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Incorporating or resisting assistive devices: Different approaches in achieving a desired occupational self-image
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
2003 (English)In: OTJR (Thorofare, N.J.), ISSN 1539-4492, Vol. 23, no 2, 67-75 p.Article in journal (Refereed) Published
Abstract [en]

The purpose of this study was to enhance the understanding of how people with disabilities experience the meaning of their assistive devices in their occupations and how they act on their experiences. Seventeen participants were interviewed and data were analyzed using a qualitative approach. The participants’ experiences showed that they reacted differently to the manifold and often contradictory meaning of assistive devices. The analysts organized the participants’ reactions into three categories: pragmatic users, ambivalent users, and reluctant users. The differences between the participants were understood as representing different adaptive approaches to achieve desired occupational self-images. Thus, the assistive devices were not in themselves important, but were merely a means to achieve a desired self-image. The findings reflect that the participants’ experiences of using assistive devices reveal meanings about their use that go beyond the traditional medical perspective that focuses on the role of assistive devices as compensation for physical impairment.

Place, publisher, year, edition, pages
2003. Vol. 23, no 2, 67-75 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:umu:diva-4107OAI: oai:DiVA.org:umu-4107DiVA: diva2:143076
Available from: 2004-09-17 Created: 2004-09-17 Last updated: 2010-08-03Bibliographically approved
In thesis
1. Living with physical disability: experiences of the rehabilitation process, occupations and participation in everyday life
Open this publication in new window or tab >>Living with physical disability: experiences of the rehabilitation process, occupations and participation in everyday life
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

A comprehensive understanding is lacking of the experiences persons with acquired physical disabilities have of changes in their engagement in occupations and of the conditions influencing these experiences Furthermore, little is known about the experiences these people have of the rehabilitation process and whether the rehabilitation services satisfy their needs. Access to such knowledge would significantly add to the ability to design rehabilitation services intended to enhance participation in everyday life. The overall aim of this thesis was, therefore, to illuminate and enhance the understanding of how persons with acquired physical disabilities experienced their rehabilitation process and their possibilities to engage in occupations in everyday life.

The thesis is comprised of five studies. The planning of the clients’ rehabilitation at hospital was explored through interviews with the clients (n=57) and the professionals (n=50). Interviews exploring how persons with physical disabilities experienced their rehabilitation process (n=15), their occupational lives in their homes (n=13) and the use of assistive devices (n =17) were analysed qualitatively. Data was also collected from persons with spinal cord injury (n =161) by the Impact on Participation and Autonomy questionnaire.

The findings showed that the professionals used different strategies to encourage the clients to participate in the planning of the rehabilitation and that the strategies were based on traditions rather than on the individual clients’ desires to participate. The informants’ experiences reflected three parallel chains of rehabilitation over a period of time, a medical, a psychological and a social one. The influence of the different rehabilitation chains on how the clients’ lives turned out varied over time, and the professionals were predominantly involved in the medical rehabilitation chain. The informants’ experiences showed that their engagement in occupations in the home differed profoundly. Access to social support, which was provided under different conditions, was of decisive importance for their occupational engagement. The findings also showed that changes in the informants’ occupations in the home setting transformed the meaning of the home in general. The meaning of using assistive devices was experienced as manifold and double-edged. The incorporation of or resistance to assistive devices was understood as different approaches to adaptation with the same intention: to achieve desired occupational self-images. The majority of the informants perceived their participation in the life situation as sufficient but more than half reported one or more severe problems with participation. Access to social support in everyday occupations had a greater impact on predicting severe problems with participation than certain traditional health related factors or aspects related to the individual.

To conclude, the findings indicate that the rehabilitation services need to be better able to adapt to clients’ desires to participate in the planning of their rehabilitation, and designed to satisfy the various needs the clients experience throughout the rehabilitation process. It was revealed that the societal and social environment, as manifested through social interactions, are of central importance in understanding the consequences of and possibilities to engage in occupations supporting participation in everyday life.

Publisher
70 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 901
Keyword
disabled persons, activities of daily living, occupations, social environment, social support, disability evaluation, rehabilitation, occupational therapy, patient participation, patient-centred care
Research subject
Occupational and Environmental Medicine
Identifiers
urn:nbn:se:umu:diva-317 (URN)91-7305-684-7 (ISBN)
Public defence
2004-10-08, Aulan, Vårdvetarhuset, 10:00
Opponent
Available from: 2004-09-17 Created: 2004-09-17 Last updated: 2010-08-03Bibliographically approved

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