Everyday activities outside the home are a struggle: Narratives from two persons with acquired brain injury

Abstract

Background: Participation restriction is a common consequence after acquired brain injury (ABI). Aim: To explore and identify problematic situations in everyday activities outside the home for persons with acquired brain injury. Material and Method: Two persons of working age with ABI were included. Data were generated through repeated semi-structured interviews and participant observations. Narrative analysis was used to capture ongoing processes related to problematic situations during engagement in everyday activities outside the home. Results: The narratives reflect how places, everyday activities and social relations were closely connected and influenced engagement in everyday activities outside the home. The participants visited fewer places and performed more of their everyday activities alone in their homes after the injury compared to before. They were struggling to create meaning in their lives and trying to reformulate their identity. Problematic situations often occurred outside the home as a result of unexpected events. The narratives indicate a struggle to find new routines to handle challenging situations. Conclusions: The results provide an understanding of how problematic situations occurred and were managed in different ways. By observing everyday situations professionals can gain access to how persons with ABI act in and reflect upon problematic situations which can eventually improve the design of individually tailored interventions.

Perceived occupational value in people with acquired brain injury

“…Interestingly, two out of four items representing symbolic value were perceived as low. This might indicate, in line with previous research [16,17] that engagement in socio-cultural occupations becomes restricted, such as occupations with others in public space. The results also showed that all three dimensions of values were of significant importance for somatic health, psychological health and life as a whole.…”

“…Their engagement in occupations becomes more or less limited to activities that need to be performed to function in everyday life [15]. Furthermore, engagement in activities outside the home, such as social and leisure activities, often becomes challenging, and as a result, people with ABI visit fewer places and perform more of their activities at home and alone [15][16][17].…”

Patterns of participation: Facilitating and hindering aspects related to places for activities outside the home after stroke

“…Participation commonly include engagement in activities in numerous places. After a stroke, it can be challenging to be engaged in activities in places outside the home [1][2][3][4]. Recent research has found that people with a severe or moderate disability after a stroke visit fewer places, compared to those with good recovery after stroke [5].…”

Places visited for activities outside the home after stroke: Relationship with the severity of disability

“…Consequently, these results indicate the importance of considering places visited for activities outside the home to understand better the extent of participation in different areas of life after stroke, especially for those with severe/moderate disability. With respect to the results and research (Olofsson et al, 2017(Olofsson et al, , 2018, it is suggested that the possibility of facilitating participation can be enhanced by considering places and activities in combination. However, generalisation of the results should be made with caution with respect to the small and non-randomised study sample of working age.…”