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Interpretive Description of Recreational Therapy Within Selected Health Care Professions in South Africa

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Interpretive Description of Recreational Therapy Within Selected Health Care Professions in South Africa Interpretive description of recreational therapy within selected health care professions in South Africa C Kriel orcid.org / 0000-0003-3173-8553 Thesis submitted for the degree Doctor Philosophiae in Recreation Sciences at North-West University Promoter: Dr JT Weilbach Co-promoter: Prof LL Caldwell Graduation: October 2019 Student number: 20700938 Acknowledgements The completion of this study would not have been possible without my support system and some special people in my life. I wish to express my sincere appreciation to the following people: • To my promoter, colleague and friend, Dr. Theron Weilbach, words cannot express my appreciation towards you. I have learned so much from you during this process and I would not have been able to complete this study without your input. Thank you so much for the guidance, support and encouragement throughout this process. • To my co-promoter, Prof. Linda Caldwell, what a privilege to have worked with you. Thank you for being part of this study, for all your time and input. I’m looking forward to working with you in the near future. • Cornelia Schreck, thank you for taking the time to assist with my co-coding, it is much appreciated. • Francois Watson, thank you for the assistance with the development of the interview schedule and research advice. • The participants who took time off to take part in the interviews. • Valerie, I asked you to assist with the audio transcriptions and you said yes without knowing what you were getting yourself into. Thank you so much for taking the time to assist me. • My language editor, Helen, thank you for the time you put into this study. • Natasha, thank you for being just a phone call away and for assisting with the technical editing of my study. • Anneke Barnard, for assisting with the references. • The late Prof. Charlé Meyer and Anél van Rooy, you are not with us anymore, but I would like to thank you for the role you played in my life and for exposing me to the world of recreational therapy. I missed you so much throughout this process. • My parents, André and Merie, this would not have been possible if you had not taught me to dream big. Thanks for the support and endless opportunities in my life. • My children, my dearest boy, Riaan and my unborn baby. Even though you made no direct contribution to the completion of this study, you motivated me by my being a parent, highlighting the importance of setting a good example. Believe in yourself, always do your best and finish what you have started. • To my dearest husband, Pieter, no words can express my gratitude for your love and support. Thank you for your words of encouragement, for always listening and trying to help. II • Our heavenly Father for giving me the ability to complete the study and for being present throughout this process. I wish I could write the name of every friend (this includes my colleagues) and family member who meant something to me during the production of this study. Thank you for blessing me with your love, support, friendship and encouragement. Cindy Kriel The author February 2019 III Abstract Clients participating in recreational therapy/therapeutic recreation (RT/TR)-related programmes stand to gain physical, emotional/psychological and social benefits. However, RT/TR as a profession in South Africa (SA) ended when “Remedial gymnastics and recreational therapy” was removed from the register of the SA Medical and Dental Council (now Health Professions Council of SA) in June 1978, resulting in a loss of recognition of the practice of RT/TR. There are currently three professions registered with the HPCSA – biokinetics, physiotherapy and occupational therapy – with definitions in their scopes of practice with similarities to the international definition of RT/TR. Despite the potential of leisure to have a positive influence on the SA population, whether the health professions in SA, in the absence of formal RT/TR, have used opportunities to provide RT/TR-based services, was unclear. Therefore, a research question was posed: “How can RT/TR-related training and services and be interpreted and described within selected healthcare professions in SA?” A qualitative research approach was used, with a qualitative interpretive descriptive design, using inductive and deductive content analysis, as well as thematic analysis of semi-structured telephonic interviews. The document: Certification Standards: Information for New Applicants 2018, published by the United States’ National Council for Therapeutic Recreation Certification, was subjected to inductive content analysis to develop a control sheet of concepts, which was then used to