Occupational therapists' perspectives on the impact of COVID-19 lockdowns on their clients in Gauteng, South Africa - a qualitative retrospective study

INTRODUCTION: In March 2020, the South African government responded to the threat of the COVID-19 pandemic by issuing a national lockdown, calling a halt to all non-essential services and movements, including most occupational therapy services. Occupational therapy clients had no access to treatment during this time and may have experienced occupational injustices. AIM: We explore occupational therapists' perceptions of the influence of COVID-19 lockdowns on rehabilitation clients in Gauteng, South Africa. METHODOLOGY: We analysed secondary data collected in July 2020. The original qualitative study assessed occupational therapists' perceptions of the influence of COVID-19 on their service delivery. Sixteen occupational therapists participated in asynchronous on-online focus group discussions. The therapists worked in public and private settings in Gauteng. This study focussed on the influence of COVID-19 lockdowns on clients as perceived by occupational therapists. All data relating to the influence of COVID-19 lockdowns on clients were extracted from the original dataset using ATLAS. ti and then thematically analysed using deductive reasoning. RESULTS: Five themes emerged from the data. Occupational therapists felt that clients had altered clinical presentation due to infection prevention and control measures (Theme 1). Therapists also felt that the quality of services was negatively impacted, which was detrimental for clients (Theme 2); that their clients experienced occupational injustice due to disrupted services (Theme 3) that vulnerable populations experienced the greatest challenges (Theme 4) and that clients' experienced positive impacts or benefits during the COVID-19 lockdown (Theme 5). CONCLUSIONS: In future pandemics, decision-makers need to carefully consider the impact of disrupted service delivery for occupational therapy clients, especially vulnerable populations. A syndemic approach is recommended for occupational therapy service delivery during a pandemic. Tailor-made recommendations that are needed for vulnerable populations in South Africa are proposed.