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Research Article  |   July 2003
Impact of the Social Environment on Occupational Experience and Performance Among Persons With Unilateral Neglect
Author Affiliations
  • Kerstin Tham, PhD, OT, is Head, Division of Occupational Therapy, Neurotec Department, Karolinska Institutet, Alfred Nobels Allé 23, 141 83 Huddinge, Sweden; kerstin.tham@neurotec.ki.se
  • Gary Kielhofner, DrPH, OTR, is Professor and Head, Department of Occupational Therapy, College of Applied Health Sciences, University of Illinois, Chicago, Illinois
Article Information
Rehabilitation, Participation, and Disability / The Experience of Disability and Occupation
Research Article   |   July 2003
Impact of the Social Environment on Occupational Experience and Performance Among Persons With Unilateral Neglect
American Journal of Occupational Therapy, July/August 2003, Vol. 57, 403-412. doi:10.5014/ajot.57.4.403
American Journal of Occupational Therapy, July/August 2003, Vol. 57, 403-412. doi:10.5014/ajot.57.4.403
Abstract

OBJECTIVE. The purpose of this study was to gain an understanding of social environmental influences on occupational experience and performance over the course of rehabilitation of four persons with unilateral neglect.

METHODS. The Phenomenological Psychological Method (Karlsson, 1993) was used to gather and analyze qualitative data on four women over a 4-month period. Four women were interviewed five to seven times each and observed during their rehabilitation process. Analysis focused on how these persons with unilateral neglect experienced and responded to their interactions with others in their everyday lives.

FINDINGS. As perceived by the study participants, rehabilitation professionals and relatives demonstrated a sequence of strategies for dealing with and helping the women perform despite their unilateral neglect. The sequence of strategies reflects the changing experience of neglect over time. The strategies used by professionals and family members during the rehabilitation process enabled these women to reclaim and occupy the neglected half of the world. Moreover, the women with neglect learned to incorporate others as extensions of their bodies in order to compensate for their ongoing inability to directly experience the left half of the world.

CONCLUSION. The results suggest that it is important for others (e.g., therapists, nurses, or relatives) to understand the client’s changing experience of neglect and adjust their support and collaboration accordingly. Occupational therapy intervention for persons with neglect could potentially become more effective by systematically incorporating the kinds of strategies identified in this study. Moreover, therapists could consult with others to increase their understanding and effectiveness in interacting with persons who have unilateral neglect.