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OT THE KEY PLAYER IN PHC

As defined by the World Health Organization, health is not merely the absence of disease. Health considers the person holistically within their complete state of physical, mental and social well-being. Primary health care (PHC)  is essentially based on maintaining this state of well-being achieved through various factors such as lifestyles, housing, relationships, spiritual beliefs, income, and workplaces which are important indicators of health and well-being. As an upcoming Occupational Therapist I feel privileged to play a key role in this service delivery. There is, however, little knowledge on the expected role of occupational therapists within PHC practice. As a consequence of numerous economic and political issues the government has faced, the establishment of a strong primary care network has proven hard. This blog aims at unpacking the role of OT in PHC, hope it hit the bulls’ eye. 

The PHC has greater role assigned with great responsibility which focuses on community with emphases on promotion, prevention and rehabilitative services. It is set to provide life skills programs, work readiness skills, individual task analysis In primary health care. Yet they have been poorly integrated in less manifested within the Kenville clinic this is because they might be running less on multi-disciplinary team at site. We as OTs possess the supernatural power, allow me to say to transfers basic rehabilitation skills to community members in the form of caregiver training to decrease the burden of care. The unknown role within the PHC still makes the flag hard to raise high. We still remain one of the key players towards the role of first line referral services and guidance to help people find their way into the system through clinics and community engagement in health promotion talks. OT’s presents with enormous  skills and knowledge in health promotion, different kinds of chronic disease management, individual lifestyle interventions, and adaptive equipment to benefit clients accessing primary care this was supported by LeClair 2005. So I guess it’s not far-fetched right? LOL

The principles of PHC includes equity, community participation, social and economic development as well as interventions focused on the determinants of poor health. This is an important aspect that is needed in disadvantaged communities such as Kenville where they need  the role of PHC as a proved theory based on actions. This community should have information delivered to them and informed about the services, but we have covered lesser spectrum since we as practitioners mostly use social media for our personal benefit more than health promotion, prevention techniques, cure and rehabilitation that have been the core existing cornerstones of PHC, but we want to be the same as greedy politicians withholding peoples services. With the use of social media we could establish An integrated referral system to facilitate a continuum of care, teams of health professionals with specific and sophisticated biomedical- and social skills, adequate resources, and a client-centred approach is of vital importance. Service delivery and training of occupational therapists (OTs) need to be aligned with these principles of PHC to bring the best services to the public eye, but we keep blinding it by our old fashioned approaches that are said to be ineffective, I truly kid you not.

Social media should be increasingly used in public health and health promotion as it provides many options for distributing research, ideas and strategies concerning health promotion. However, these interventions can also possibly increase health inequities for individuals who do not have access to or do not use social media but an area like Kenville with free WIFI from Ethekwin municipality, this leaves no room for excuses unless you just want save your phone battery .There are also other forms of media that can be utilised in the community, such as the local newspaper, includes radio, TV and social media (i.e. Instagram, Twitter and Facebook to name a few). In the community of Kenville, we now have Occupational Therapy students who work closely with the primary health care workers at the clinic. The most prominent services provided by the students includes health promotion talk, screenings of paediatrics and adults and provision of home-based interventions. Within the primary health care system of Kenville, the students can be seen operating with various structures such as schools, crèches & personal homes within the community to prevent disease and promote health. 

As an OT student there are various ways that I can use media to not only promote health in general to also advocate for my profession. The media can be used as a form of educational platform to inform people on the services provided within the health care by OT . Health promotion can be done through various social media strategies such as creating hashtags on social platforms such as twitter based on current or relevant health issues. Media can be utilized in various form to bring awareness, advocate, and promote for health in social groups. 

OTs can contribute to the health care profession and offer important services within the primary health care system. I believe we are highly capable of providing holistic and client-centred support and services to tackle problems in occupational performance areas & limitations in everyday tasks to the community at large. And the readily available resources that supports social media serves as a key to equip us to be one of the best service providers and having to advocate successfully for our profession. If you can use social media to get us to know all about your personal life, you can get social media to inform us about OT, health promotion and prevention within PHC.

