Title

Poster Session - Using the Empirical Phenomenological Psychological method to explore and describe the lived experience of falls self-efficacy among people with multiple sclerosis.

Location

Winter Garden

Start Time

16-10-2014 6:00 PM

End Time

16-10-2014 9:00 PM

Abstract

Background/Purpose: Falls are a serious threat to people living with multiple sclerosis (MS) worldwide1, 2. Although fear of falling (FoF) and low falls self-efficacy (FSE) are widely recognized fall risk factors, 2,3 and MOHO-based research highlights the relationship between FSE and personal causation,4 understanding of FSE is overwhelmingly based upon etic perspectives. This presentation describes how the Empirical Phenomenological Psychological (EPP) method was used by U.S. and Sweden-based researchers to explore and describe the lived experience of FSE among people with MS (PwMS)5.

Methods: Three men and three women with MS, ages 58-67, were interviewed in person. Inclusion criteria included having a diagnosis of MS, being age 40 or older, history of at least1 fall in the past year, and participation in a U.S.-based fall risk management program. The EPP method, used to collect and analyze data, aims to trace the meaning structure of phenomenon based on participants’ lived experiences. Interviews and field notes were data sources. Participants were interviewed by the Principal Investigator (PI) 1x/month over 3 months. A semi-structured interview guide with open-ended questions that focused on generating detailed accounts of daily occupations and managing fall risk was used. Interviews were audiotaped, transcribed verbatim, and averaged 69 minutes. The PI recorded field notes which were used during analysis to understand the participants’ experiences. To support data trustworthiness, participants verified accuracy of interview summaries. A deliberate and systematic process of self-examination was used by the PI to partition previous knowledge of medical and occupational science (OS) concepts. All themes initially identified by the PI were refined multiple times through discussions among investigators.

Results/Limitations/Contribution to OS: One main theme, managing fall risk as a means of supporting activity, and 6 subthemes were reflected in participants’ lived experiences: understanding personal MS symptoms, abilities and fall risk; accepting one’s changed capacity; focusing on what you can control; on-going learning by doing; vigilance while doing; and taking personal responsibility to reduce fall risk. While findings may represent PwMS with high FSE, the study highlights the value of EPP to understand how FSE operates as part of a larger volitional process, and contributes to OS by illustrating the fundamental value of occupation to PwMS, and how such insights can inform innovative, occupation-based fall prevention assessments and interventions.

Key words: falls self-efficacy, Empirical Phenomenological Psychological method, multiple sclerosis

References

1 Ytterberg, C., Einarsson, U., Widén Holmqvist, L., & Peterson, E.W. (2013). A population-based study of fall risk factors among people with multiple sclerosis in Stockholm County. Journal of Rehabilitation Medicine, 45, 452-457. doi: 10.2340/16501977-1129

2 Peterson, E.W., Cho, C.C., von Koch, L., & Finlayson, M. L. (2008). Injurious falls among middle aged and older adults with multiple sclerosis. Archives of Physical Medicine and Rehabilitation, 89, 1031-1037. doi:10.1016/j.apmr.2007.10.043

3 Cumming, R.G., Salkeld, G., Thomas, M., & Szonyi, G. (2000). Prospective study of the impact of fear of falling on activities of daily living, SF-36 scores, and nursing home admission. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 55, M299-305. doi: 10.1093/Gerona/55.5.M299

4 Peterson, E., Howland, J., Kielhofner, G., Lachman, M.E., Assmann, S., Cote, J. & Jette, A. (1999). Falls self-efficacy and occupational adaptation among elders. Physical & Occupational Therapy in Geriatrics, 16 (1/2), 1-16.

5 Peterson, E., Kielhofner, G., Tham, K. & von Koch, L. (2010). Falls self-efficacy among adults with multiple sclerosis: A phenomenological study. OTJR: Occupation, Participation & Health, 30, 148-157. doi: 10.3928/15394492-20091123-02

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Oct 16th, 6:00 PM Oct 16th, 9:00 PM

Poster Session - Using the Empirical Phenomenological Psychological method to explore and describe the lived experience of falls self-efficacy among people with multiple sclerosis.

Winter Garden

Background/Purpose: Falls are a serious threat to people living with multiple sclerosis (MS) worldwide1, 2. Although fear of falling (FoF) and low falls self-efficacy (FSE) are widely recognized fall risk factors, 2,3 and MOHO-based research highlights the relationship between FSE and personal causation,4 understanding of FSE is overwhelmingly based upon etic perspectives. This presentation describes how the Empirical Phenomenological Psychological (EPP) method was used by U.S. and Sweden-based researchers to explore and describe the lived experience of FSE among people with MS (PwMS)5.

Methods: Three men and three women with MS, ages 58-67, were interviewed in person. Inclusion criteria included having a diagnosis of MS, being age 40 or older, history of at least1 fall in the past year, and participation in a U.S.-based fall risk management program. The EPP method, used to collect and analyze data, aims to trace the meaning structure of phenomenon based on participants’ lived experiences. Interviews and field notes were data sources. Participants were interviewed by the Principal Investigator (PI) 1x/month over 3 months. A semi-structured interview guide with open-ended questions that focused on generating detailed accounts of daily occupations and managing fall risk was used. Interviews were audiotaped, transcribed verbatim, and averaged 69 minutes. The PI recorded field notes which were used during analysis to understand the participants’ experiences. To support data trustworthiness, participants verified accuracy of interview summaries. A deliberate and systematic process of self-examination was used by the PI to partition previous knowledge of medical and occupational science (OS) concepts. All themes initially identified by the PI were refined multiple times through discussions among investigators.

Results/Limitations/Contribution to OS: One main theme, managing fall risk as a means of supporting activity, and 6 subthemes were reflected in participants’ lived experiences: understanding personal MS symptoms, abilities and fall risk; accepting one’s changed capacity; focusing on what you can control; on-going learning by doing; vigilance while doing; and taking personal responsibility to reduce fall risk. While findings may represent PwMS with high FSE, the study highlights the value of EPP to understand how FSE operates as part of a larger volitional process, and contributes to OS by illustrating the fundamental value of occupation to PwMS, and how such insights can inform innovative, occupation-based fall prevention assessments and interventions.

Key words: falls self-efficacy, Empirical Phenomenological Psychological method, multiple sclerosis