Date Presented 04/20/2023
Narrative inquiry was used to understand the time-use choices of one person with tetraplegia. By exploring the link between time use and well-being, OTs can help restore engagement in meaningful occupations and promote health.
Primary Author and Speaker: Amanda Balser
Additional Authors and Speakers: Dana M. Howell
Contributing Authors: Donna Colaianni
PURPOSE: Optimal health-maintenance routines have been tied to better health, well-being, and community participation outcomes. Basic ADL routines and health management practices for individuals with tetraplegia have a high daily time burden. How this time-use impacts participation in more personally meaningful occupations is an underexplored area in the literature. The purpose of this study was to explore the stories an individual with tetraplegia has about their ADL and health management time-use, occupational patterns, and daily routines, as well as their feelings about quality of life and life satisfaction.
METHOD: Narrative inquiry was used to understand the situational elements that shaped time-use choices of one individual living with tetraplegia, and how their occupational engagement and experience evolved over time. In-depth conversational interviews were conducted, transcribed, and analyzed, following a narrative inquiry framework.
RESULTS: The interpretive stories were thematically represented and demonstrated the transactional relationships between person, occupation, and context. Each narrative highlighted the complexity of occupation and how personal meaning was attached to both the mundane aspects of self-care and health management routines as well as the more meaningful and personally important uses of time.
CONCLUSIONS: This study has made important contributions to the understanding of occupation and time-use as experienced by an individual with tetraplegia. In this case, finding value and meaning of ADL and health management practices and routines occurred through the discovery of meaningful occupation in the form of productive work and creating artwork.
IMPACT STATEMENT: By exploring each client’s personal meaning of the link between occupation and well-being, occupational therapists can help clients restore engagement in meaningful occupations and promote positive health behaviors.
Backman, C. L., Christiansen, C. H., Hooper, B. R., Pierce, D., & Price, M. P. (2021). Occupational science concepts essential to occupation-based practice: Development of expert consensus. The American Journal of Occupational Therapy, 75(6). https://doi.org/10.5014/ajot.2021.049090
Sonday, A., Ramugondo, E., & Kathard, H. (2020). Case study and narrative inquiry as merged methodologies: A critical narrative perspective. International Journal of Qualitative Methods, 19. https://doi.org/10.1177/1609406920937880
Walsh, R. J., McKay, V. R., Hansen, P. E., Barco, P. P., Jones, K., Lee, Y., Patel, R. D., Chen, D., Heinemann, A. W., Lenze, E. J., & Wong, A. (2022). Using implementation science to guide the process of adapting a patient engagement intervention for inpatient spinal cord injury/disorder rehabilitation. Archives of Physical Medicine and Rehabilitation, 103(11), 2180–2188. https://doi.org/10.1016/j.apmr.2022.04.010
Wood, W. (2019). Envisioning the environment, time, and occupation. Journal of Occupational Science, 26(4), 456–469. https://doi.org/10.1080/14427591.2019.1595097