Occupational adaptation and identity reconstruction: A grounded theory synthesis of qualitative studies exploring adults’ experiences of adjustment to chronic disease, major illness or injury

Walder, Kim; Molineux, Matthew

doi:10.1080/14427591.2016.1269240

Cited by 51 publications

(49 citation statements)

References 64 publications

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“…Motivation, another theme in the study, was shown to be dynamic, complex and multifactorial. Consistent with other studies (Ellis-Hill et al, 2009;Luker et al, 2015;Walder & Molineux, 2017a) participants in this study identified that periods of low motivation were often underpinned by fatigue or lack of progress. Occupational therapists must remain cognisant of individual motivational factors and adjust services in line with client needs.…”

Section: Discussionsupporting

confidence: 90%

Listening to the client voice – A constructivist grounded theory study of the experiences of client‐centred practice after stroke

Walder

Molineux

2019

Aus Occup Therapy J

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Introduction Collaboration, choice and power‐sharing are cornerstones of practice as occupational therapists support individuals to re‐establish an occupational identity and reintegrate into the community following stroke. Yet evidence of unmet client needs suggests client‐centred care is not optimal, and little is known of client perspectives of client‐centred practice. A deeper understanding of the client experience of therapeutic relationships during adjustment following stroke, will help facilitate client‐centred practice. This paper reports on a study exploring the research question: how do stroke survivors perceive their relationship with their health care team as they adjust to life following stroke? Methods In this constructivist grounded theory study, in‐depth interviews were conducted with six adult stroke survivors from South‐East Queensland, Australia. Transcribed interviews were analysed using a constant comparative approach, identifying emerging concepts and patterns, to construct a theoretical understanding of the experience and meaning of adjustment and reintegration back into the community, with a specific focus on perceptions of therapeutic relationships and client‐centred practice. Results Participant perspectives of client‐centred care during their rehabilitation following stroke were revealed and implications of this for their recovery identified. Themes of being understood; out of the driver's seat; knowing what's going on; and what I need when I need it emerged. Participants described not being: involved in decision making, provided with information, or receiving services aligned to their needs. Periods of frustration, loss of hope and fluctuating motivation were also common. Conclusion Findings shed further light on previously reported health service and discharge experiences. The insight gained into individual experiences of client‐centred care following stroke suggest ways therapists can understand and address each client's adjustment experience and the impact this has on their needs, goal‐setting, motivation, and confidence. Client‐centred care must be grounded in client reality.

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Section: Discussionsupporting

confidence: 90%

Listening to the client voice – A constructivist grounded theory study of the experiences of client‐centred practice after stroke

Walder

Molineux

2019

Aus Occup Therapy J

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“…The focus of occupational therapy is to help individuals achieve health, well-being, and participation in life through engagement in occupations. A significant health event, such as a stroke, can cause a sudden and significant change in occupational ability [1]. Thus, the event of having a stroke carries the potential risk of affecting the ability to engage in occupations.…”

Section: Introductionmentioning

confidence: 99%

Integrating consequences of stroke into everyday life – Experiences from a long-term perspective

Wassenius

Claesson

Blomstrand

et al. 2020

Scandinavian Journal of Occupational Therapy

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“…Emotional support promotes positive interactions between the adolescent and significant others in their environment. This is important given the impact of the TBI on the adolescent's emotional functions that may affect their interpersonal interactions and relationships, specifically with those whom they rely on for support [14, 31, 41, 42]. As primary caregivers in this study highlighted that TBI also has an impact on the family unit, it is imperative that emotional support should be provided to the family of the adolescent with TBI.…”

Section: Discussionmentioning

confidence: 96%

“…These changes often impacted negatively on their self-esteem, motivation, and competence in their day to day functioning. This in turn negatively impacted on their sense of belief in self and on their ability to transition to various life situations post TBI including that of school [31]. As a facilitator , the occupational therapist may cultivate the adolescent's belief in self through facilitating the adolescent's skill development and experiences of mastery through enabling the adolescent to identify and employ remediative and compensatory strategies that allow for the engagement in academic, nonacademic, and extracurricular school-related activities.…”

Section: Discussionmentioning

confidence: 99%

A Service User Perspective Informing the Role of Occupational Therapy in School Transition Practice for High School Learners with TBI: An African Perspective

Khuabi

Swart

Soeker

2019

Occupational Therapy International

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Background. In the South African context, there are no specific guidelines regarding how to prepare and support adolescents for the transition from a health care to a high school setting post TBI. This raises questions about the relevance and responsiveness of the current transition practices in occupational therapy in terms of adequately preparing and supporting these adolescents to participate in school and hence exercise their right to a quality education. Method. This study explored adolescents and other key role players’ perspectives on and experiences of the high school transition (i.e., school reentry and continued school participation) post TBI. It was anticipated that this would provide an increased understanding of the enablers and barriers to high school reentry and participation post TBI. This served as a basis to explore the main aim of this study which was to help occupational therapists identify where efforts in terms of service delivery are needed. This study was situated in the interpretivist qualitative paradigm and used a multicase study design, which included semistructured interviews with eight adolescent learners with TBI, their primary caregivers, teachers, and principals as well as observations and documentation review. Results. This paper will focus on a central theme in the research, namely, the nature and extent of support needed to facilitate the high school transition of adolescents with TBI within a developing context. Similar to the findings of studies conducted in developed contexts, participants highlighted that they felt that adolescents need support at various stages of the school transition. Participants further alluded to support that should be collaborative, coordinated, flexible, and monitored to ensure it is relevant and responsive to these adolescents’ changing needs. Conclusion. The study findings conclude that occupational therapists have a crucial role in fostering an enabling environment (directly and indirectly) through fulfilling various roles including that of a facilitator, intermediary, coach, collaborator, supporter, and advocator.

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Occupational adaptation and identity reconstruction: A grounded theory synthesis of qualitative studies exploring adults’ experiences of adjustment to chronic disease, major illness or injury

Abstract: Occupational adaptation and identity reconstruction-A grounded theory synthesis of qualitative studies exploring adults' experiences of adjustment to chronic disease, major illness or injury

Cited by 51 publications

References 64 publications

Listening to the client voice – A constructivist grounded theory study of the experiences of client‐centred practice after stroke

Listening to the client voice – A constructivist grounded theory study of the experiences of client‐centred practice after stroke

Integrating consequences of stroke into everyday life – Experiences from a long-term perspective

A Service User Perspective Informing the Role of Occupational Therapy in School Transition Practice for High School Learners with TBI: An African Perspective

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