“The Strength to Leave”: Women With Disabilities Navigating Violent Relationships and Occupational Identities

Abstract

Importance: Being in an intimate relationship is a desired occupation for many people, in particular for women living in low- and middle-income countries (LMICs), where relationships can provide material support, intimacy, and social integration and increase chances of survival. Objective: To explore accounts of navigating intimate relationships from women with disabilities in Sierra Leone. Design: A qualitative study was conducted, guided by a critical occupational approach and informed by feminist disability scholarship. Data were generated through interviews and analyzed using reflexive thematic analysis. Setting: Community-based across four districts of Sierra Leone. Participants: Thirteen women with disabilities were recruited by means of snowball and purposive sampling. Results: Four themes were generated that illuminated the women’s experiences of intimate relationships as viewed through the lens of gender and disability dimensions. The overarching theme, “violence in intimate relationships,” describes the incidences of violence and abuse they experienced. “Becoming a wife” explores the women’s occupational identity wishes. “Leaving as an occupational rupture” illuminates the actions the women took to end the relationship. “Mothering as an occupational identity and resource” focuses on the women’s role as mothers and transitions in their occupations. Conclusions and Relevance: Taking their unique narratives into account draws attention to how the women have met their occupational needs and resisted occupational injustices, enabled by social and structural supports, including their children, disability social benefits, and their engagement in the disability rights movement. Implications are directed at socially committed occupational therapists to address systemic issues of disability- and gender-based violence. What This Article Adds: This study adds much-needed knowledge in an area in which there is a paucity of research: the experiences of women with disabilities being in an intimate relationship as a social occupation in an LMIC. The results illuminate the importance of considering the systemic issues that affect the social occupations of women with disabilities, particularly in light of the shift within occupational therapy practice toward developing a socially transformative focus.

Convergence of Occupational Science and Occupational Therapy: Updates on OTJR’s Occupational Science Section

“…This greater connection to the occupational therapy profession will be achieved in part through the Occupational Science Section’s publication of high-quality occupational science research that provides evidence on occupation-based, client-centered, and contextual practices, thus advancing the founding vision of the field of occupational therapy (AOTA, 2020). As the new Associate Editor of the Occupational Science Section, I bring my commitment of advancing the mobilization of occupational science knowledge to inform occupational therapy practices (Njelesani et al, 2021) through collaborations with communities (Njelesani et al, 2012) and prioritizing the perspectives of people from historically underrepresented groups (Njelesani et al, 2022). I look ahead to the continued growth of the Occupational Science Section and am excited about the new work and novel ideas that scholars bring forward in 2023 and beyond.…”

Occupational Concepts: An Underutilized Resource to Further Disabled People and Others Being Occupied: A Scoping Review

“…"Occupational injustice" refers to restricted access to occupational possibilities and various other occupational concepts are used to flag various ways to and consequences of restricting the access such as occupational alienation [26][27][28][29][30]70]; "occupational deprivation" [24,25], "occupational apartheid" [50] and "occupational marginalization" [18,28]. "Occupational injustice" is heavily influenced by one's social position [71][72][73] and the UN Convention on the Rights of Persons with Disabilities [53] reveals that disabled people are in a low social position and experience many occupational injustices. Barriers to engagement in meaningful occupation are considered injustices [18,43,44].…”

Disability Studies and Occupational Therapy: Renewing the Call for Change

“…DS research acknowledges disabled people (rather than practitioners or researchers) as the disability experts. Many articles in this special issue prioritize the firsthand lived experiences of disabled people in different areas (Bathje et al, 2021;Njelesani et al, 2021;Rabaey et al, 2021;Stasell & Bathje, 2021;VanPuymbrouck et al, 2021;Wasmuth et al, 2021). Articles also demonstrate participatory research methodologies that center community priorities through Photovoice (Rabaey et al, 2021) and share power with those most affected by the research by partnering with community members as co-researchers (Magasi et al, 2021) or co-creators of the studied intervention (Wasmuth et al, 2021).…”

“…Although not specifically intervention focused, several articles in the special issue use a DS approach to explore instrumental activities of daily living often neglected by mainstream research, such as sexuality (Bathje et al, 2021), intimate partner roles (Njelesani et al, 2021), navigation of health care systems (Magasi et al, 2021;VanPuymbrouck et al, 2021), and travel (Stasell & Bathje, 2021). This work challenges assumptions of what disabled people prioritize in their routines and roles and broadens the view of which occupations interventions should address.…”

“…Implications for occupational therapy outlined across the articles in this special issue call on the profession and individual practitioners to engage in advocacy. The authors recommend facilitating the development of client selfadvocacy (Bathje et al, 2021;Rabaey et al, 2021;Stasell & Bathje, 2021), collaborating with and referring to programs and organizations that support community participation and occupational justice (Bathje et al, 2021;Sheth et al, 2021;Wasmuth et al, 2021), and advocating for disability benefits, accessible community and health care services, and equitable policies (McArthur & Gill, 2021;Njelesani et al, 2021;Stasell & Bathje, 2021;VanPuymbrouck et al, 2021;Washington et al, 2021). In addition, some authors call for the profession and its educators, researchers, practitioners, and students to confront implicit bias (Friedman & VanPuymbrouck, 2021) and power dynamics (Magasi et al, 2021) to more authentically infuse DS priorities into practice.…”