References Frenchman, K. (2014). The health promoting role of occupational therapy in primary healthcare: A reflection and emergent vision. New Zealand Journal of Occupational Therapy ,61(2), 64-69. Kennel, E. (2018). What is Primary Health Care? Available at: http://www.primaryhealthcare.uct.ac.za/phcd/approach LeClair, L., Restall, G., Edwards, J., Cooper, J., Stern, M., Soltys, P., & Sapacz, R(2005). Occupational therapists and primary health care: Manitoba Society for Occupational Therapists. Naidoo, D., Van Wyk, J., & Joubert, RW (2016) Exploring the occupational therapists role in primary health care: Listening to voices of stakeholders. Afr J Prm Health Care Fam Med.8(1), a1139. Scheffler, E., Visagie, S. & Schneider, M(2015) The impact of health service variables on healthcare access in low resourced urban setting in the Western Cape, South Africa. African Journal of Primary Health Care & Family Medicine 7(1). Wilcock, A & Hocking, C (2015) An Occupational perspective of health, 3rd edn., Slack Incorporate, New Jersey. ·         Gray, A., Vawda, Y., & Jack, C. (2011). Health Policy and Legislation. In: Padarath A, English R, editors. South African Health Review 2011. Durban: Health Systems Trust. Retrieved from http://www.hst.org.za/publications/south-african-health-review-2011 ·         Maillacheruvu, P., & McDuff, E. (2014). South Africa’s Return to Primary Care: The Struggles and Strides of the Primary Health Care System. The Journal of Global Health. Retrieved from https://www.ghjournal.org/south-africas-return-to-primary-care-the-struggles-and-strides-of-the-primary-health-care-system/ ·         Naidoo, D., Van Wyk, J., & Joubert, R. W. E. (2016). Exploring the occupational therapist’s role in primary health care: Listening to voices of stakeholders. African Journal of Primary Health Care & Family Medicine, 8(1), 1139. http://doi.org/10.4102/phcfm.v8i1.1139 ·         Visagie, S., & Schneider, M. (2014). Implementation of the principles of primary health care in a rural area of South Africa. African Journal of Primary Health Care & Family Medicine, 6(1), 562. Retrieved from http://doi.org/10.4102/phcfm.v6i1.562 ·         WHO (2018). Primary Health Care (PHC). Retrieved from http://www.who.int/primary-health/en/ ·         Welch, V., Petkovic, J., Pardo, J. P., Rader, T., & Tugwell, P. (2016). Interactive social media interventions to promote health equity: an overview of reviews. Health Promotion and Chronic Disease Prevention in Canada : Research, Policy and Practice, 36(4), 63–75.

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OT’s THE ADVOCATES OF WELLBEING

Occupational therapy occasionally has a clinical focus on human occupation which can result in the neglect of considering contextual, social and political factors in the communities such as poverty, marginalization, exclusion and unemployment. In addition it’s important as OT’s to understand and acknowledge that the daily lives of the community can be enabled, and potentially hindered by several cultural and political constructs, such as gender, employment status and ethnicity (Sakellariou & Pollard, 2012).

As OT’s we believe strongly in occupational justice, that is, all individuals having the right to opportunities and resources (personal, environmental & societal) which enable them to engage in an assortment of occupations that are culturally and personally meaningful. Sadly, occupational injustice is uncontrolled in most parts across the world, and strongly evident in the community of Kenville, where there is imbalances that were noted. Occupational Injustice occurs when people are excluded, dis-empowered, segregated or restricted from taking part in occupations to meet their basic needs (Kronenberg & Pollard, 2005). From the establishment of the community by the apartheid government to the current existence, Kenville is still faced with occupational injustice and suffers apartheid consequences. This is evident due to their limited resources, poor properly built homes/infrastructure, lack of proper sanitation and water, as well as poor quality education that presents with high dropout rates. This is Elicited by governance forces where political eye is shut to help the ones at the top pyramid, it is an unbreakable system and preys on social, cultural, and economic factors which jeopardize health and wellbeing as experienced by individuals living within the community. The societies are left to mend the brokenness of the system and bring hope to the upcoming generation, which I must say its hope gave to our very old Christmas Santa.

Upon observation in the community of Kenville, occupational injustice was noted as some individuals were restricted access to meaningful occupations of daily life such as having a well-paying job on the basis of their race, access to public services due to nationality, fair disability employment and  access to basic services .Through anecdotal evidence from members in the community occupational alienation was noted as people with disabilities reported that they were often stigmatized and socially excluded, which made it difficult for them to obtain paid work and so experienced multiple disadvantages and was not given opportunities to partake in work provided to non-disabled people.

Occupational deprivation is part of the political practice model and was undoubtedly noted in the community of Kenville. According to Whiteford (2000) occupational deprivation is defined as “A state of preclusion from engagement in occupations of necessity and/or meaning due to factors that stand outside the immediate control of the individual.” This is regarded as consequence of socially and economic changes which affects the community negatively seen at Kenville through inability to fully engage in daily occupations such as home management tasks as a result of poor service delivery (i.e. running water and proper electricity) as this factor was out of their control they  carry water from communal taps located within the settlements at a perimeter to their homes or do their laundry onsite where the taps were located.

This is an important issue for Occupational therapists, who are concerned with individuals or communities that are exposed to injustices that can cause restrictions of meaningful occupations in their everyday lives. My practice at this community emphasizes on the enhancement of occupational participation for all individuals and across different ethnic, with no set cultural barriers, religious choices and age grouping. as community-based OT’s we should present with political consciousness which actively enables us to deeply understand the influential factors of politics on human occupation and the decisions that underpins.

