3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item Development of a hand function questionnaire to evaluate occupational performance in rheumatology clients(2011-06-09) Obermeyer, IzelPurpose of this study was to develop an appropriate and valid hand function assessment: the Steinmann-Obermeyer questionnaire (SOQ) for clients attending the Rheumatology Clinic at Kalafong Hospital. To achieve this • the construct validity of the SOQ had to be examined by assessing the face and content validity. • the criterion –related validity of the SOQ was assessed using convergent, concurrent and discriminative validity compared to pain, severity of deformity and disease severity. • the criterion –related validity of the SOQ was further assessed using the predictive validity by assessing normal subjects with the SOQ. Objective: The objective of this study was to test the following null hypotheses: 1.4.1 The SOQ is not a valid method of evaluating the functional ability of rheumatology clients treated at Kalafong hospital out patient clinic. 1.4.2 There is no correlation between the severity of the rheumatic disease and the score obtained by the SOQ. 1.4.3 There is no correlation between the disease activity and the score obtained by the SOQ. 1.4.4 There is no correlation between the client’s assessment of their level of pain and the score obtained by the SOQ. Method. The SOQ consisted of 48 questions, was translated into Sotho and Zulu and was administered and analysed on 96 arthritic clients between 18 and 69 years of age. An occupational therapy assistant (OTA), who spoke both the tribal languages fluently, completed the questionnaire with each client. An interviewer-administered format was used because many of the clients were illiterate. Results. After the analyses were completed, three questions were excluded and the final questionnaire consisted of 45 questions. This questionnaire was found to be a valid method of evaluating the functional ability of rheumatology clients treated at Kalafong hospital. Clients with severe functional limitations scored high on the questionnaire and those with minimal functional difficulty scored low on the questionnaire. The questionnaire scores correlated significantly with the pain levels experienced by the clients and their disease activity. The statistical analyses also showed that there is no correlation between the questionnaire score and the deformities of the clients. Inter-rater reliability was established. Conclusion. The 45-question occupational performance evaluation was developed, analysed and proven to be valid and sensitive for use with rheumatology clients with hand function difficulties at the Kalafong rheumatology clinic.Item The effect of a comprehensive occupational therapy intervention programme on the occupational performance of people with rheumatoid arthritis, living in Soweto(2008-04-08T12:30:54Z) Dreijer du Plessis, CarinABSTRACT: THE EFFECT OF A COMPREHENSIVE OCCUPATIONAL THERAPY INTERVENTION PROGRAMME ON THE OCCUPATIONAL PERFORMANCE OF PEOPLE WITH RHEUMATOID ARTHRITIS, LIVING IN SOWETO. C Dreijer du Plessis Post-graduate student, University of the Witwatersrand, Johannesburg, South Africa Introduction: Rheumatoid Arthritis (RA) is a chronic disabling joint disease. Empowering patients with RA to self manage the disease can lead to changes in behaviour, pain or physical health and psychosocial health status. Limited evidence exists for the efficacy of comprehensive Occupational Therapy (OT) intervention for patients with RA in improving functional ability. Objective: The primary objective of the study was to evaluate the impact of comprehensive OT intervention on patients with RA in producing a sustained improvement in patients' functional ability. Methods: A prospective randomized control study over 4 months in which patients with moderately disabling RA, following a week of in-patient rehabilitation care, received either home visits and focus group care (group 1) or standard care (group 2). Primary outcome measures included the modified Health Assessment Questionnaire Disability Index (HAQ-DI), Disease activity score (DAS28) and SF- 36 scores. Results: There were 29 and 22 patients in each group, respectively. The HAQ-DI improved significantly in both groups following the 1 week in-patient care (p<0.05) and there was a clinically significant difference between the groups at the 4 months follow-up visit. The SF-36 scores did not change significantly for group 1 while group 2 showed significant improvements in 5 of the 8 domains at four months. However, group 2, had significantly worse SF-36 scores at baseline compared to group 1. There was a significant improvement in disease activity with the experimental group having 25% fewer tender joints. During the focus groups,the two main themes of "behavior and self management" and "problems that interfere with occupational performance" emerged. Conclusion: A comprehensive in-patient occupational therapy programme does lead to sustained significant improvement in functional ability and Health related quality of life (HR-QOL). Focus groups and home based intervention appears to have a clinically significant impact on disease activity. Key words: Rheumatoid Arthritis, Comprehensive Occupational Therapy intervention, Home based intervention, Occupational Performance.