Participation In Everyday Life Research Articles

What Makes Participation Meaningful? Using Photo-Elicitation to Interview Children with Disabilities

Aims The purpose of this study was to describe meaningful participation in everyday life from the perspectives of children with disabilities. Methods Nine children (5–10 years, mean age 7.2 years, 5 boys, 4 girls) with disabilities participated in individual photo-elicitation interviews. The interview data was transcribed verbatim and analyzed with inductive content analysis. Results The children’s meaningful participation mainly comprised free leisure activities that fostered enjoyment, capability, autonomy and social involvement with family and friends. The children’s emotions and physical sensations, opportunities to influence, knowledge about the activity and the participation context, presumptions and previous experiences of the activity and the environment played a vital role in their decisions to participate. Conclusion The meaningful participation facilitated enjoyment and self-determination for the children. Identifying personal and environmental factors supporting or restricting participation from the child’s perspective emerges as important in order to provide opportunities for the child’s meaningful participation in everyday life. The photo-elicitation interviews demonstrated the potential to act as a tool to identify and explore the children’s views about participation in a real-life context.

The motivation and opportunities for weight loss related to the everyday life of people with obesity: A qualitative analysis within the DO:IT study

Background Unsuccessful weight loss or weight loss maintenance is due to different barriers and physical limitations related to participation in everyday life. It will, therefore, be relevant to investigate the field from an occupational therapy perspective, since occupational therapists are uniquely trained in focussing on people’s resources, meaningfulness and participation in everyday life. Aim The aim was to explore what motivates people to lose weight from an OT perspective and which opportunities people with obesity experience in their everyday lives to achieve and maintain lost weight. Material and Methods A descriptive phenomenological study including 21 semi-structured individual interviews was conducted as part of the DO:IT study. Results The data analysis led to the identification of three main themes: The influence of external circumstances on the desire for weight loss; use of time in everyday life; and changes in habits, routines and structure. Conclusion People who are overweight or obese are motivated to lose weight because of health issues and feeling more comfortable with their body. The opportunities for weight loss lie in creating habits, routines and structuring everyday life activities to facilitate a healthier lifestyle. Significance The findings indicate that an occupational therapist should be part of weight-loss interventions.

Socio-demographic status of Children with Autism Spectrum Disorder and their Parents in Dhaka city

Background: Autism spectrum disorder (ASD) has increased dramatically in the last two decades in the whole world. ASD hampers child’s and their parent’s quality of participation in everyday life. This study examined socio-demographic status of ASD children and their parents in Dhaka city, Bangladesh.Methodology: This is a descriptive type of crosssectional study. Total 44 parents of Autistic children were interviewed, excluding 9 non respondent parents. We collected data by using self-administered questionnaires. Data was analyzed in SPSS-16.Results: Majority (52.3%) ASD children were within 11-15 years, 75% of them had 2-4 siblings and 95.5% of them had no health insurance for themselves or their parents. About parents of ASD children, majority (34.1%) were between 41-50 years old, 90.9% of the participants were mother, 90.9% were married, 79.5% parent lives in a nuclear family, 75% of them were unemployed and most (29.5%) of them are with medium education (HSC). However, male female ratio of ASD children was 2.05:1 in our study.Conclusion:The findings from this study indicated that parents of children with ASD are with medium education. They are unemployed and with no medical insurance either for themselves or for their children. Again, abetter study design is needed in future to collect gender of all selected ASD population.International Journal of Human and Health Sciences Vol. 04 No. 01 January’20 Page : 36-40

Exploring future possibilities of using information and communication technology in multidisciplinary rehabilitation after stroke – a grounded theory study

