In-home contextual reality: a qualitative analysis using the Multiple Errands Test Home Version (MET-Home)

ABSTRACT

Adults with stroke frequently experience executive dysfunction. Despite the range of assessments that examine the effects of executive dysfunction on daily tasks, there remains a paucity of literature that examines the influence of the environment on performance in the community. The MET-Home is an ecologically valid assessment for examining post-stroke executive dysfunction in the home environment. This qualitative study explores the relationship between the environment and MET-Home performance among home-dwelling adults with stroke and matched controls. Using a descriptive qualitative approach, we analysed video, interview, and observation notes from a MET-Home validation study. An overarching theme of interplay between everyday task performance and the home environment produced further themes: naturalistically emerging supports and barriers and environment as strategy. Within naturalistically emerging supports and barriers, five contextual sub-themes were discovered: physical environment, social environment, temporal context, virtual context, and personal context. Within environment as strategy, we identified four sub-themes: reducing distractions, using everyday technologies, planning in context, and seeking social support. These findings extend the conceptualisation of how we evaluate executive dysfunction in the context of the community to also consider the inherent influence of the environment.

KEYWORDS:

• Stroke
• Environment
• Home
• Assessment
• Executive function

Acknowledgements

We thank all participants who volunteered for this study. We also thank the Texas Occupational Therapy Foundation and Texas Woman's University for supporting this research.

Disclosure statement

In accordance with Taylor & Francis policy and the author’s ethical obligations, we are reporting that this work is funded by the Texas Occupational Therapy Foundation and Texas Woman’s University in Dallas. We have disclosed those interests fully to Taylor & Francis, and have in place an approved plan for managing any potential conflicts arising from that involvement.