Occupational performance in older stroke wheelchair users living at home

Abstract

AbstractThis research aimed to identify problems in occupational performance experienced by survivors of stroke who used a wheelchair, both from their perspective and from the perspective of their caregivers. Sixteen stroke survivors over the age of 65 years who had used a prescribed wheelchair for at least one year, who lived in their own home, who were able to participate in a conversational interview and who had a caregiver willing to participate comprised the sample. The Canadian Occupational Performance Measure (COPM) was used to identify occupational performance problems and to measure stroke survivors' and caregivers' perceptions of performance. The Functional Autonomy Measurement System (SMAF) was also used to evaluate the functional performance of stroke survivors from the caregivers' perspective. The frequency and type of problems identified by the COPM were descriptively analysed and compared for both groups. The results of Mann‐Whitney U tests showed no differences in the frequency of self‐care, productivity and leisure problems reported between the two groups. Within‐group comparisons using the Wilcoxon Signed Ranks Test showed that stroke survivors identified significantly more self‐care problems than productivity‐type problems (p=0.001), and more leisure problems than productivity problems (p=0.013). Caregivers identified significantly more self‐care problems than productivity problems (p=0.001). The most common self‐care problems reported by both stroke survivors and caregivers were dressing and bathing. Results suggest a high level of functional disability among the stroke survivors. There was a significant correlation between the score on the SMAF Instrumental Activities of Daily Living subscale and the frequency of caregiver assistance (r=0.747, p=0.001). Addressing the perspectives of both stroke survivors who are wheelchair users and their caregivers in identifying occupational performance problems at home is important for occupational therapists for planning home‐based intervention. Copyright © 2001 Whurr Publishers Ltd.