Background: Using Information and Communication Technology (ICT) could increase the intensity of rehabilitation, the level of patient activity and participation in everyday life after stroke and is in line with having a person-centred approach.Aim: To explore how healthcare professionals use and could potentially use ICT to enable a person-centred rehabilitation process after stroke.Methods: Six individual and two focus group interviews were conducted with a group of healthcare professionals working within rehabilitation after stroke. A grounded theory approach was used to collect and analyze the data.Results: The professionals described their current use of ICT as well as their vision of how ICT could be incorporated as a tool in rehabilitation for sharing in four categories: (1) Sharing of information, (2) Collaborating from a distance, (3) Having transparency in the documentation and (4) Supporting patients’ use of ICT.Conclusion: Professionals state that using ICT solutions in rehabilitation after stroke could increase sharing between professionals and their patients and increase patient participation in the rehabilitation process.Significance: This study highlights the importance of developing ICT that healthcare professionals could use along with a person-centred approach. The results will be used to develop an ICT-supported multidisciplinary intervention for rehabilitation after stroke.

Asserting Our Competence and Affirming the Value of Occupation With Confidence.

Throughout the years, leaders in the profession have challenged us to affirm the value of occupational therapy and to substantiate what we do. Occupational therapy practitioners have always focused on what most matters to clients in what is now called client-centered or patient-centered practice. We have also focused on client function to enable participation in everyday life. In a welcome shift, society's views about health and meaning-making are becoming more congruent with the long-standing ideals of occupational therapy. Now, more than ever, we have a powerful opportunity to communicate our competence. But how do we assert our competence and the complexity of occupation with confidence? This lecture draws on the conceptual foundations of theories about competence and confidence and provides examples from the research literature, and a practitioner and client narrative to illustrate the factors that enable us to effectively demonstrate the value of occupational therapy.

Hippotherapy: a systematic mapping review of peer-reviewed research, 1980 to 2018

Purpose Comprehensively and systematically map peer-reviewed studies of hippotherapy published over 30 years, from 1980 through 2018, from the perspective of a phased scientific approach to developing complex interventions as a guide to future research and practice. Methods A systematic mapping review of research of hippotherapy was conducted. Searches of nine databases produced 3,528 unique records; 78 full-text, English-written studies were reviewed, the earliest of which was published in 1998. Data relevant to study aims were extracted electronically from these studies and analyzed using queries and pivot tables. Results Children with cerebral palsy and physical therapists were most prevalent as participants and providers. Equine movement was hippotherapy’s core component and mechanism. Early-phase outcomes-oriented research predominated. “Hippotherapy” was ambiguously defined as treatment strategies and comprehensive professional services, even as interventions grew more distinctive and complex. A treatment theory and proof of concept related to motor outcomes were established, and efficacy research with comparison conditions emerged. Conclusions Continuing research of complex interventions that integrate hippotherapy, equine movement as a therapy tool, is warranted. Attention to gaps in foundational scientific work concurrent with continued piloting and efficacy work will help to identify the most promising interventions worthy of replication, evaluation and widespread adoption. IMPLICATIONS FOR REHABILITATION To advance the evidence base of complex interventions that incorporate hippotherapy: •Proponents of hippotherapy need to define and represent hippotherapy to the public and in practice and research contexts as a therapy tool involving the use of the movement of horses by qualified professionals, rather than simply as a generic therapy with the help of a horse or simulated horse; •Providers of hippotherapy need to identify their professional degrees and certifications, and explicate their disciplinary perspectives that influence their selected components of intervention, related methods, and outcomes; and •Providers and researchers need to partner to develop an enablement theory of hippotherapy that links improved body functions with improved participation in everyday life and quality of life.

“The fact that I can be in front of others, I am used to being a bit behind”: how assistive activity technology affects participation in everyday life

