Gunilla Isaksson

Women's perception of changes in the social network after a spinal cord injury

Purpose. To describe how women with a spinal cord injury (SCI) perceived changes in the social network, and how these changes affected their ability to participate in occupation. Method. Thirteen women, aged 25 to 61 years, with a SCI were interviewed twice. The interviews focused on their ability to participate in occupation, their relations with individuals within the social network, and changes in the social network following the SCI. The analysis was carried out using qualitative content analysis. Results. The women described an emotional need for social support after the SCI to participate in occupation. This was a new experience that required time to adapt to. The women also described a need for practical social support from the social network members to manage meaningful occupation. After the SCI, the women had developed new habits through close cooperation with members in the social network. The women felt that they had become more responsible for the development of their relations. Many relations had improved after the SCI, while some had decreased. The women had also developed new relations with other persons with disabilities. Conclusions. The women perceived substantial changes in the social network following the SCI, which in several ways affected their ability to participate in occupation. To adapt to their new life situation, the women gradually developed different strategies. The results point out the need to identify persons in the social network that women with SCI develop relations with, and integrate them in the rehabilitation process.

To regain participation in occupations through human encounters - narratives from women with spinal cord injury

Purpose. To gain an understanding of how women with spinal cord injury (SCI) experienced human encounters in occupations and how these influenced their participation. Method. The data were collected through two or three in-depth interviews with 13 women (age 25 – 61 years) with SCI. Data analysis was carried out by using a paradigmatic analysis of narrative data, followed by an interpretation based on a narrative theory. Results. The results showed a complexity where the womens experiences and acting in human encounters changed over time. In these human encounters the women struggled with conflicts, supported other persons that were insecure and revaluated their apprehension about persons in their social network. These multidimensional human encounters thereby enabled them to regain participation in occupations. Conclusions. This shows that human encounters are important for persons with disabilities so they can restructure their occupational identity and their needs for participation in occupations. The study also showed that the use of narratives as a tool within rehabilitation could lead to an increased understanding of the subjective changes that occur over time for a person with a disability.

Social support provides motivation and ability to participate in occupation

In this study, a qualitative perspective of how 13 women (aged 25 to 61 years) with spinal cord injury perceive the importance of social support for their participation in occupation is presented. The data were collected through repeated in-depth interviews and field notes, and the analysis used a grounded theory approach. The women needed both emotional and practical support, which was important in a time perspective and motivated them to participate in occupation. The women needed to receive support soon after the injury, but after a period of time they needed to give and receive support in a reciprocal fashion. Social support is therefore an effective rehabilitation strategy that can motivate people with disabilities to participate in meaningful occupation. The importance of social support for a persons motivation and ability to participate in occupation expands our knowledge of the relationship between individuals, their social environment, and occupation.

A Narrative of Agency Enacted within the Everyday Occupations of an Older Swedish Woman

This article explores how agency is enacted in everyday occupations with others and evolves over time. Agency is a complex concept that is closely linked to human occupation. By using a transactional perspective and a narrative approach, our ambition was to explore agency beyond individual acts or responsibilities. To achieve this, we used a story of an older woman in the context of being widowed and living with late-life depression. Data were generated over time using interviews and by taking part in the participants everyday occupations. Narrative analysis was used to create a contextualized in-depth story. The findings show how resources embedded in enacted stories can challenge ones view of oneself as a victim and create possibilities to be an agent, thereby illustrating how agency becomes enacted in the context of acting together in everyday occupations. In light of these findings, we reflect on how a transactional perspective can contribute to exploring the concept of agency as contextually situated and embedded in occupations. Further, we reflect on how the transactional dimensions of everyday occupations can be explored through a narrative approach.

How adults with ADHD get engaged in and perform everyday activities

Abstract Objective: An increasing number of adults with ADHD face problems with everyday activities, and occupational therapists play an important role regarding interventions for this particular group. However, there is a knowledge gap within occupational therapy regarding how adults with ADHD experience engagement in everyday activities. The aim of this study was to understand the experiences of engagement in, and describe how adults with ADHD performed everyday activities. Methods: Twelve people with ADHD between the ages of 21 and 38 were interviewed using a semi-structured interview guide. Data were analysed based on a qualitative content analysis. Results: The results showed how engagement in and performance of everyday activities depended on inspiration, facilitating support, and feelings of togetherness with other people. Conclusions: These results show how adults with ADHD can find strategies to become more independent in their performance of everyday activities. Furthermore, this study suggests how occupational therapists can increase opportunities for adults with ADHD to engage in different activities, make choices, and find meaning in everyday activities.