In conclusion, as Occupational therapists who advocate as political angels, it is our duty to advocate for the rights of people within the community and be more aware of social and political factors that impact on intervention provided to those in need. Political consciousness would allow for human rights advocacy in the physically and mentally handicap and underprivileged individuals in the community. Occupational therapist work more closely with the individuals and would therefore have better understanding of their circumstances. In the years 2017, the death of at least 118 psychiatric patients after being transferred from Life Esidimeni to other NGOs has been described as one of the greatest cause of human rights violation since the dawn of our democracy (Bornman, 2017). The occupational therapy practice must be aware of these issues and what steps to take to prevent human rights violation and offer equal engagement in occupation for their clients. occupational therapy is not a profession but a calling which you can only answer in love and passion, it is how you respond that saves, or destroy lives. Let us arise and become the voice to the voiceless, for we are the chosen ones.

References: ¥ Kronenberg, F., and N. Pollard. (2005). Overcoming occupational apartheid: A preliminary exploration of the political nature of occupational therapy. In Occupational therapy without borders, ed. F. Kronenberg, S. Simó-Algado, and N. Pollard, 58–86. Oxford: Sage. ¥ occupational alienation. (n.d.) Medical Dictionary. (2009). Retrieved October 5 2018 from https://medical-dictionary.thefreedictionary.com/occupational+alienation ¥ Sakellariou, D., & Pollard, N. (2012). A commentary on the social responsibility of occupational therapy education. Retrieved October 4 2018 fromhttps://www.researchgate.net/publication/254304596_A_commentary_on_the_social_responsibility_of_occupational_therapy_education ¥ Whiteford G. (2000). Occupational deprivation: global challenge in the new millennium. Br J Occup Ther .63:200–204. ¥ Bornman, J. (2017). Life Esidimeni: The greatest cause of human rights violations since democracy. [online] News24. Available at: https://m.news24.com/SouthAfrica/News/life-esidimeni-the-greatest-casue-of-human-right-violations-since-democracy-20171009 ¥ De Jongh, J. (2009). An innovative curriculum change to enhance occupational therapy student practice. South African Journal of Occupational Therapy, 39(1), pp.31-37. ¥ De Jongh, J., April, L. and Wegner, L. (2012). Curriculum transformation: A proposed route to reflect a political consciousness in occupational therapy education. South African Journal of Occupational Therapy, 42(1), pp.16-20. ¥ Pollard, N. and Sakellariou, D. (2014). The occupational therapist as a political being. pp.643-652. Available at: http://shura.shu.ac.uk/id/eprint/8798 [Accessed 7 Aug. 2018].

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A SHUTTERED ECONOMY WITH UNITED COMMUNITIES

The shift in South Africa’s economy has resulted in adverse change in the lives of South Africans. These changes are mostly beneficial to those with big bellies in the parliament unfavourable to a kid at Kenville with malnutrition and now suffering from stigma and removed from school due to back to back hospital appointments. In the Budget speech 2018/19, our cabinet set out an ambitious agenda for our nation. It lays out a series of interventions that will put South Africa on a bold new path, so they say. But when I entered the Kenville clinic I felt like the speech was for a different nation having to consider the surrounding conditions, whilst Billions and billions are engraved by signatures and allocated to individual pockets.

The determinants of economic growth are inter-related factors influencing the growth rate of an economy (Boldeanu and Constantinescu, 2015). The main factors affecting the economy which I noticed sharply included limited natural resources such as land since there are clustered settlements squeezed to hide heads at night in an uneven and unsafe terrains that can be easily flooded by the summer rain, little physical infrastructure(which was fairly present, such as other proper housing, schools, and a community clinic, crèches), uncontrolled population now reaching to 45 000 residents, technology and law. The country has experienced development in infrastructure, technology and natural resources over the years but there has been areas such as Kenville still set to be at the back of the race track.

The evidence of development and economic changes in the country of South Africa is undeniable, and the budget also indicates how well the figures has been distributed among departments, yet the residents seem to be feeding on the crust. Social development being among the ones of high priority on the budget. The department of social development keep on enforcing new mandates, which are to provide social protection and is working with Non-profit Organisations and faith based organization which is evident at the local clinic. The frameworks focuses on basic services.

The development should regulate substance abuse services and facilities which is not evident at Kenville community, since slot of residents are exposed to highly addictive drugs which are easily accessible and tend to be on the watch for preys. So you better always keep your back watched. Every corner its demarcated by smoking crew and all you can see is smoke breeding from the youngsters souls that seek for help. They busk in the sun as vitamin D penetrates into their skin while some are making a living off washing taxis most spotted topless, it must be a custom, or they can’t bear the heat. This are consequences of decreased  job availability and service provision within South Africa and Kenville has made a culture out of it. There has been little change in the lives of the poor and uneducated population with human capital and labour being one of the factors affecting the economy. Inequality experienced by people with disabilities as they are fighting poverty with their grant and pension money to sustain their families.

