Books / book chapters by Lizahn Cloete
Papers by Lizahn Cloete
Mental Health and Social Inclusion, Jun 1, 2022
Purpose The purpose of this study is to explore social barriers affecting participation in chosen... more Purpose The purpose of this study is to explore social barriers affecting participation in chosen instrumental activities of daily living (IADL) among community-dwelling persons with schizophrenia in Rwanda. Design/methodology/approach A qualitative study used an embedded single case study design and constructivist epistemology paradigm. Purposive sampling and semistructured interviews of 10 persons with schizophrenia and their 10 caregivers were conducted. Data analysis was done thematically using an inductive analysis approach, following within-case and cross-case analysis. Findings The hindrances to participation and community negative attitudes were explored as the two themes. This study focuses on the community negative attitudes including family exclusion and stigmatization, which hinder the participation of persons with schizophrenia in their chosen IADLs. Practical implications This study highlights the need for psychoeducation about mental illness for the caregivers of the persons with schizophrenia, community outreach activities for sensitizing about mental illness to address stigma toward persons with mental illness and strengthening the activities which promote the social interaction and sense of belonging of persons with mental illness. Originality/value Persons with schizophrenia are facing maltreatment and stigma from the community members while participating in their chosen IADLs. Awareness raising of the support needs of persons living with schizophrenia will contribute to relevant stakeholders advocating for inclusion into families and communities.
African Journal of Disability, Jun 28, 2023
Considering a positive and negative syndrome scale (PANSS) classification of symptoms of schizoph... more Considering a positive and negative syndrome scale (PANSS) classification of symptoms of schizophrenia, positive symptoms include sensory, behavioural and thought disturbances Background: Mental disorders are a major health concern across the globe. Schizophrenia, one of the mental disorders, affects approximately 20 million people globally and 5 million people within the African continent. Schizophrenia can affect all areas of life, including participation in instrumental activities of daily living (IADLs). Objectives: The study aimed to explore personal barriers affecting participation in chosen IADLs among community-dwelling persons with schizophrenia in Kigali city, Rwanda. Method: A qualitative, embedded case study design and constructivist epistemology paradigm were used. Purposive sampling and semi-structured interviews were conducted with 20 participants that included 10 persons diagnosed with schizophrenia (case 1) and 10 of their caregivers (case 2). Data were analysed according to the seven steps of Ziebland and Mcpherson. Findings: The two themes identified were community negative attitudes and individual hindrances to participation in IADLs. Theme 1 demonstrated the community's poor support towards persons with schizophrenia due to the stigma attached to mental health illness, which is reported elsewhere. This paper reports on individual hindrances to participation, which revealed limited knowledge and skills, decreased motivation and interest, financial problems, maladaptive behaviours, medication side effects, loss of social interaction and isolation, and disorganised in performing activities to negatively affect persons with schizophrenia's full participation in their chosen IADLs. Conclusion: Community-dwelling persons with schizophrenia are experiencing various hindrances to participating in their chosen IADLs, which shows a need for support from different stakeholders to improve access and participation of persons with schizophrenia in their daily activities based on their abilities. Contribution: Different barriers affecting participation of the persons with schizophrenia in their chosen IADLs were highlighted together with the common affected IADLs. It is recommended that when right support is provided, persons with schizophrenia may function at their maximum abilities in their activities of choice and may live at their highest independence level.
Background Fetal alcohol spectrum disorder (FASD) is among the leading causes of developmental an... more Background Fetal alcohol spectrum disorder (FASD) is among the leading causes of developmental and intellectual disabilities in individuals. Although efforts are being made toward the prevention and management of FASD in South Africa, the prevalence remains high. The sustained high prevalence could be attributed to several factors, including the lack of policy for a coordinated effort to prevent, diagnose and manage FASD nationally. In this study, our aim was to explore the perspectives of service providers (health and allied professionals, teachers, social workers) on the prevention and management of FASD towards developing a guideline to inform policy. Method Guided by the exploratory qualitative research design, we purposively sampled relevant service providers in the field of FASD prevention and management for focus group discussions. Nine of these discussions were conducted with to eight participants per discussion session. The discussants were asked various questions on the cu...
