The International Classification of Functioning, Disability and Health (ICF; World Health Organization, 2001) provides an international and interprofessional scientific basis for understanding and studying health. The concept of participation plays an important role in the classification and has become a central construct in health care, rehabilitation, and in occupational therapy. The aim of this paper is to provide a critical analysis of the concept of participation in the ICF. As background, the origins and current presentation of the ICF are presented. The use and function of the ICF and the contemporary discussions regarding the classification are reviewed. An occupational perspective on participation in the ICF reveals major shortcomings regarding the subjective experience of meaning and autonomy. Furthermore, the ICF has limitations in capturing different kinds of participation in a single life situation. Following these analyses we discuss the advantages and shortcomings of using the ICF, and how an occupational perspective can contribute to an ongoing discussion about the development of the ICF.

The purpose of this study was to explore and gain an understanding of how habits are experienced when performing daily occupations after a stroke. In-depth interviews were conducted with 7 participants and a constant comparative method was used for data analysis. Four men and three women with stroke between the ages of 42 and 82 years participated in the study. The interviews were conducted 1.5 to 7 months after the participants had been discharged from hospital to their home. The findings show that the participants experienced frustration when performing daily occupations because changes in their performance meant that former habits could not automatically be reestablished; daily occupations had to be re-organized and planned with greater deliberation than had been required prior to the stroke. In reestablishing their daily occupations, the participants experienced an ongoing conflict about whether or not to develop new habits. Although adaptation and change would be beneficial in the short-term, both also represented giving up possible improvements, and participants seemed to consider that their eventual recovery and independence would be compromised if they allowed themselves to alter their habits. This dilemma led to a sensation of waiting: waiting to get better, waiting for another solution and waiting for the treatment to make an impact. As a result, few new habits were established in daily occupations. The findings suggest that occupational therapists need to be aware of the dilemma clients may perceive regarding decisions about whether or not to adapt and develop new habits during poststroke recovery.

Objective. This study is the first part of a longitudinal investigation of the retirement process. This stage of the inquiry concerned how older persons anticipate their retirement. Method. Thirty-two workers were randomly selected from all workers age 63 years in a suburb of Stockholm. They participated in semistructured interviews about their work and their expectations for retirement. Results. The participants’ narratives illustrated the complex work of interpreting the past and expected meaning in one’s occupational life. The narratives, which anticipated widely different future trajectories, revealed many of the challenges and dilemmas of anticipating retirement and the close association of work experience to expectations for retirement. In particular, the narratives highlighted the participants’ concerns about maintaining the quality of experience in activity. The findings also demonstrate the process by which persons anticipate and make choices about life change. Conclusions. People anticipate retirement through volitional narratives in which they link together past, present, and future. Understanding this volitional process of interpreting, anticipating, and making choices is important to understanding how people adapt to life changes.