We are to keep in mind that the state of the country has direct impact on its inhabitants in a physical, psychological and spiritual level. South Africa’s public health sector is funded by the state and 40% of all expenditure on health comes from the National Treasury. The high levels of poverty and unemployment in the country mean that healthcare remains largely the burden of the state with the National Department of Health holding overall responsibility for health care, with a specific responsibility for the public sector (Jobson, 2015). Delays in provision of health services, shortage of medical personnel’s and scarce resources are direct consequences of the ever-changing economic state of South Africa.

Health services to all should be easily accessible, from caring facilities, based on primary health care approach. The department of health is responsible for such an achievement towards the reducing the burden of the disease and strengthening the health system, yet it’s a tale we might have to discuss some other day. The focus should be pointed towards preventing and treating communicable and non-communicable diseases. Although TB, HIV and AIDS require specific attention. It is important not to see this in isolation from other communicable disease given their cumulative impact, But it’s a prayer Kenville has to plead upon.With this being said, the government in implementing numerous strategies to improve the health and wellbeing of the South African communities despite the state of the economy. The foundation of the public health system is the primary healthcare clinics that are the first line of access for people needing healthcare services (Jobson, 2015).

Consequently, the health and wellbeing of the community affects their overall engagement in occupations of choice that bring meaning to life.  Kielhofner defines occupational participation as “Engagement in work, play, or activities of daily living that are part of one’s sociocultural context and that are desired and/or necessary to one’s well-being” (Kielhofner, 2008). The low economic state of South African communities has placed barriers in occupational participation amongst the people. Physical changes occur as we age, impacting on our overall health, but changes in our mental well-being, roles and occupations also affect health (Young, 2017).

It is therefore the role of occupational therapists to ensure occupational participation of the vulnerable community members. The economy has placed a barrier in the provision of such interventions within the communities with no posts being available for occupational therapy. Furthermore, occupational therapists could assist the community members to be functional within their context and ensure wellbeing through the provision of therapeutic interventions to alleviate barriers to health.

References http://www.treasury.gov.za/documents/national%20budget/2019/enebooklets/Vote%2016%20Health.pdf http://www.treasury.gov.za/documents/national%20budget/2019/enebooklets/Vote%2017%20Social%20Development.pdf http://www.treasury.gov.za/documents/national%20budget/2019/enebooklets/Vote%2025%20Economic%20Development.pdf http://www.treasury.gov.za/documents/national%20budget/2019/enebooklets/Vote%2038%20Human%20Settlements.pdf http://www.treasury.gov.za/documents/national%20budget/2019/enebooklets/Vote%2036%20Water%20and%20Sanitation.pdf http://www.treasury.gov.za/documents/national%20budget/2019/enebooklets/Vote%2016%20Health.pdf

BOLDEANU, F. and CONSTANTINESCU, L. (2015). The main determinants affecting economic growth. Series V: Economic Sciences, 8(57), pp.1-6. Jobson, D. (2015). Structure of the health system in South Africa. [online] Bing.com. Available at: Kielhofner, G. (2008). Model of human occupation. 3rd ed. Baltimore, MD: Lippincott Williams & Wilkins, p.122. Pubdocs.worldbank.org. (2018). [online] Available at: http://pubdocs.worldbank.org/en/798731523331698204/South-Africa-Economic-Update-April-2018.pdf [Accessed 19 Jul. 2018]. Young, A. (2017). What Are the Facilitators and Barriers to Participation in Meaningful Occupations of Retired Community Based Older Adults?. [online] Dalspace.library.dal.ca. Available at: http://dalspace.library.dal.ca/xmlui/bitstream/handle/10222/72981/Young-Angela-MSc-OCCU-June-2017.pdf?sequence=1&isAllowed=y [Accessed 25 Jul. 2018].

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A COMMUNITY ACCESSED IS A COMMUNITY BETTER DEFINED

In the beginning of this block I asked myself, ‘what is a real community is and what it mean to be part of a community. As I approached a new context and new group of people I had to be part of for the next six weeks, Anxiety and fear struck me when I looked back at the history of this new community that I will now be part of for the next few weeks. The Oxford online dictionary described a community according to location as a group of people living in the same place or having a particular characteristic in common. But the definition was just not enough to calm me down

I was then privileged to be part of a community which had no idea what OT was, and if they did, it was only a few who had accessed hospital appointments. The geographic structure was very interesting, with uneven terrain, no proper housing, illegal electricity connection on the ground. They just dare you to watch your steps, you wouldn’t get lost every corner had a unique feature to recall. It’s an informal setting with a lot of improper built material that compromises safety and health, but who cares as long they have a place to hide their heads. After long walks in it you are rewarded by water from communal taps which are a little far apart. With no proper sanitation except the hole ones. You would just want take a taxi but the rank its just too small and to shady looked like a carwash.

