguqua an area within the Witbank Health
District in the Highveld region of Mpumalanga, South Africa. Adults with
physical disabilities who were registered at the two workshops for people with
disabilities in Kwaguqua, and the health care professions who render services
in this area, participated in the research. Following two pilot studies, semi-structured interviews were conducted with
twenty-five adults with physical disabilities, to determine their occupational
performance priorities. From these interviews a ranked list were subsequently
obtained. Seven health care workers predicted the occupational performance
priorities for adults with physical disabilities and these were ranked and reranked,
using Delphi Technique, until consensus were reached.
The ranked lists obtained from both groups of participants were categorized
according to the International Classification of Functioning, Disability and
Health and evaluated. The results indicated that although both groups of
participants proposed similar priorities, some variations in the ranking existed.
Valuable insight into the occupational performance priorities of the people with
physical disabilities in Kwaguqua was obtained.