Perceptions on transitioning from impairment-based to occupation-based practice in public healthcare within KwaZulu-Natal

Abstract

Introduction: Holistic healthcare service delivery requires rehabilitation personnel to consider all the components of health that  influence the client's quality of life. However, there is limited literature on approaches to implementing rehabilitation services within  South African public healthcare. This study explored rehabilitation personnel's (such as occupational therapists, speech therapists,  physiotherapists) use of occupation-based practice impairment-based practice and the barriers and facilitators associated with their  practice choice.

Methods: A qualitative research design was conducted through semi- structured interviews (13 participants), a focus  group (4 participants) and community mapping. Purposive sampling was utilised to select participants in the iLembe district, KwaZulu- Natal, South Africa. Data were analysed using deductive thematic analysis.

Findings: Three themes emerged from the study; Attitudes  towards impairment-based practice, Reflections on OBP, and The way forward. The need to focus on all the components of health rather  than just the disease and the benefits of using the occupation-based practice approach were highlighted. Additionally, different factors  required to implement holistic rehabilitation services and the barriers to OBP were identified.

Conclusion: Although the study identified  OBP benefits, various barriers associated with its implementation were identified. Rehabilitation personnel, community stakeholders, and  clients must work together to improve OBP implementation in public healthcare by combating the barriers identified in the study.