The community I am waking in is troubled with social issues such as poverty, teenage pregnancy, improper housing, abuse, low employment rate and drugs just to name a few. These factors then make it difficult for the environment to flourish. According to an article by Jim Cavaye on Understanding Community Development, it is described as a process where local people can not only create more jobs, income and infrastructure, but also help their community become fundamentally better able to manage change. Infrastructure and provision of health care are fundamental in the development of a community and helping it flourish, and yes with access to schools, community halls, running water, electricity, housing and clinics for better health care services such as immunization, disease prevention and family planning, one can argue that community development is presently strong. 

Numerous people and varied services promote the welfare of local communities. Structures/systems in place by the government play a larger role in the physical development of communities. This has not been evident in my current community due to lack of  improvements in infrastructure and health care provided in the community, they haven’t alleviated the impact of apartheid on the lives of these community members with this being evident in their low socio-economic status. Government needs to develop a multiple response to the changing situation of communities. A response that not only improves the delivery of services and adjusts policy but also includes a greater government role in helping communities build their capacity to manage change(Cavaye, 2015). 

The setting is of uniqueness, not like the basic housings we would find in a decent township that has street lights, running water, paved roads, proper housing, registered local stores owww and proper sanitation you would have to stress of a spider having to rush out as you help yourself. It does not possess a structure where it is organised or with set roads and physical addresses. But ask where mam mkhize stay, they wouldn’t hesitate but to show you where the shack is. As much as the current community is deprived of certain services. Except that blue shower container you had to wait 3 hours before a decent shower. They also do present with qualities that define them, values that makes them unique and have those common characteristics that makes them a community, which am still intrigued to explore

An article by Kristina Grage Ricketts on The Importance of Community Leadership to Successful Communities argues that in areas such as public education and job training, technology, networking with state and regional agencies, health care, leadership and strategic planning, communities are learning that community development is not the responsibility of any one group, but a community-wide effort. Which in this setting is evident by community leaders that are very commented, it is within a Faith Based setting where religious leaders ensures its smooth running and bring flourishness, although its affected by racial issues as well as religious barriers, that’s an a international issues right, if not I guess you living in the ancient times. 

It is imperative, in my opinion, to form the basis of a community on religion because that governs the individual personally by values that religion instilled in an individual. I have identified more than one member of the community centre that is part of a local church within the community. These people are already in place working with young people to pass down religious values that govern them to act differently and with positive attitude when compared to other community members that are not part of any religious group. Dan McKanan says that, ‘‘strength for the struggle ultimately comes from the sense of identity that people gain when they are bound together in community’’.  

In my argument I would say that people are more than their needs & struggles and are to be treated in a way that reflects their inner potential (Canonico, 2014). To flourish is to grow or develop in a healthy or vigorous way (oxford online dictionary). Improved living conditions, improvement of employment rate, decrease in drug abuse amongst youth and overall improved socio economic status would then really tackle the issue of development of a community. Engagement in culturally and developmentally appropriate occupation/activities and improving the skills of everyday living and participation from an Occupational Therapy perspective would improve or develop the person therefore developing the community as a whole. It is therefore imperative that health care services are provided to the current community. It will be challenging to work within this context but I have found new hope for this community through the people I meet every day in community and excited to leave a mark as an OT oww the first one in the community, how great does that sound, if not cool enough I might as well have to put u in a freezer

References Anon, (2018). [online] Available at: https://en.oxforddictionaries.com/definition/community [Accessed 18 Jul. 2018]. Canonico, L. (2014). Chapter 6: Principles of Community Development. [online] prezi.com. Available at: https://prezi.com/h2xjjc17xsaq/chapter-6-principles-of-community-development/ [Accessed 18 Jul. 2018]. Cavaye, J. (2015). The Role of Government in Community Capacity Building. [ebook] Queensland, Australia: Department of Primary Industries, pp.4-5. Available at: https://www.researchgate.net/publication/239919315_The_Role_of_Government_in_Community_Capacity_Building?enrichId=rgreq-cb623dbba7ce4c2370f61cecf3b996cb-XXX&enrichSource=Y292ZXJQYWdlOzIzOTkxOTMxNTtBUzozMDAyOTA3MzA0MTQwODFAMTQ0ODYwNjI5NzI0MA%3D%3D&el=1_x_3&_esc=publicationCoverPdf [Accessed 19 Jul. 2018]. McKanan, D. (2010). How Religion Strengthens Community | Chats, Up For Discussion | Zócalo Public Square. [online] Zócalo Public Square. Available at: http://www.zocalopublicsquare.org/2010/10/19/how-religion-strengthens-community/ideas/up-for-discussion/ [Accessed 19 Jul. 2018]. https://www.google.com/search?biw=661&bih=666&tbm=isch&sa=1&ei=kv9vXPaLFcysa8yMpMAD&q=kenville+cOMMUNITY&oq=kenville+cOMMUNITY&gs_l=img.3...2537.10162..10750...0.0..0.387.4353.2-2j11......1....1..gws-wiz-img.......35i39j0i24j0i10i24.H-g2t_vqoRI#imgrc=Hk89qRrVvpSGpM

