Understanding the compliance of patients with hand injuries in South Africa: a quantitative study of occupational therapists’ views

Abstract

Background: Patient compliance has been reported to have a substantial impact on hand rehabilitation outcomes in South Africa. In a low to middle-income country (LMIC), where a hand injury may cost a patient their livelihood, it is essential to develop local evidence to support patient compliance. This study aimed to describe how South African occupational therapists understand the compliance of hand-injured patients and their perceptions of the factors affecting, and strategies, used to facilitate patient compliance. Method: A descriptive quantitative cross-sectional survey was employed. The online survey questionnaire was based on a review of the literature and its content validity was strengthened through expert review and refinement. Descriptive statistics and quantitative content analysis were employed. Results: A response rate of 52.7% (n=99) was achieved. Participants who work in the private (48.5%) and public (46.5%) health sectors were represented. Most of the participants (61.2%) believed ‘compliance’ to be the most appropriate term. Socioeconomic and healthcare system/team-related factors were more frequently perceived to influence compliance than condition, therapy, and patient-related factors. However, the latter factors were more frequently targeted for intervention by therapists and their respective departments/practices. Conclusion: Participants continue to prefer the use of the term ‘compliance’ despite literature dissuading this. Several socio-economic and healthcare system/teamrelated factors were identified, and therapy-related strategies were recommended. It is recommended that a collaborative workshop with South African occupational therapists be used to discuss results and collectively formulate realistic avenues for action.