complete a deductive analysis. The yearbooks of seven SA universities, each presenting qualifications in all three professions of biokinetics, physiotherapy and occupational therapy, were analysed deductively. Thirty semi-structured telephonic interviews were conducted with biokineticists, physiotherapists and occupational therapists from across SA and data analysis resulted in the identification of three categories: 1) professional activities, 2) professional approach and 3) professional bodies, each with its own set of themes and sub-themes and one distinct standalone theme, RT/TR in SA. The study concluded that biokineticists, physiotherapists and occupational therapists are not trained or educated to provide RT/TR-related programmes and that similarities in their training to that of RT/TR is mostly in terms of the foundational knowledge required to work within the healthcare sector. Occupational therapists receive more RT/TR-related training than biokineticists and physiotherapists, and they also provide programmes with the most similarity to those of RT/TR. Although biokineticists, physiotherapists and occupational therapists provide functional interventions, their programmes are not RT/TR-orientated. Therefore, a clear gap exists that could be filled by RT/TR in SA, especially in terms of leisure education and recreation participation. IV The study not only contributes to the body of knowledge of RT/TR in SA, but provides information on gaps in the services of the currently available healthcare professions. Recommendations include short- and long-term operationalisation guidelines which can contribute to the development of RT/TR in the future. The study concludes with a proposed continuum that indicates which services are currently provided and where RT/TR can fit in within the current healthcare sector. [Keywords: Biokinetics, occupational therapy, physiotherapy, profession, therapeutic recreation, therapeutic recreation specialist] V Opsomming Kliënte wat aan rekreasieterapie/terapeutiese rekreasie (RT/TR)-verwante programme deelneem kan fisiese, emosionele/psigologiese en sosiale voordele verkry. RT/TR as professie in Suid- Afrika (SA) het egter geëindig toe "Remediërende gimnastiek en rekreasieterapie" in Junie 1978 uit die register van die SA Geneeskundige en Tandheelkundige Raad (nou die Raad vir Gesondheidsberoepe van SA) verwyder is en het gevolglik tot die verlies aan erkenning van die praktyk van RT/TR gelei. Daar is tans drie beroepe by die HPCSA geregistreer – biokinetika, fisioterapie en arbeidsterapie – met definisies wat ooreenkomste met die internasionale definisie van RT/TR toon. Ten spyte van die potensiaal van vryetydsbesteding om 'n positiewe invloed op die SA-bevolking te hê, was dit onduidelik of die gesondheidsberoepe in SA die geleentheid gebruik het om RT/TR-gebaseerde dienste te lewer, in die afwesigheid van formele RT/TR. Daarom is die navorsingsvraag gestel: "Hoe kan RT/TR-verwante dienste en opleiding binne geselekteerde gesondheidsberoepe in SA geïnterpreteer en beskryf word?" 'n Kwalitatiewe navorsingsbenadering, met ʼn beskrywende kwalitatiewe interpreterende ontwerp is gebruik. Die ontwerp het bestaande uit induktiewe en deduktiewe inhoudsanalise, sowel as die tematiese analise van semi-gestruktureerde telefoniese onderhoud. Die dokument: “Certification Standards: Information for New Applicants 2018”, gepubliseer deur die Verenigde State se “National Council for Therapeutic Recreation Certification”, is aan induktiewe inhoudsanalise onderwerp om 'n kontrolelys van konsepte te ontwikkel, wat gebruik is om 'n deduktiewe analise te voltooi. Die jaarboeke van sewe SA universiteite, wat kwalifikasies in al drie professies, naamlik biokinetika, fisioterapie en arbeidsterapie aanbied, is deduktief ontleed. Dertig semi- gestruktureerde telefoniese onderhoude is met biokinetici, fisioterapeute en arbeidsterapeute van regoor Suid-Afrika gevoer en data-ontleding het gelei tot die identifisering van drie kategorieë: 1) professionele aktiwiteite, 2) professionele benadering en 3) professionele liggame, elk met sy eie temas en subtemas, en een duidelike, alleenstaande tema, RT/TR in SA. Die studie het bevind dat biokinetici, fisioterapeute en arbeidsterapeute nie opgelei en onderrig word om RT/TR-verwante programme te voorsien nie en dat ooreenkomste in hul opleiding ten opsigte van RT/TR meestal in terme van die grondslagkennis is wat benodig word om binne die gesondheidsorgsektor te werk. Arbeidsterapeute ontvang meer RT/TR-verwante opleiding as biokinetici en fisioterapeute en bied ook programme wat ooreenstem met dié van RT/TR. Alhoewel biokinetici, fisioterapeute en arbeidsterapeute funksionele intervensies aanbied, is hulle programme nie RT/TR-georiënteerd nie. Daarom bestaan daar 'n duidelike gaping wat deur RT/TR in SA gevul kan word, veral ten opsigte van vryetydsopvoeding en rekreasie-deelname. VI Hierdie studie
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