Purpose This article explores the experiences of mobility-impaired individuals participating in leisure-time physical activities through the use of assistive activity technology (AAT). Its purpose is to highlight how these experiences affect participation in everyday life. This article provides new knowledge about the participation of this population in leisure-time physical activities. Methodology Qualitative, semi-structured interviews were analysed according to the stepwise-deductive–inductive approach. During the analysis, self-determination theory (SDT) emerged as a theoretical tool for understanding how social context affects motivation as an interacting concept in the participation of leisure-time physical activity (LTPA). Findings Individuals with mobility impairments who use AAT for leisure-time physical activities experience opportunities to participate in ordinary and valued activities that allow them to improve their social positions. Further, use of AAT provided the informants with opportunities to alter their daily routines, enjoy time on their own and enhance their personal awareness. Having opportunities to use AAT independently is experienced as a recognition of their individuality. Thus, this article highlights a new aspect of participation as performing a socially valued activity in solitude. Conclusions How technology provides opportunities for social interaction influences the informants’ experiences and motivation to use technology. LTPA through the use of AAT promotes mastery and personal dignity, thereby revealing a new aspect of participation as being involved in an independent activity. IMPLICATIONS FOR REHABILITATION The allocation system for assistive activity technology requires knowledge about personal motivation for assistive activity technology use and the connection between leisure-time physical activity and social participation. Additional education about and understanding of motivational factors for assistive technology use is needed.

Exploring the Journey of Clinician to Clinician Researcher

Abstract Date Presented 04/04/19 This descriptive study examined the experience of OT and PT clinicians involved in research. Needs, supports, and barriers were identified for involvement in research. Strategies were discovered to enhance the development of clinical researchers. This new knowledge can foster the preparation of more OT clinician researchers, ensuring achievement of Vision 2025, enhancing effective solutions for participation in everyday life by creating evidence for practice, and improving outcomes. Primary Author and Speaker: Elizabeth Ridgway Additional Authors and Speakers: Carol Terilli, Tim Conly, Joanne Hunt, Donna Kelly, Roseann Schaaf

"Together on the Way": Occupational Therapy in Mainstream Education-A Narrative Study of Emerging Practice in Switzerland.

In Switzerland, recent changes in legislation have reformed special needs education; more children with special needs are now integrated into mainstream schools. Health professionals such as occupational therapists are not embedded in the Swiss education system, but pediatric occupational therapists are starting to work at schools, with the aim of enabling children's full participation as school students. This is bringing a change to the practice of pediatric occupational therapists. Cultural, political, and social factors differ in many ways from those of other countries where most of the current research on pediatric occupational therapists in mainstream education has been conducted. The need for school-based research that is situated within the political, structural, and cultural context of a country has been stressed in different studies. This qualitative study employed narrative analysis to explore the practice experiences and clinical reasoning of Swiss pediatric occupational therapists when working with children with special needs in the school context. Three main themes were identified in the narratives: “bringing in an occupational therapy perspective,” “focusing on school-related occupations,” and “collaborating with different inclusion players.” These represent three different aspects of the therapists' emerging practice. The participants highlight different approaches for children with special needs to enable their participation in everyday life at school through learning, playing, and being with their peers. The findings are discussed in relation to current international research and with respect to European countries with a similar political and structural context, thus complementing approaches to school-based occupational therapy.

Preparing a dialogue conference together with persons with intellectual disabilities

ABSTRACT In Norway, conducting research projects together with people with intellectual disabilities has been rare. This article provides reflections on conducting a pilot project where people with intellectual disabilities prepared a dialogue conference, together with academics, related to participation in everyday life in large shared housing. Two working groups were established and comprised academics, people with intellectual disabilities and staff. The following themes emerged through analysis of data; ‘facilitation for safety as support strategy’, ‘roles and processes in co-production of knowledge’ and ‘different voices and power’. Experiences and reflections from this pilot project show both tensions and pitfalls when involving people with intellectual disability in research. A key conclusion is that involving people with intellectual disability and staff had an impact, added values and new insights that without their participation would not have emerged.

Long-term participation 7-8 years after stroke: Experiences of people in working-age.