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STEAMY MOCK PRAC ON CAMPUS

As the psych block is about begin, and as supervisors break the ice for our boats to pass through. and calming us with easiness yet with pile of readings to go look up.

as it commenced, we were informed about the ethics and conduct on how we have to be on prac, as we were briefed about our clinical supervisors . when they entered i could feel my hair starting to rise, felt like they were some giants sent to crush us out. but to my surprise i was so so motivated by the new supervisors, where i was fortunate to get one hahaha. i was so motivated about the clips we watched, about the WHY, HOW and WHAT inside the OT profession. this was the inspiration of the day, which enabled me to find reasons and motives as to push and continue what am doing, and why am doing it. it enlighten the inner bulb that i am here to be great and exercise my true and full potential. and to be really who i really am.

I was further equipped with how to use theoretical frame of reference since its different from the physical block. and how it can be guidelines to successful treatment intervention. refresher slides was provided on SMART AIMS which are key elements of being an OT. because you always have to be smart, set measurable goals, come with therapeutic activities, be able to review your treatment session, and be able to have it on time based.

funny enough the envelope and card making, which is an escape option for treatment session, was cut off, what a disappointment. but it allowed us as class to discuss what treatment sessions can one implement, that which are beneficial and therapeutic.more was said but above all.i am proud after this day since i know why and doing OT, and HOW am planning to succeed in the current prac block. 

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PYCH BLOG PREPARATIONS

its that time of the semester, where it all about the patients patients and patients, where previous attained information on assessments needs to be revisited for effective treatment for the block. 

As nerves hit the peak, and as anxiety kicks in with the unknown anticipation of the conditions to treat for the block and which treatment approach may be effective. I ran to open previous notes from OCTH 245 theory and fundamentals theory. where all the assessments files are now collected, printed and arranged, ready to commence with treatment. since

since I know I have difficulties with time management I had to visit sites https://www.youtube.com/watch?v=-opxaWMoZxo  

https://www.youtube.com/watch?v=GBM2k2zp-MQ

to get strategies to help me cope and work effectively on the current block.

as I got excited over the block I looked at mental condition affecting elderly and browsed through various articles. but the one that interested me and found resourceful was from https://www.spomincica.si/files/zborniki/zbornik02/2pgs1.pdf

this has been said to be a challenging and interesting block, and am happy to be taking part and making change in mental health, as well as to change peoples perception when handling people with mental condition

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INDIVIDUAL STRENGTH AND WEAKNESSES

its that time of the week again where you have to hear from me again. as this practical block comes to an end. it presented me with opportunities to help find myself and  know my individual strengths, and weaknesses . know what works best for me and what works better for the client. which was quite tricky since it required alternate approaches but when getting used to it, its a smooth flow.

my strengths includes handling skills towards clients as am able to physically and verbally handle the client well, and accordingly . while considering individual needs and abilities. i am able to look out  therapeutic opportunities and help improve my handlings. i am also able to create therapeutic environment and activity simulation relevant to the client context my presentation skills are adequate since i enable the environment to be  controlled by all means to minimal distractions for enhanced participation. client dignity and privacy was ensured by all time 

activity selection has also been my strength since i look into the client holistically and conduct a session relevant to their context.

every individual strengths is underlined by weaknesses. time management has been a challenge and having to balance my time within my clients. my implementation of intervention and the ability to grade the session fully to adapt for the clients ability.i have had challenges to come with activity requirement since i mostly confused it with the actual requirements of the client. i discovered to have lack in-depth clinical reasoning towards my treatment and why i want to achieve certain aims. it is also a challenge to establish a subprogram according to order and urgency to be adressed.

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THEORY VS IMPLEMENTATION

Extracting information from the class given theory has always seemed like an easy process. theory is very and standardised. which does not cover the broad spectrum of severity we face in hospitals. each client is unique in their different way in relation to the level of lesion.

therefore, being at hospital has been one of the challenging experiences since u integrate practically apply t, it becomes different from the written information since it requires grading and additional application at. i have personally struggled with some approaches towards the client for example the neurodevelopment approach, where in theory they explain the key-points of control and inhibiting abnormal movement patterns.but the challenge was having to do it on an actual client now, not having to simulate it in class over a friend who is pretending to be a paraplegia you have to compensate and make alterations to it.

but with this challenge faced i am happy that the information given to me has been of great knowledge for application on the given theory. The theory allowed for a firm establishment of specific treatment principles and why do you need such, as to why do you need a mirror as a visual cue, for self reflection of the client on their postural patterns. how handling skills consist of verbal and visual handling. and how grading consisted of addition of components or removing them not just manipulating the existing one.

