Vorster Ilande, Buchanan Helen
Division of Occupational Therapy, Department of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa.
The Hand Rehabilitation Unit, Netcare Christiaan Barnard Hospital, Cape Town, South Africa.
Hand Ther. 2024 Sep;29(3):102-111. doi: 10.1177/17589983241239272. Epub 2024 Mar 13.
Hand injuries affect occupational engagement and participation, yet anecdotal evidence reports a focus on body structures and functions within hand therapy. Failing to address occupational challenges may result in sub-optimal patient outcomes. In line with the growing body of evidence of positive outcomes relating to occupation-based practice (OBP), this article aimed to describe the knowledge, attitudes and practices towards OBP of occupational therapists treating hand-related conditions in South Africa.
In this quantitative, cross-sectional study, South African occupational therapists treating hand conditions were recruited. Data were collected via an emailed survey developed for the study. Data were analysed descriptively.
Sixty-seven responses met the inclusion criteria, a response rate of 62%. Most respondents worked in the private sector (73%) with many holding postgraduate qualifications (54%). Lack of access to evidence and a preference for biomedical literature impacted on acquiring knowledge on OBP. Attitudes towards OBP were mostly positive. Barriers were contextual, patient-related and therapist-related. Practice focussed predominantly on performance components and aimed to reduce impairment rather than promoting occupational engagement.
Current hand therapy services in South Africa reflect a biomechanically-focused practice that is mis-aligned with occupational therapy philosophy. In line with existing research, OBP should be adopted more routinely in hand therapy in South Africa.
手部损伤会影响职业参与，但有轶事证据表明，手部治疗侧重于身体结构和功能。未能应对职业挑战可能导致患者的治疗效果欠佳。鉴于越来越多的证据表明基于职业的实践（OBP）能带来积极成果，本文旨在描述南非治疗手部相关疾病的职业治疗师对OBP的知识、态度和实践情况。
在这项定量横断面研究中，招募了南非治疗手部疾病的职业治疗师。通过为该研究设计的电子邮件调查问卷收集数据。对数据进行描述性分析。
67份回复符合纳入标准，回复率为62%。大多数受访者在私营部门工作（73%），许多人拥有研究生学历（54%）。获取证据的机会不足以及对生物医学文献的偏好影响了对OBP知识的获取。对OBP的态度大多是积极的。障碍包括环境因素、患者相关因素和治疗师相关因素。实践主要侧重于表现成分，旨在减少损伤而非促进职业参与。
南非目前的手部治疗服务反映出一种以生物力学为重点的实践，这与职业治疗理念不符。与现有研究一致，南非的手部治疗应更常规地采用OBP。