ObjectiveTo enhance the understanding of long-term participation in working-aged people 7–8 years after stroke.MethodsThis study had a qualitative design, using a thematic analysis methodology. Eleven individuals took part in an in depth interview 7–8 years after a first time stroke. They had received care at the Sahlgrenska University Hospital in Gothenburg, and were recruited as a heterogenic sample with respect to age, gender, stroke severity and subtype.ResultsFrom the participants’ experiences four themes emerged: “Returning to work after stroke”; “Working life 7–8 years after stroke”; “Social life 7–8 years after stroke”; and “A state of reorientation in life”. Quotes about experienced participation in everyday life were summarized and presented as “Participation after stroke narratives”. Participants chose to emphasize on work- and social life when describing situations of successful participation. Being included in the wider community and having a sense of purpose, when interacting with others, were factors that these narratives had in common. Participants had gradually become accustomed to a somewhat altered life situation. Some consequences after stroke were still considered frustrating in social or work situations. However, the importance of these issues had reduced and were no longer problematized.ConclusionsParticipants felt content with their everyday life in general, which was a principal and positive result of this study. Reaching a stage of acceptance seemed to be a complex and continuous struggle, and an individual approach in long-term rehabilitation would be valuable to support this personal process. More knowledge about what factors that facilitate participation in people of working-age many years after stroke is needed, so that more people can reach a state of positive identity and participation.

Discourses about Daily Activity Contracts: A Ground for Children’s Participation?

The paper presents the findings of a secondary analysis of qualitative research conducted in Turin (Northern Italy) in 2012–2013 on autonomy and responsibility in the relationships between children and parents. A total of 46 parents and 48 children aged 9–13 were interviewed. The secondary analysis focuses on a specific section of the in-depth interview dealing with daily activity contracts. The aim is to investigate children’s participation in everyday life through children’s and parents’ narratives about daily activity contracts. Thematic analysis of this section of the interviews shows that children make room for acquiring such relational and dialogue skills as self-confidence and speaking up, which are recognized to be essential for any level and type of participation. Moreover, children’s and parents’ discourses on daily activity contracts provide an opportunity to “cultivate” participation and autonomy through a sort of alliance between parents and children in decision-making. The question is whether these dialogic attitudes and negotiation abilities are a resource not restricted to the family sphere but which extends to other areas of participation that go beyond the realm of private, protected, and reversible choices.

Social cognition and emotion regulation: a multifaceted treatment (T-ScEmo) for patients with traumatic brain injury

Background: Many patients with moderate to severe traumatic brain injury have deficits in social cognition. Social cognition refers to the ability to perceive, interpret, and act upon social information. Few studies have investigated the effectiveness of treatment for impairments of social cognition in patients with traumatic brain injury. Moreover, these studies have targeted only a single aspect of the problem. They all reported improvements, but evidence for transfer of learned skills to daily life was scarce. We evaluated a multifaceted treatment protocol for poor social cognition and emotion regulation impairments (called T-ScEmo) in patients with traumatic brain injury and found evidence for transfer to participation and quality of life. Purpose: In the current paper, we describe the theoretical underpinning, the design, and the content of our treatment of social cognition and emotion regulation (T-ScEmo). Theory into practice: The multifaceted treatment that we describe is aimed at improving social cognition, regulation of social behavior and participation in everyday life. Some of the methods taught were already evidence-based and derived from existing studies. They were combined, modified, or extended with newly developed material. Protocol design: T-ScEmo consists of 20 one-hour individual sessions and incorporates three modules: (1) emotion perception, (2) perspective taking and theory of mind, and (3) regulation of social behavior. It includes goal-setting, psycho-education, function training, compensatory strategy training, self-monitoring, role-play with participation of a significant other, and homework assignments. Recommendations: It is strongly recommended to offer all three modules, as they build upon each other. However, therapists can vary the time spent per module, in line with the patients’ individual needs and goals. In future, development of e-learning modules and virtual reality sessions might shorten the treatment.