Experiences of participation in occupations of women on long-term sick leave

Abstract The majority of individuals on long-term sick leave experience negative effects in their lives associated with limitations on their participation, decreased income, and feelings of guilt. The aim was to describe the experiences that women on long-term sick leave have of participation in occupation. Unstructured interviews were used for the data collection, which involved eight women; a grounded theory approach was used. The results showed that the womens long-term sick leave changed their roles, daily habits, and routines, and their participation in occupations was negatively influenced. Their occupational performance also diminished, thereby having a negative influence on their social relationships. However, over time they came to find different strategies that contributed to a feeling of occupational competence and thence they started to rebuild their occupational identity. Through this began the process of occupational adaptation, which resulted in an increased experience of participating in occupation. As a conclusion, it should be noted that occupational therapy interventions should be directed at women on long-term sick leave at an early stage in the rehabilitation process to address the adaptation of their roles, habits, routines, and social environment.

One woman's story about her everyday life after a spinal cord injury

Purpose. The aim was to describe and offer an explanation for how one woman viewed her everyday life after a spinal cord injury (SCI). Method. Data were collected by conducting three interviews with one woman with a SCI. Open-ended questions were used with the intention of capturing the womans own story. The narrative approach inspired by Polkinghorne was used to describe the womans experiences of her everyday life after the SCI. Results. The analysis revealed that, events influenced her everyday life after a SCI and these events influenced her identity, habits and participation in activities. Further, how she has gone from a state of hopelessness in the early days to a reconstructed identity, associated with a new insight during the 2 years after the accident through a complex and dynamic process of change. In our interpretation we have attempted to provide an explanation of why this outcome came about. Conclusions. When using narratives, professionals within health-care could focus on the individual instead of the diagnosis or disability. Further, according to a client-centred perspective it is important to attain the clients experiences and knowledge to gain a more complete picture in order to obtain a profound understanding of the client.

Men's experiences of giving and taking social support after their wife's spinal cord injury

The aim of this study was to gain an understanding of how men living with women with spinal cord injury (SCI) experienced and acted when they were giving and taking social support to and from their wives and other persons in their social network. Another aim was to give some possible explanations of the complex process of change that they went through. Data were collected through in-depth interviews with four men and field notes. To describe the mens subjective experiences and the process of change, a narrative approach inspired by Polkinghorne was used. The analyses resulted in one story that included the four mens experiences and action. The story showed that when the men went through a process of change, they used and needed both emotional and practical support to handle their new life situation. Furthermore, the mens experiences and action against social support changed over time. This indicated that, through narratives from spouses, professionals within rehabilitation could understand the process of change they went through after their partners sudden injury, and support them to find strategies to handle their changed life situation. To give some possible explanations for the mens experiences and action during the process of change, the findings are discussed in relation to theories concerning adaptation and coping.

Being part of an unfolding story: togetherness in everyday occupations when ageing

Abstract Aim: The aim of this study was to explore and enhance the understanding of how togetherness in everyday occupations is experienced and discussed among older adults. Method: Focus-group discussions generated the data and a total of 12 participants, including six women and six men, divided into three groups, participated in this study. Analysis was performed using a grounded theory approach. Results: The findings reflect how togetherness in everyday occupations can be comprehended as multifold transactional processes, emphasizing how an acted belonging was a situated experience connecting people and places through unfolding stories. The findings suggest that the process of meaning-making in ongoing life was closely associated with togetherness and was negotiated with others through shared culture and experiences. Togetherness meant being part of something in which the persons involved were contributing to each other in various ways. However, being part of togetherness was complicated, especially when the person’s life situation was challenged in some way. Conclusions: It was apparent from the analysis that togetherness could not be taken for granted. Rather, the findings reflect how togetherness was created and maintained through an ongoing process of nurturing established relationships as well as creating something new around occupations with others.

Experiences of participation in everyday occupations among persons aging with a tetraplegia

Abstract Purpose: This study aimed to gain understanding of participation in everyday occupations through life stories of persons aging with a traumatic spinal cord injury (SCI). Method: A narrative method was used for data collection and a paradigmatic analysis was used to analyze data. Results: The analysis resulted in three themes that illustrate how the participants acted to participate in everyday occupations, how that changed over time, and some concerns about their future. The first theme illustrates how participants following SCI acted to become agents of their lives and participate in everyday occupations. The second theme illustrates how participants had to prioritize participation in meaningful occupations due to personal and environmental factors. The third theme shows how they had to try new strategies to continue participation in occupations, due to secondary health complications related to aging. Conclusions: This study captures how persons aging with tetraplegia acted to participate in everyday occupations from soon after the injury until several decades later. In addition, their ability to act and participate changed over time. Our findings provide knowledge that can guide clinicians in their work within this complex area of rehabilitation. Besides, it can also guide the work with policy recommendations for healthcare and social service systems. Implications for Rehabilitation Aging with a SCI is a complex daily struggle in order to be able to continue acting and participating in everyday occupations, and thereby this gives implications for a lifelong support. This study provides knowledge that can guide clinicians in their work within this complex area of rehabilitation. Knowledge from this study can guide the work with policy recommendations for healthcare and social service systems.