Identified policy requirements. (DOCX 18 kb)
Current practices and interventions. (DOCX 19 kb)
Interview guide for focus groups interviews. (DOCX 14 kb)
Work, 2020
BACKGROUND: Unemployment rates are generally higher among persons with mental disabilities who ex... more BACKGROUND: Unemployment rates are generally higher among persons with mental disabilities who experience many barriers and challenges that limit their participation in work and employment. Occupational therapy can play a key role in promoting participation and engagement in work by persons with mental disabilities. OBJECTIVE: This review sought to identify the barriers and facilitators to work participation for persons with mental disabilities globally in comparison to Zimbabwe, and to identify the competencies related to work practice in occupational therapy curricula internationally and regionally. METHODS: A narrative literature review was conducted using the SALSA (Search, Appraisal, Synthesis and Analysis) framework which informed retrieval and analysis of articles published between 2012 and 2018. RESULTS: Fifty-one out of 227 articles were selected to inform the review. A synthesis of the literature provided insights and ideas on facilitators and barriers to work for persons ...
Collaborative capacity development to complement stroke rehabilitation in Africa Published by AOS... more Collaborative capacity development to complement stroke rehabilitation in Africa Published by AOSIS Books, an imprint of AOSIS Publishing.
South African Journal of Occupational Therapy, 2020
Background: Common ways of planning and evaluating occupational therapy services include the clin... more Background: Common ways of planning and evaluating occupational therapy services include the clinical judgement of therapists and cause-effect interpretation of statistics. Patient-informed methods of planning occupational therapy services are yet to be explored within occupational therapy, and more specifically within the provision of in-and outpatient mental health services in South Africa. An Appreciative Inquiry was conducted to explore the views of a group of outpatients on a craft group at a tertiary mental health hospital in the Western Cape, South Africa. Objectives: To highlight the use of Appreciative Inquiry to explore the perspectives of outpatient mental health consumers. To identify the enabling elements contained in an Occupational Therapy outpatient craft group. Methodology: A social constructivist paradigm framed the research process. The 4-D model of Appreciative Inquiry was used. Six participants selected via purposive sampling were recruited as co-researchers. Five data collection sessions of 90 minutes each were conducted. Inductive analysis was used. Findings: The research participants come from differing ethnic and social backgrounds which contributed to the richness and transferability of the findings. Participants identified ten elements that enabled them to improve their mental health and enhanced their sense of belonging to the group. These included non-judgement, being able to redo the craft activity at home, no pressure, the stimulating effect of the group, being able to talk to the therapist about anything, feeling like a family, socialising nicely, a calm environment, feeling safe at the group and a quiet environment. It may be unrealistic for an occupational therapist to have the time available to evaluate their clinical services using the Appreciative Inquiry model. However, it may be beneficial for occupational therapists to apply the principles of Appreciative Inquiry in the evaluation of their groups Conclusion: Appreciative Inquiry is a valuable method for exploring patient views of useful aspects of occupational therapy outpatient art groups.
Scandinavian Journal of Occupational Therapy, 2019
Background: Persons with disabilities experience higher unemployment rates and limited participat... more Background: Persons with disabilities experience higher unemployment rates and limited participation in work. Occupational therapy can promote participation and engagement in work by persons with disabilities. However, there is no clarity on the required set of competencies for entry-level occupational therapists with a bachelor's degree to start up and participate in intersectoral work practice initiatives in Zimbabwe. Aims: To explore what work practice competencies entry-level occupational therapists require to meet the work-related needs of persons with disabilities. Material and Methods: This exploratory qualitative research sought to explore what professional competencies entry-level occupational therapists required for them to offer collaborative inter-sectoral work practice initiatives for persons with disabilities within the Zimbabwean context. Six participants selected using criterion sampling, participated in semi-structured interviews. Inductive content analysis was conducted. The Stellenbosch Health Research Ethics Committee and Medical Rehabilitation Practitioner's Council of Zimbabwe gave ethical clearance and permissions to conduct the study. Results: Three themes; core knowledge for work practice, skills for work practice and occupational therapy professional attributes; emerged. These were used in formulation of ten professional competency statements for occupational therapists offering work practice services. Conclusions: Although Zimbabwean occupational therapists require similar competencies for work practice as those required in other countries, additional competencies that fall outside traditional health care contexts are essential in order to promote contextually relevant practice.