My client management has improved sue to the constant application of theory since it draws green and red lines with regards to the establishment of treatment and how the course is supposed to be driven towards. theory strengthens and support the application of theory. Which has help improve my practice and help build rapport towards the confidence of theory applied 

the book that has been very helpful that you can also acess under Moroz, A. (2015).Rehabilitation After a Spinal Injury. Retrieved from The Merck Manual Consumer Edition: http://www.merckmanuals.com/home/fundamentals/rehabilitation/rehabilitation-after-a-spinal-injury

Trombly, M. R. (2008). Occupational Therapy for Physical Dysfunction (6th ed). Philadelphia.

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THE RISING OF A QUAD PHOENIX (SCI)

The clients progress has been the main aim to get him back to his independent function and getting him ready for school return since MR X is a grade 11 pupil. archived through decreasing the amount assistance required from caregivers and allowing client to carry areas of occupation with no supervision.there has been progress from the initial assessment of the client.

 Mr X was was dependent in 70% of BADL- to mention few the client could not dress independently and depended on staff daily, due to generalised weakness on both UL and LL .but has learnt a compensatory technique to carry out independently, client had difficulties in grooming ( hair combing, teeth brushing). the client was wheelchair bound with little potential to move from sit to stand and now he is able to move from sit to stand on a standing frame independently

client presented with unsafe transfer techniques, poor wheelchair mobility and handlings skills. poor bed mobility. inability to weight bear on LL. un able to work against moderate resistance on UL 

for IADL which we have initially commenced the client was trained and taught a compensatory technique to help make his bed independently preparing him for discharge, in which he is making progress since re enforcement from the nursing staff   implemented and the progress is monitored by the student therapist.

for the archived progress the fundamental PRINCIPLES  were as follows.activity requirements would include repetition and resistance to improve strength. allow for weight bearing on lower limbs, and allowing for active ROM of UL .

the structuring included therapeutic environment to simulate how the mr X would be expected to do in in a home setting, ensure controlled environment to prevent distractions. and ensure that all tools are available prior to the commencing of the session.ensure that most activity are carried out from standing to allow weight-bearing and improving trunk control. 

the client was well presented with activities activity and everything was explained in layman's terms and what it aims to archive. i ensured to handle him physically by keeping a close distance for easy facilitation of the activity

NOTE: do not remove a back support if you dont have a back bone. hahahaha

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THE SWEAT BEHIND MIDTERMS DEMO’S ASSESSMENTS

Formal assessments have always made me nervous always gave me sleepless night before hand, i always felt like i was not ready,double checked if my principles and aims are attainable. the whole feeling has always been overwhelming. getting to have a supervisors checking your DO’s and DONT”s for 15 minutes seems like 15 hours.but with this one the outcomes were very rewarding during my session with Ms X my right CVA client

through out my midterms block i have learnt that for each session to work effectively en-cooperate all the things covered during the previous one. client centredness was one of the keys to a success for the activity selection relevant to the client. the activity chosen was grooming,where the client was required to groom using a learnt compensatory technique ,followed by wiping of face, and washing hands to promote personal hygiene. the principles applied towards the client were specific towards the clients needs. for structuring, i ensured that the activity was carried out in a bathroom at a sink which was a therapeutic environment for the activity. the room was controlled to minimal noise level for better concentration and for privacy.

a close distance was ensured towards the client for safety preacautions and for physical and verbal facilitation and application of NDT where possible. removed the arm rest for adequate spacing. and ensured weight-bearing of the affected UL on the sink. the activity was presented to the client in layman's terms to avoid confusion and explained  the importance of involving  the affected limb on activities.

the activity was well managed and the aims were archived since the activity promoted bilateral hand use, allowed for the client’s decision making and promoted concrete judgement.repetition was allowed for muscle strengthening  . what more could you ever ask from a session.this requirements were met.

although the session went very well there were the things that did not go well, and could not be changed  such as the height of the since which was low and the wheelchair could not go through, but what could have been done was to allow the client to lean forward by facilitating her trunk through NDT. the feet were not weight bearing on the floor which is also an importance aspect to address. 

 if you would like to learn more on NDT facilitation like i did especially if you have that stroke client you want to improve function check 

https://media.lanecc.edu/users/howardc/PTA204L/204LNeuromuscReEd/204LNeuromuscReEd5.html

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this prac block has been the hardest but mostly rewarding 4th week and still counting. the block is an integrated block as it does not end by assessment forms completion yet incorporate it into individual treatment intervention. there are few successes compared to difficulties which is caused by mainly secondary aims as to whether they were able to be achieved or not. client differ from one to another, therefore client centeredness approaches need to be specific.

thus far my successes include my verbal and physical handling skills towards both my clients which is influenced by good rapport created through medium of instruction used which is isiZulu. where clients are able to express themselves fully in their home language and improves the level of communication. As well as my ability to address matters in their level of understanding. I have improved on my smart aims after few beginner weeks that I was struggling. Among activities conducted I was able to execute ADLs of the clients effectively with the client, was able to address leisure of the client constructively. my other success in the prac so far is that am always on time at prac venue which allows me to structure my day properly according to the daily plan and stick to it as well as submit all the necessary daily documentation. i am also able to personally critique myself with the feedback i get from supervisor to implement better intervention sessions to achieve optimal functioning of the clients.
 

