A Study to Explore the Occupational Adaptation of Adults with MDR- TB Who Undergo Long-Term Hospitalisation

Abstract

The management of multi drug resistant tuberculosis (MDR TB) is a lengthy process that involves medical treatment for a period of at least 18-24 months that includes compulsory hospitalisation for a period of at least six months. MDR TB is, however, associated with poor treatment outcomes in South Africa. Although Occupational therapy's philosophy focusses on the use of occupation to promote health and well-being, the occupational engagement and adaptation of patients hospitalised for MDR TB have never been explored. This article reports on a qualitative study that was aimed at exploring the occupational adaptation of adults with MDR TB while undergoing long term hospitalisation at a hospital in the Western Cape. An exploratory and descriptive research design employing an interpretive research approach was utilised in the study.  Data collection methods included participant diaries, semi-structured interviews, participant observation and a focus group discussion. All data were analysed through thematic analysis.  The findings highlighted several occupational adaptation strategies adopted by the participants while hospitalised. Certain environmental demands were, however, perceived as infringing upon their occupational choices and influencing their occupational identity and competence. It was recommended that the hospital adopt an occupational therapy programme that focusses on occupational enrichment to facilitate occupational adaptation.

Key Words:  MDR TB, long-term hospitalisation, Occupation, Occupational Adaptation, Occupational enrichment.