Open Journal of Pediatrics and Child Health, 2019
Background and introduction: Autism Spectrum Disorder is a global public health concern which has... more Background and introduction: Autism Spectrum Disorder is a global public health concern which has attracted little attention from African countries such as Kenya. As a result, children with ASD and their caregivers are facing signifi cant barriers to accessing crucial services compared with the general population. Methodology: A qualitative, descriptive phenomenological study utilizing Focus Group Discussions (FGDs) was conducted. The data was transcribed verbatim before QSR N'Vivo 10 was used to organize and analyze the data from transcripts of fi eld notes and interviews. Content analysis was used to identify important ideas and concepts. Findings: One theme, namely, "the burden of caring for children with ASD" was identifi ed. Implications and recommendations: Occupational therapists and other relevant stakeholders should provide accessible services that will promote the quality of life for children with ASD and their caregivers in Kenya.
International Journal of Environmental Research and Public Health, 2019
Fetal alcohol spectrum disorder (FASD) has a high prevalence in South Africa, especially among th... more Fetal alcohol spectrum disorder (FASD) has a high prevalence in South Africa, especially among the poor socioeconomic communities. However, there is no specific policy to address FASD. Using a qualitative study design, we explored the perspectives of policymakers on guidelines/policies for FASD, current practices and interventions, and what practices and interventions could be included in a policy for FASD. The data analysis was done using the Framework Method. Applying a working analytical framework to the data, we found that there is no specific policy for FASD in South Africa, however, clauses of FASD policy exist in other policy documents. Preventive services for women and screening, identification, assessment, and support for children are some of the current practices. Nevertheless, a multi-sectoral collaboration and streamlined program for the prevention and management of FASD are aspects that should be included in the policy. While there are generic clauses in existing releva...
African Journal of Disability, 2019
Background: Autism spectrum disorder (ASD) is a global public health concern. In African countrie... more Background: Autism spectrum disorder (ASD) is a global public health concern. In African countries such as Kenya, there is a greater need for establishing support services for developmental disorders such as ASD. The emotional, social and economic burden of ASD on caregivers is unknown because of a number of challenges. Citizens of Kenya have a unique view of disability and inclusion.Objectives: To explore the perspectives of caregivers who are responsible for caring for both family and children living with ASD and to highlight the needs of children with ASD as well as the needs of their caregivers.Method: A qualitative, descriptive phenomenological study utilising focus group discussions (FGDs) was conducted. Verbatim transcription was used. QSR N ’Vivo 10 was used to organise and analyse the data. Content analysis was used to identify important ideas and concepts.Results: One theme, namely ‘the burden of caring for children with ASD’, was identified. Children with ASD and their ca...
The Open Journal of Occupational Therapy, 2018
The assessment of clinical competence of undergraduate students is a crucial part of higher educa... more The assessment of clinical competence of undergraduate students is a crucial part of higher education training in occupational therapy. The use of online objective standardized practical examinations (e-OSPEs) was piloted as a technological innovation to determine student learning needs. An action research framework with four phases was used. Descriptive statistics in the form of frequency tables and percentages were used to report survey results. The students had multiple practice opportunities before uploading their best attempt. Thirty participants completed a 12-item survey. The results were analyzed using descriptive analysis and presented by means of statistical graphs. Peer assessment facilitated experiential learning. Twenty-seven out of 30 students (90%) felt adequately prepared for submitting their video clips. The students found the opportunity to practice the skills multiple times before uploading the e-OSPEs helpful. The students experienced an increase in workload when the e-OSPEs were due during clinical placement and examination periods. Additional resources are needed for creating initial infrastructure for implementing e-OSPEs. The findings of this study could inform the planning of future online assessment practices of clinical competencies in occupational therapy. Identifying, formulating, and assessing competence standards electronically may guide occupational therapy practitioners' work with diverse patients and populations.