difficulties faced in this prac block, includes choosing the correct activity to address factors that are limiting clients functioning. Handling skills are hard to implement in writing as structuring also influence them therefore that becomes a difficulty for me. I have difficulty is time management as to balance both my clients with equal durations daily since they also have a scheduled plan at hospital and other sessions they attend to. there’s lack of consistency in terms of my principles since they appear general and not specific to individual clients and a gap in making them client centred. 
implementation of principles differs with regards to different diagnosis, therefore putting that into consideration becomes tricky as to separate it for each client. The presentation also differs as sometimes you use verbal prompts sometimes you will need to demonstrate, handling becomes very challenging as you do not know if you should provide minimal or moderate assistance towards client’s ability, if you are putting a-lot of input for the client as well as avoiding making the activity harder. I personally have difficulties in terms of implementing activity requirements as sometimes I confuse it with the actual requirements of the activity chosen, which brings a different meaning from the activity requirement from the client. 
putting this into mind I am pushed to work against the difficulties i face in prac block to provide consistent and effective therapy beneficial to the client at all times. the challenges acts as building blocks in improving my understanding in this prac and how hard i should read up on certain content to improve the approaches. The successes also open room for improvement.

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planning and implementation of intervention

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CLIENT CENTRED CIRCLE AROUND THE CLIENT" " client centred" sounds familiar right?, this is very practical. it means the client is in the centre of a circle and everything you do have to revolve around his diameter and perimeter. being client centred means to let the client be the leader of therapy, putting the client first, asking the client what are their goals in therapy what do they want to achieve. The therapist must understand the client fully in terms of their context where they come from what are their roles, values, habits interest. What they believe in.asking them what did they feel after a session and if they feel like they benefiting from therapy is being client centred. In my second week of prac block, client engaged in dressing of the UL, sounds easy right? i thought so too. But for a C6 bust quadriplegia, a spinal cord injured patient it was not as easy as it has to be. i chose this activity according to the client needs and functioning since he had limited active ROM of the upper limb with no muscle strength of the wrist the client still needed to be independence in his activities of daily by compensatory technique. He had decreased self-esteem due to dependency on nursing stuff and having his private parts exposed to strangers. The client was well managed since it was conducted in a private environment, which was the ward, with the curtains closed ensuring enough privacy as possible and to enhance participation. the session went very well, the client was able to meet the requirements of the session to bring the best outcomes, the quality of dressing was fair and the client was happy to have carried out a self-care management task after 7 months of hospitalization .therefore the results were enormously rewarding to both the client and therapy. i would have improve the session for greater outcomes to be archived by ensuring that the client had a vest on prior to the session to avoid exposing his body to my supervisor which he might have found it very uncomfortable to dress in front of her, allowing her to see his body.so self privacy was more needed which could have enhanced the clients participation since invasion to personal space could have been discouraged. treatment principles are always hard to implement, since they have to be specific to client, boom!!! back to client centred . i structured the environment and ensured that there were no obstruction to injure the patient during dressing,  the activity allowed for autonomy  ,allowed for active ROM of the UL,presented the activity in layman terms, provided alternate methods and allow the client to choose the one suitable for his context. I stood next to the client for safety and to help with facilitation of activity. #OT3 #ADVOCATES_AGAINST_DISABILITY

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first week on prac! supposed to have been fun and exciting but the dull smell as you enter the facility overwhelms you as you drag your big bags full of assessment kit, just as big as those guys bag who come in for hospital maintainance. the smiles from the staff just welcomes you in the hell’s den, where little angels like us come in to save peoples souls into their independent functioning. the supervisors eyes are filled with hope towards imparting knowing and grooming our skills so we could face the real devil himself called dysfunction,which inhibit people from their independent normal functioning

first week ? one word to define it “Hardest” .the expectations from the clients eyes and supervisors are so tough like a rigid limb .as i saw people to my eyes diagnoses started flashing throughout as they pass. i  started to arrange the goniometer on my mind. i started giving them  muscle strength of above  OS 3 because they were able to wave at me.his impairments such as diminished sensation becomes my landmarks to start pricking him with my pin. when i saw his limited ROM, contractures ,pain, start clicking and BANG! a baseline for treatment was running towards me.His slummed posture got me  running as fast to go look at posture notes. to see if he presents with scoliosis or lordosis.

i gave him my bag to see his hand function as he was excited to hold my kit i gave him a bottle of water to see his cylindrical, as it got exciting i tested his grasp and pinches hand function. the results were very arousing and wanted to know more

am pretty sure you wondering what case it is that is getting me of my toes,that is still making me find my ground.he is a spinal cord C6 quad, whom  i didn't have to do tone, my vocal tone towards him was loud enough. stay tune as every Friday i will reveal insight of how treatment sessions went with this diagnosis

#OT3 

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Occupational therapy