Outcomes for children and adolescents with Juvenile idiopathic arthritis addressed by occupational therapy services in specialist rheumatology clinics in South Africa

Introduction: International guidelines for best practice indicate specialised treatment is required for Juvenile idiopathic arthritis (JIA). While occupational therapy intervention for functional limitations in this chronic condition is conditionally recommended, the extent to which this is provided...

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Bibliographic Details
Published in:The British journal of occupational therapy 2023-07, Vol.86 (7), p.493-503
Main Authors: Moodley, Darrel, Jacobs, Lizelle, Franzsen, Denise, de Witt, Patricia
Format: Article
Language:English
Subjects:
Adolescents
Arthritis
Best practice
Biomedical models
Chronic illnesses
Clients
Clinics
Functional impairment
Functional status
Health status
Hospitals
Idiopathic
Intervention
Occupational therapists
Occupational therapy
Pediatrics
Psychosocial factors
Quality of life
Rheumatology
Specialized services
Teenagers
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Summary:Introduction: International guidelines for best practice indicate specialised treatment is required for Juvenile idiopathic arthritis (JIA). While occupational therapy intervention for functional limitations in this chronic condition is conditionally recommended, the extent to which this is provided in public specialist rheumatology clinics in South Africa is unknown. The aim of this study was to determine which needs related to outcomes for occupational performance or functional status, condition-related factors and health-related quality of life, reported by children and adolescents with JIA were addressed by current occupational therapy services. Methods: The study used two descriptive, quantitative studies with limited samples of 37 clients with JIA attending specialist rheumatology clinics and nine occupational therapists who currently provide intervention for clients with JIA. Results: Functional deficits reported by 30–63% of clients with JIA were increased symptoms of active disease and difficulties with school activities. Occupational therapy services addressed condition-related factors and participation in personal management but not many related to the social, educational and psychosocial needs of clients with JIA. Conclusion: Occupational therapy services followed international guidelines but based on the reductionist biomedical model approach used within specialist services in tertiary hospitals, which limit context-based therapy for children and adolescents with JIA in the community.
ISSN:0308-0226
1477-6006
DOI:10.1177/03080226231156526