BMC Public Health, 2018
Background: Fetal alcohol spectrum disorder (FASD) is among the leading causes of developmental a... more Background: Fetal alcohol spectrum disorder (FASD) is among the leading causes of developmental and intellectual disabilities in individuals. Although efforts are being made toward the prevention and management of FASD in South Africa, the prevalence remains high. The sustained high prevalence could be attributed to several factors, including the lack of policy for a coordinated effort to prevent, diagnose and manage FASD nationally. In this study, our aim was to explore the perspectives of service providers (health and allied professionals, teachers, social workers) on the prevention and management of FASD towards developing a guideline to inform policy. Method: Guided by the exploratory qualitative research design, we purposively sampled relevant service providers in the field of FASD prevention and management for focus group discussions. Nine of these discussions were conducted with to eight participants per discussion session. The discussants were asked various questions on the current and required interventions and practices for the prevention and management of FASD. Following the Framework Method, data were transcribed verbatim and analysed using the thematic content analysis approach. Results: Our findings show that aspects of the prevention and management of alcohol-related conditions are present in various policies. However, there is no clear focus on coordinated, multi-sectoral efforts for a more comprehensive approach to the prevention and management of FASD. The participants recognized the need for specific requirements on broad-based preventive awareness programs, training and support for parents and caregivers, inclusive education in mainstream schools and training of relevant professionals. Conclusion: Comprehensive and coordinated prevention and management programs guided by a specific policy could improve the prevention and management of FASD. Policy formulation demonstrates commitment from the government, highlights the importance of the condition, and elaborates on context-specific prevention and management protocols.
African Journal of Disability, 2017
Background: Twenty-two years after the promulgation of a plethora of progressive health policies ... more Background: Twenty-two years after the promulgation of a plethora of progressive health policies since 1994, the South African public health system reflects a number of stumbling blocks regarding implementation. Rehabilitation professionals are not sufficiently equipped nor allowed the opportunity to comprehensively implement Primary Healthcare (PHC) from a bottom-up approach, thus engaging communities. Training on addressing social health determinants and their impact on ill-health and health outcomes is inadequate. The inadequate understanding of the advocacy role that rehabilitation professionals could play in addressing social health determinants remains a challenge in healthcare. Rehabilitation, a pillar of PHC, remains poorly understood in terms of its role within the health system.Aim: We argue for rehabilitation as a vehicle for addressing social determinants of health with community service practitioners playing a critical role in addressing the inequities within the health...
Occupational Therapy International, 2015
Occupational therapists believe that play is a child's main occupation and is considered essentia... more Occupational therapists believe that play is a child's main occupation and is considered essential for healthy motor, cognitive and emotional development. However, play spaces and activities in low socioeconomic areas are often different to those provided in structured occupational therapy treatment environments. The main objective was to determine play opportunities, activities, equipment, toys and the play environment for 5-to 6-year-olds living in a low-socioeconomic community outside a small town in South Africa, in order to understand the nature of play in this environment better. Participant observation together with an adapted photovoice method to capture the play experience was used. Data was analysed using inductive content analysis. Two global themes emerged from the results: "neighbourhood children find ways to play" and "context influences play". Children were given ample opportunity to play and participated in extensive outdoor play. Their games were highly social and involved the imaginative use of found items as toys. Play was also used to make sense of social hazards. An understanding of play in a low-income context has implications for the development of future play assessments and the provision of play therapy in these communities.
Scandinavian Journal of Occupational Therapy, 2022
Human Functioning, Technology and Health, 2021
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Books / book chapters by Lizahn Cloete
Papers by Lizahn Cloete