Occupational Transaction after Stroke Constructed as Threat and Balance

Abstract

Older adults who have had a stroke may experience anxiety, depression and difficulties participating in meaningful occupations while also experiencing excitement, discovery and satisfaction in creating a new occupational balance. The aim of this qualitative study was to explore how older adults experienced the changes in their everyday occupations after a stroke. Five women and three men who had experienced a mild to moderate stroke participated in focus group discussions. Systematic text condensation was applied. The participants' experiences revealed how the stroke was perceived as an ‘occupational threat’ that produced feelings of social exclusion which were experienced as occupational exclusion, deprivation, marginalisation and imbalance. However, at the same time, the participants reconstructed occupational balance by performing occupations in new ways. The participants' experiences provided insight into how they perceived their occupations as threatened after their stroke, while at the same time endeavoring to reconstruct occupational balance. These findings indicate that everyday life after stroke is a time of transaction where people are actively involved in creating control, occupational balance and being socially included.

Keywords:

• Older adults
• Occupational threat
• Occupational balance
• Stroke
• Participation
• Focus groups

Acknowledgements

The Eastern Health Region in Norway, Oslo University Hospital, Ullevaal, Research Unit, the Department of Geriatric Medicine and the Norwegian Women's Public Health Association funded this study. The study was also supported by grants from Oslo University College and the Norwegian Association for Occupational Therapists. The authors would like to thank all the participants who took part. We also thank Professor Chris Mayers, Research Fellow (Occupational Therapy), Faculty of Health & Life Sciences, York St John University for her valuable comments and assistance with the English language and Professor Emerita Elizabeth Townsend, School of Occupational Therapy, School of Nursing and Department of Community Health and Epidemiology, Dalhousie University, Faculty of Education, University of Prince Edward Island for valuable comments on this manuscript.