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Participation in everyday occupations in a late phase of recovery after brain injury.
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
2007 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 14, no 2, 116-125 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to describe to what extent individuals of working age, in a late phase after an acquired brain injury, participate in everyday occupations related to home maintenance, work, and leisure. The aim was also to evaluate if participation in different occupations influences their life satisfaction. A sample of 157 people consecutively admitted to a rehabilitation clinic between June 1995 and December 2000 answered a mailed questionnaire. The subjects who were of working age had had a brain injury on average 6 years before this study. The perceived participation was reported using the Reintegration to Normal Living Index (RNL) and life satisfaction according to an expanded version of the LiSat 11. This study showed that in this late phase of recovery after brain injury the subjects still experienced many restrictions in participation in everyday occupations. The area with the lowest reported participation was work activity while most comfort with the situation was reported for self-care. The RNL subscales showed a significant connection with satisfaction with life as a whole. Furthermore an interaction was found between the two subscales "Daily living" and "Perception of self". This study showed restrictions in participation in the community even several years after brain injury, which underlines the need for rehabilitation services long after injury.

Place, publisher, year, edition, pages
2007. Vol. 14, no 2, 116-125 p.
Keyword [en]
Activities of Daily Living, Adult, Aged, Brain Injuries/*rehabilitation, Cohort Studies, Data Collection, Female, Follow-Up Studies, Humans, Male, Middle Aged, Occupations, Patient Compliance, Patient Satisfaction, Recovery of Function, Self Concept
National Category
Medical and Health Sciences
URN: urn:nbn:se:umu:diva-10213DOI: 10.1080/11038120601095093PubMedID: 17538856OAI: diva2:149884
Available from: 2008-07-03 Created: 2008-07-03 Last updated: 2010-06-28Bibliographically approved
In thesis
1. Long-term outcome after brain injury with a focus on return to work, life satisfaction and participation
Open this publication in new window or tab >>Long-term outcome after brain injury with a focus on return to work, life satisfaction and participation
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Rehabilitation after brain injury is often a process which is spread over several years and runs through different phases. After sub acute in-patient rehabilitation a community based post-acute rehabilitation can follow. In this late phase after injury the rehabilitation focuses on reintegration into the community through a return to work and participation in other occupations in society. The overall aim of this dissertation was to study the long-term outcome of brain injury, with a special emphasis on the return to everyday domestic and productive occupations and the connection these have to life satisfaction as a whole. The aim was also to describe and understand the lived experience of the consequences of brain injury in these areas.

This dissertation comprises four studies on different aspects of the long-term outcome of those who have had a brain injury. In a sample of 56 people, the value of occupational therapy assessments as predictors of an eventual return to work was investigated. In a longitudinal follow-up study, the life satisfaction of the participants (n 36) was reported and its correlation to a return to work was evaluated. Interviews were conducted (n 10) to explore the main characteristics of the meaning of work after brain injury in ten respondents. And, finally, in the fourth study, 157 people reported their participation in community activities. The extent of the correspondence between the level of participation and life satisfaction was calculated.

The findings showed that occupational therapy assessments were useful in predicting a return to work in the late phase of the recovery after brain injury. A combination of assessments on the level of body function with assessments on activity level appeared to comprise the best predictive model. In two different studies the reported life satisfaction was found to be significantly lower than the level of life satisfaction in a sample of healthy Swedes for almost all domains. When comparing life satisfaction at two points in time with an interval of three years between them in the longitudinal study, no significant improvement was found. There was no difference reported by the participants for their overall life satisfaction regardless of whether they were back at work or in education, or not. On the other hand, participation in daily occupations in a wider perspective was found to have a positive impact on satisfaction with life as a whole. However, half or more than half of the participants claimed that their participation was restricted except for the items self-care and mobility, where a higher degree of participation was reported. The meaning of work after the brain injury had changed: Work had taken on a new place in life and the importance of work had decreased. In contrast, the social dimension of work had expanded in importance. After the brain injury, the perception of the participants’ own competence and work identity had changed and the respondents described their striving to return to normality.

To conclude, brain injury has a lasting effect on a person’s life, even many years after the injury; consequently there is need for rehabilitation in this late phase. Life satisfaction, which is often used as an overriding goal for rehabilitation, did not improve over time. This finding raises the question of whether life satisfaction is too broad a concept and/or insufficiently sensitive to improvements. There is need for further research in this area to clarify the factors that have an impact on life satisfaction.

Place, publisher, year, edition, pages
Arbetsterapi, Umeå Universitet, 2004. 70 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 920
activities of daily living, brain injury, community integration, lived experience, life satisfaction, longitudinal, occupational therapy, participation, phenomenology, prediction, return to work, rehabilitation
National Category
Medical and Health Sciences
Research subject
Occupational and Environmental Medicine
urn:nbn:se:umu:diva-375 (URN)91-7305-739-8 (ISBN)
Public defence
2004-12-10, Aulan, Vårdvetarhuset, Umeå, 09:00
Available from: 2004-11-22 Created: 2004-11-22 Last updated: 2010-06-28Bibliographically approved

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