Suitability of ‘Guidelines for screening of prosthetic candidates: lower limb’ for Eastern Cape

Thesis (MHumanRehabSt)--Stellenbosch University, 2017.ENGLISH SUMMARY : Background: Major lower limb amputation has a severe impact on functional mobility. While mobility can be salvaged with a prosthesis, it is not always the most optimal choice. It is often difficult to decide whether to refer someone for a prosthesis. An evidence-based prosthetic screening tool ‘Guidelines for Screening of Prosthetic Candidates: Lower Limb’ is used for prosthetic prescription in the Western Cape Province of South Africa. Objectives: The study aimed to explore the suitability of the tool ‘Guidelines for Screening of Prosthetic Candidates: Lower Limb’ for use in the Eastern Cape Province of South Africa. Method: A qualitative study was conducted with conveniently sampled occupational therapists (n=10), physiotherapists (n=12) and medical orthotists/prosthetists (n=6) in government employment in the Buffalo City Metro Municipality. Participants were trained to use the tool and then used it for four weeks. Their experiences of the tool were assessed through three focus group discussions. Emergent themes were identified during analysis. Findings: Participants indicated that the tool could assist with prosthetic prescription, goal setting, communication and teamwork. They thought the tool was multidisciplinary in nature, comprehensive and practical. Findings showed challenges with regard to teamwork in the study setting. Resistance to change and a lack of time might hamper implementation of the tool. Participants suggested a longer test period, with structured feedback sessions, and supported by hospital management. Conclusion: The tool can assist with managing the backlog for prostheses and to guiding prosthetic prescription in the Eastern Cape Province.AFRIKAANSE OPSOMMING : Agtergrond: ‘n Amputasie van die onderste ledemaat beinvloed ‘n persoon se funksionele mobiliteit drasties. Alhoewel ‘n prostese mobiliteit kan verbeter is dit nie altyd die mees optimale keuse nie. Dit is meermale meoilik om te besluit of iemand verwys moet word vir ‘n prostese. ‘n Navorsings gebaseerde evalueringsvorm ‘Guidelines for Screening of Prosthetic Candidates: Lower Limb’ word gebruik vir die voorskryf van prosteses in die Wes Kaap Provinsie van Suid Afrika. Doel: Die doel van die studie was om vas te stel of die evaluering ‘Guidelines for Screening of Prosthetic Candidates: Lower Limb’ geskik is vir gebruik in die Oos Kaap Provinsie van Suid Afrika. Metode: ‘n Gerieflikheids steekproef van arbeidsterapeute (n=10), fisioterapeute (n=12) en mediese ortotiste/prostetiste (n=6), wat in die Buffalo City Metro Munisipale area vir die regering werk, het aan die kwalitatiewe studie deelgeneem. Die deelnemers het opleiding ontvang in die gebruik van die vorm, waarna hulle dit vir vier weke met pasiente gebruik het. Hulle opinies oor die vorm is gekry tydens drie fokusgroep besprekings. Ontluikende temas is geidentifiseer tydens data analise. Bevindinge: Deelnemers het gevoel die vorm kan help met voorskryf van prosteses, beplanning van behandeling, kommunikasie en spanwerk. Die vorm is multidissipliner, omvattend en prakties. Hindernisse ten opsigte van spanwerk is uitgewys. Weerstand teen verandering en tydsdruk mag gebruik van die vorm strem. ‘n Langer toets periode met gestruktureerde terugvoer sessies, in samewerking met hospital bestuur, is voorgestel. Gevolgtrekking: Die evalueringsvorm kan help met die hantering van die waglys, en leiding gee met die voorskryf van prostesis in die Oos Kaap Provisie