The Importance of Public Transport for Mobility and Everyday Activities among Rural Residents

A lack of transport opportunities has been shown to be a barrier for accessibility and social inclusion in contemporary society. In rural and sparsely populated areas, access to public transport is often poor compared to urban areas, leading to fewer possibilities to participate in normal relationships and activities among rural dwellers. Based on qualitative interviews with rural dwellers in Sweden, the aim of this study was to explore how access to transport can meet the needs of mobility and activity participation in everyday life and how different modes of transport are being used. The study has been permeated by the time-geographical perspective, which considers people’s use of time and space and the restrictions they face in order to carry out activities, including travel. The results show that travel by private car plays a central role in realizing everyday activities for rural dwellers, as well as a perception of the car as being the norm in contemporary society. Frequent car use is the consequence of a combination of time-space restrictions, habit, and a lack of services, activities, and public transport in rural areas. Poor public transport services limit children’s and adolescents’ independent mobility in particular. Further, the physical environment influences the ability to use public transport, for example if roads and bus stops are seen as unsafe. Based on the results of the study, several measures and improvements are proposed that could increase mobility and accessibility in rural areas and reduce car dependency.

Significant others’ perspectives on person-centred information and communication technology in stroke rehabilitation – a grounded theory study

Aim: The aim of this study was to explore significant others’ perspectives on how information and communication technology can support the rehabilitation process after stroke and facilitate participation in everyday life.Method: Thirteen significant others were included in the study, and to capture their perspectives, two focus groups, and five individual interviews were carried out in Denmark and Sweden 6-12 months after the stroke incident. A grounded theory approach was used throughout the study and a constant comparative method was used in the analysis.Results: Five subcategories were identified from the analysis of the interviews: (1) Information and communication technology providing a sense of security, (2) Information and communication technology as a social mediator, (3) Information and communication technology as a compensator for deficits, (4) Information and communication technology as a way to reach information, and (5) Information and communication technology as a possibility to supplement the rehabilitation process. From these categories, one core category emerged: The potential of information and communication technology to facilitate participation in everyday life and thereby reduce the strains that significant others experience after stroke.Conclusion: Information and communication technology has the potential to facilitate participation in everyday life after stroke. It is important, therefore, to start using information and communication technology in the rehabilitation process after stroke, to bring meaning to everyday life and to support both the stroke survivors and their significant others.IMPLICATIONS FOR REHABILITATIONIntegration of information and communication technology in the rehabilitation process after stroke can accommodate several of the significant others´ needs.Educating stroke survivors to use information and communication technology as part of the rehabilitation process offloads their significant others.Integration of information and communication technology in the rehabilitation process after stroke can bring new meaning in everyday life and can facilitate both independence and participation in everyday life.

Significant others’ influence on participation in everyday life – the perspectives of persons with early diagnosed rheumatoid arthritis

Purpose: To describe the meaning of significant others in relation to participation in everyday life of persons with early diagnosed rheumatoid arthritis (RA).Materials and methods: Fifty-nine persons participated in this interview study. Inclusion criteria were three years’ experience of diagnosis and being of working age. Semi-structured interviews were conducted using critical incident technique (CIT), and the material was analysed using content analysis.Results: Four categories were revealed: (1) My early RA causes activity adaptations for us all, referring to the person and significant others modifying activities. (2) Making the significant others balance between shortfalls and participation, where the participants distinguished between needing help and feeling involved in activities. (3) Physical interactions with significant others, referring to both the problematic and manageable impact RA could have on body contact. (4) Emotions in relation to activities with others, where participants described feelings of failing others, and anxiety about future activities.Conclusions: For persons with early diagnosed RA, significant others can be both hindering and facilitating for participation in everyday life. As a clinical implication, it is valuable to identify how significant others can be involved in the rehabilitation process, to enhance participation in everyday life early in the disease process.Implications for rehabilitationSignificant others of persons with rheumatoid arthritis can facilitate as well as hinder participation in everyday life, even early in the disease process.It is important to include the significant others in the rehabilitation process of persons with early diagnosed rheumatoid arthritis.It is of great importance to identify when and how significant others can be facilitators of participation in everyday life for persons with early rheumatoid arthritis.To make it easier for significant others to facilitate participation, there is a need for the healthcare system to explore ways to support significant others with easily accessible information about early rheumatoid arthritis.

Factors affecting outcome in participation one year after stroke: A secondary analysis of a randomized controlled trial.

