Healthcare Transition Practices of Occupational Therapists in South African Public Healthcare Facilities

Abstract

Introduction Healthcare transition (HCT) is the process of transitioning an adolescent from family-centred paediatric models of care, to adult models of care that involve greater autonomy of the adolescent. This process is vital for improving the long-term health of adolescents with chronic conditions. The role of occupational therapy in HCT has not been well researched. This is necessary to ensure that adolescents have coordinated, optimal and uninterrupted access to appropriate occupational therapy services throughout this period of development. This research study aims to describe the healthcare transition practices used by occupational therapists in South African public healthcare facilities when transitioning service-users from paediatric to adult-oriented services. Methods The study utilised a quantitative, non-experimental, descriptive cross-sectional design. Simple convenience and snowballing sampling were used to recruit participants via professional databases and social media forums. An online survey was used to collect and store data within an access-controlled and encrypted REDCap account. Descriptive statistics and simple content analysis was used to analyse the information. Results Sixty-five responses for this study were received between January and June 2023 (response rate: 5.3%). The study reveals limitations in the understanding and practical application of HCT concepts. Implementation of HCT appears to be characterised by the use of no (29%) or minimal (42%) policy on HCT, with 66% of participants using age as the primary factor in determining transition readiness. Over 60% of participants indicated that adolescents and caregivers are not involved in HCT process and that HCT outcomes are not formally measured. Participants highlighted the need for improved training and policy development to support HCT implementation within South African occupational therapy practice. Conclusion There is a need for the development of training programmes and practice guidelines to optimise and standardise the HCT practice of occupational therapists in South African public healthcare facilities. These should be developed in collaboration with service-users and caregivers, and should include tools to identify transition readiness, guide the process of transition and evaluate outcomes of transition.