Title

Disrupted dance or just out of step? The role of sociocultural norms and individual beliefs on co-occupation

1

Location

Regency Room

Start Time

30-9-2016 10:30 AM

End Time

30-9-2016 12:00 PM

Session Type

Research Paper

Abstract

Statement of purpose:

Recent federal rulings have led to an increasing population of individuals with disabilities receiving support services from paid caregivers in their communities (Smith et al., 2000). Paid caregivers are strangers who enter an individual's life and often spend prolonged periods of time in a one-to-one relationship with the individual. These paid caregivers provide assistance for the essential occupations that make up one's life. Co-occupations, the occupations that occur between two or more people, have been described as a "dance" in which each individual in the relationship shapes the final occupational outcome (Pierce, 2009). It has been suggested that co-occupations are comprised of shared physicality, shared emotionality and shared intentionality (Pickens & Pizur‐Barnekow, 2009). However, what happens to the dance when the partners diverge? This study explored the ways in which the beliefs and attitudes of paid caregivers and their care receivers influenced the co-occupations that occurred within the context of their relationships.

Description of methods: Constructivist grounded theory methodology was used to explore the perceptions of individuals with brain injury and their paid caregivers. Thirty-four interviews were conducted with eight participants over a six-month period. The interviews included two in-depth semi-structured interviews with each participant and, in between these interviews, short phone interviews using an adapted Ecological Momentary Assessment method.

Report of results: Based on the study findings, a model was developed which represents the factors and perceptions that influenced day-to-day interactions between individuals with brain injury and their paid caregivers. These included differing conceptualizations of brain injury and in-congruent views of the paid caregiver's role. The medical model significantly influenced the beliefs of all participants. The core category that integrated all parts of the model was learning, understood as an interactive process between the individual with brain injury, the paid caregiver, and the broader sociocultural community. This study illustrates how the day-to-day occupations that occur within the context of a relationship are highly shaped by sociocultural norms.

Implications related to occupational science:

This study offers an expanded perspective regarding co-occupation and provides the basis for a discussion regarding the sociocultural influences on co-occupation between caregivers and care receivers.

Discussion questions to further occupational science concepts and ideas:

In what ways might sociocultural norms influence occupation?

What is the role for occupational science in identifying tacit beliefs that influence occupation?

Key Words: Brain Injury, Caregivers, Co-occupation

Learning Objectives for Session

Participants will

1. understand the influences on co-occupation in the relationship between paid caregivers and individuals with brain injury

2. participate in a discussion related to the role of tacit attitudes and beliefs on occupation and the role of occupational science in identifying these beliefs

References

Pickens, N. D., & Pizur‐Barnekow, K. (2009). Co‐occupation: Extending the dialogue. Journal of Occupational Science, 16(3), 151–156. doi:10.1080/14427591.2009.9686656

Pierce, D. (2009). Co‐occupation: The challenges of defining concepts original to occupational science. Journal of Occupational Science, 16(3), 203–207. doi:10.1080/14427591.2009.9686663

Smith, G., O’Keefe, J., Carpenter, L., Doty, P., Kennedy, G., Burwell, B., … Williams, L. (2000). Understanding Medicaid home and community services: A primer. U.S. Department of Health and Human Services. Retrieved from http://aspe.hhs.gov/daltcp/reports/primer.htm

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Sep 30th, 10:30 AM Sep 30th, 12:00 PM

Disrupted dance or just out of step? The role of sociocultural norms and individual beliefs on co-occupation

Regency Room

Statement of purpose:

Recent federal rulings have led to an increasing population of individuals with disabilities receiving support services from paid caregivers in their communities (Smith et al., 2000). Paid caregivers are strangers who enter an individual's life and often spend prolonged periods of time in a one-to-one relationship with the individual. These paid caregivers provide assistance for the essential occupations that make up one's life. Co-occupations, the occupations that occur between two or more people, have been described as a "dance" in which each individual in the relationship shapes the final occupational outcome (Pierce, 2009). It has been suggested that co-occupations are comprised of shared physicality, shared emotionality and shared intentionality (Pickens & Pizur‐Barnekow, 2009). However, what happens to the dance when the partners diverge? This study explored the ways in which the beliefs and attitudes of paid caregivers and their care receivers influenced the co-occupations that occurred within the context of their relationships.

Description of methods: Constructivist grounded theory methodology was used to explore the perceptions of individuals with brain injury and their paid caregivers. Thirty-four interviews were conducted with eight participants over a six-month period. The interviews included two in-depth semi-structured interviews with each participant and, in between these interviews, short phone interviews using an adapted Ecological Momentary Assessment method.

Report of results: Based on the study findings, a model was developed which represents the factors and perceptions that influenced day-to-day interactions between individuals with brain injury and their paid caregivers. These included differing conceptualizations of brain injury and in-congruent views of the paid caregiver's role. The medical model significantly influenced the beliefs of all participants. The core category that integrated all parts of the model was learning, understood as an interactive process between the individual with brain injury, the paid caregiver, and the broader sociocultural community. This study illustrates how the day-to-day occupations that occur within the context of a relationship are highly shaped by sociocultural norms.

Implications related to occupational science:

This study offers an expanded perspective regarding co-occupation and provides the basis for a discussion regarding the sociocultural influences on co-occupation between caregivers and care receivers.

Discussion questions to further occupational science concepts and ideas:

In what ways might sociocultural norms influence occupation?

What is the role for occupational science in identifying tacit beliefs that influence occupation?

Key Words: Brain Injury, Caregivers, Co-occupation

Learning Objectives for Session

Participants will

1. understand the influences on co-occupation in the relationship between paid caregivers and individuals with brain injury

2. participate in a discussion related to the role of tacit attitudes and beliefs on occupation and the role of occupational science in identifying these beliefs