"Surthriving" Hand Rehabilitation: Proposing Interventions to Support Novice Occupational Therapists Working in Underserved Contexts.
Kirsty van Stormbroek, Tania van der Merwe, Lisa O'Brien and 1 others
PMID 38130935WHAT IT FOUND
Novice occupational therapists in underserved South African public services described being submerged by poverty, strained systems, inadequate hand care, and insurmountable caseloads.
They moved from no idea to some idea and said they needed immediate supervision, resources, and emotional support.
Key findings
01The therapists described a strained system in which they spent more time fighting the system than working with patients, alongside inadequate medical and surgical hand management.
02Their hand rehabilitation journey moved from initial uncertainty to gradually starting somewhere, despite delayed presentations and protocols that did not fit.
03The proposed supports were grouped into systems and services, learning opportunities, physical resources, and emotional support.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study included nine community service occupational therapists, so it cannot show how all novice OTs experience hand rehabilitation. It was conducted in South African public settings with specific poverty, violence, staffing, and referral problems, so transferability to other health systems is uncertain. The interventions were proposed from participants' experiences and checked with participants, not tested in patients or services. The first author had prior relationships with some participants and had been a community service occupational therapist, which may have shaped questions and interpretation. The paper gives only basic participant profiles, which the authors note may limit readers' ability to judge transferability.
The easy way to misread this
Do not read the proposed interventions as proven ways to improve hand rehabilitation. They were generated from a small qualitative study of therapist experiences, not tested with patients or services.