The Meaning of Occupational Gaps in Everyday Life in the First Year after Stroke

Abstract

This longitudinal study identified how occupational gaps were characterized in people's lived experiences of performing everyday occupations during the first year after stroke. Four participants were interviewed four times during the year after stroke. The data were collected and analyzed using the Empirical, Phenomenological, Psychological method. Five main characteristics were identified: (1) encountering occupational gaps in formerly taken-for-granted activities, (2) striving to narrow gaps in desired occupations, (3) recognizing oneself in doing, (4) searching for a new sense of self through doing, and (5) creating strategies to enable doing. The findings show the importance of being able to preserve some sense of self in everyday doings after a life course disruption caused by stroke. Important implications for clinical practice include sensitivity to clients' experiences during this process, enablement of experiences in occupations promoting recognition, and support of clients in recapturing desired occupations.

Keywords

phenomenology everyday occupations psychological adaptation

Get full access to this article

View all access options for this article.

References

Asaba

(2005). I'm not much different: Occupation, identity, and spinal cord injury in America. Doctoral dissertation, University of Southern California, Los Angeles.

Atchley

R. C.

(1999). Continuity and adaptation in aging: Creating positive experiences. Baltimore: Johns Hopkins University Press.

Bateson

M. C.

(1996). Enfolded activity and the concept of occupation. In Zemke

& Clark

(Eds.), Occupational science: The evolving discipline (pp. 5–12). Philadelphia: F. A. Davis.

Becker

(1993). Continuity after a stroke: Implications of life-course disruption in old age. The Gerontologist, 33, 148–158.

Charmaz

(1995). The body, identity, and self: Adapting to impairment. The Sociological Quarterly, 36, 657–680.

Christiansen

C. H.

(1999). Defining lives: Occupation as identity. An essay on competence, coherence, and the creation of meaning. American Journal of Occupational Therapy, 53, 547–558.

Clark

Ennevor

B. L.

, & Richardson

P. L.

(1996). A grounded theory of techniques for occupational storytelling and occupational story making. In Zemke

& Clark

(Eds.), Occupational science: The evolving discipline (pp. 339–361). Philadelphia: F. A. Davis.

Clarke

(2003). Towards a greater understanding of the experience of stroke: Integrating quantitative and qualitative methods. Journal of Aging Studies, 17, 171–187.

Dahlberg

Drew

, & Nyström

(2001). Reflective lifeworld research. Lund, Sweden: Studentlitteratur.

10.

Erikson

Karlsson

Borell

, & Tham

(2007). The lived experience of memory impairment in daily occupation after acquired brain injury. OTJR: Occupation, Participation and Health, 27, 84–94.

11.

Eriksson

Kottorp

Borg

, & Tham

(2009). Relationship between occupational gaps in everyday life, depressive mood and life satisfaction after acquired brain injury. Journal of Rehabilitation Medicine, 41, 187–194.

12.

Eriksson

Tham

, & Borg

(2006). Occupational gaps in everyday life 1–4 years after acquired brain injury. Journal of Rehabilitation Medicine, 38, 159–165.

13.

Fisher

A. G.

(1998). Uniting practice and theory in an occupational framework. American Journal of Occupational Therapy, 52, 509–521.

14.

Guidetti

Asaba

, & Tham

(2007). The lived experience of recapturing self-care. American Journal of Occupational Therapy, 61, 303–310.

15.

Husserl

(1970/1925). Phenomenological psychology. The Hague, the Netherlands: Martin Nijhoff.

16.

Karlsson

(1995). Psychological qualitative research from a phenomenological perspective. Stockholm: Almqvist & Wiksell International.

17.

Kielhofner

(2008). Model of human occupation: Theory and application (4th ed.). Baltimore: Lippincott, Williams & Wilkins.

18.

Kvigne

Kirkevold

, & Gjengedal

(2004). Fighting back: Struggling to continue life and preserve the self following a stroke. Health Care for Women International, 25, 370–387.

19.

Lampinen

, & Tham

(2003). Interaction with the physical environment in everyday occupation after stroke: A phenomenological study of persons with visuospatial agnosia. Scandinavian Journal of Occupational Therapy, 10, 147–156.

20.

Merleau-Ponty

(2002/1945). Phenomenology of perception. London: Routledge.

21.

Polit

D. F.

, & Beck

C. T.

(2004). Nursing research: Principles and methods (7th ed.). Philadelphia: Lippincott Williams & Wilkins.

22.

Tham

Borell

, & Gustavsson

(2000). The discovery of disability: A phenomenological study of unilateral neglect. American Journal of Occupational Therapy, 54, 398–406.

23.

Tham

, & Kielhofner

(2003). Impact of the social environment on occupational experience and performance among persons with unilateral neglect. American Journal of Occupational Therapy, 57, 403–412.

24.

Wilcock

A. A.

(1998). An occupational perspective of health. Thorofare, NJ: SLACK Incorporated.

25.

Yerxa

(2002). Habits in context: A synthesis, with implications for research in occupational science. OTJR: Occupation, Participation and Health, 22(Suppl.), S104–S110.