To explore the importance of client characteristics (age, sex, stroke severity and participation before stroke), rehabilitation context (in-patient or client's home) and approach (enhanced client-centeredness or not) on participation in every-day life after stroke. A secondary analysis of data on 237 participants from a previous randomized controlled trial evaluating an enhanced client-centred intervention after stroke. Plausible associations between client characteristics, context and rehabilitation approach, and a positive outcome regarding participation were explored. Three different outcome measures for participation were used: Stroke Impact Scale 3.0, domain participation; Frenchay Activities Index; and Occupational Gaps Questionnaire. For all participants there was a significant association between mild stroke and a positive outcome using the Frenchay Activities Index. Among participants who had not received the enhanced client-centred approach, there was a significant association between mild stroke and a positive outcome using the Stroke Impact Scale. The context of rehabilitation, i.e. receiving home rehabilitation, was also associated with a positive outcome in the Frenchay Activities Index for the control group. In order to increase participation in every-day life for people after stroke it appears to be important to use an enhanced client-centred approach, particularly when working within in-patient rehabilitation and with people with moderate or severe stroke.

Physiotherapy for Children with CLN2 Disease

Abstract CLN2 disease (neuronal ceroid lipofuscinosis type 2) is a rare, genetic, paediatric-onset, neurodegenerative lysosomal storage disorder characterised by seizures, ataxia, rapid loss of motor function and language ability, dementia, visual loss and early death. Physiotherapy plays an important role in the management of CLN2 disease, aiming to maintain the best possible functioning and autonomy of the child, support the child’s participation in everyday life, limit secondary complications and maintain or improve quality of life. This article discusses the physiotherapeutic treatment of children diagnosed with CLN2 disease. Based on the author’s clinical experience, frequent muscular impairments associated with CLN2 disease, their impact on affected children’s sensorimotor abilities and autonomy, and physiotherapy interventions are described. Common muscular deficits included abnormal muscle tone leading to poor trunk control, difficulty standing upright, often accompanied by equinus contractures and movement disorders such as myoclonus. The use of orthotic and adaptive medical devices that support an erect posture in locomotion and positioning appear to be particularly beneficial for prolonging sensorimotor control, communication and food intake. In conclusion, early initiation of physiotherapy is recommended and should include the provision of adaptive walking, standing, sitting and positioning aids.

Healthcare professionals' perspective on how to promote older couples' participation in everyday life when using respite care.

The aim is to describe healthcare professionals' perspectives on how they understand and promote older couples' participation in everyday life when using residential respite care. Eighteen healthcare professionals with varying degrees of competence and from one residential respite care facility participated in four focus group interviews. Data were analysed through qualitative latent content analysis. The findings revealed a broad, multifaceted view of participation and ways in which participation in everyday life is promoted by these professionals. Trustworthy relationships between professionals, spousal caregivers and clients were implicated. Promoting participation also necessitated that clients have access to meaningful activities. In addition, participation entailed an environment that supported various needs. Promoting participation for older couples that are using respite care involves multifaceted perspectives that consider social-relational aspects including both the client and their spouse. Furthermore, attention is needed to the meaning a change of context between home and the respite care facility has on relationships, environments and activities in everyday life. Such an approach could benefit the couples' shared everyday life situation and in a wider perspective, also influence their health and well-being when ageing in place together.

Service managers' experiences of how the participation of people with intellectual disabilities can be promoted in Swedish group homes.

People with intellectual disabilities in staffed group homes often need lifelong support and dependency on others. Thereby, special demands are placed on staff and service managers to ensure opportunities for participation in everyday life. This study aims to explore how service managers promote participation in Swedish group homes for adults with intellectual disabilities. A qualitative research design involving individual interviews with 14 service managers was used to gain an understanding of how the participation of adults with intellectual disabilities can be promoted in Swedish group homes. The results comprise two main themes; Creating preconditions for participation and Barriers for promotion of participation. Service managers experienced that promoting service user participation in group homes was an important part of their responsibility. The findings indicate that structural strategies such as coaching, supervision and reflection are important and should be further developed.