Journal Club Discussion #12: Perceptions of Occupational Performance in Individuals with Cerebral Palsy

Hey readers! Long time no see (or read)! I am so excited to be back with another journal club discussion today. I recently read an article for school that I thought was really interesting. Unfortunately, I was unable to find it on AJOT for AOTA members, but I will include the citation at the end for you to use if you want to read the whole article. This week we are reading “When I Do, I Become Someone: Experiences of Occupational Performance in Young Adults with Cerebral Palsy” by Lena Bergqvist, Ann-Marie Ohrvall, Kate Himmelmann, and Marie Peny-Dahlstrand.

Background Info

Individuals with cerebral palsy (CP) often have lower levels of participation and independence compared to their same-age peers, even if they have relatively good motor function (Bergqvist, Ohrvall, Himmelmann, & Peny-Dahlstrand, 2019). The authors define CP as a disorder of movement and posture that causes limitations in daily activities. Individuals who have CP may have varying levels of motor impairment, but even low levels of motor impairment are commonly paired with cognitive dysfunctions as well (Bergqvist, Ohrvall, Himmelmann, & Peny-Dahlstrand, 2019). Furthermore, over time CP also leads to deterioration of body function and increases in pain and fatigue, though CP is non-progressive (Bergqvist, Ohrvall, Himmelmann, & Peny-Dahlstrand, 2019). The aim of this study was to understand how young adults with CP perceive their occupational performance in daily activities. This study was completed with participants who all had relatively good motor function.

The Results

The researchers used a qualitative, phenomenological design to assess participant perceptions of occupational performance. They divided responses into five categories:

  • “Important to do”
  • “Demanding but can be facilitated”
  • “Excludes or includes”
  • “Diminishes me or makes me grow”
  • “Comes at a price”

Read more about each of these categories, including quotes from participants, in the article!

The researchers concluded that participants generally felt a desire to be involved and included, and that “doing creates meaning in their lives” (Bergqvist, Ohrvall, Himmelmann, & Peny-Dahlstrand, 2019, p. 345).

What I Think

This is so important to know as a future occupational therapist! The researchers found that doing = meaning in the lives of their participants, which is so OT. I mean, that is the basis behind what we learn in OT school! As OTs, we want to help a person do what is meaningful to them. Furthermore, some participants expressed the importance of completing daily activities independently, even if it comes at a price. Some participants felt excluded at times due to their disability, by others or because they cannot do things in the same way that others can. As OTs, our job should be to promote inclusion whenever possible! Finally, the authors state that factors that go into perception of occupational performance include what they are doing, the context that it takes place in, and their experience in the situation. Participants as a whole wanted to do in their desired roles, and all of these factors came into play when considering their perception of occupational performance.

I think it is really important to read research on our patients’ perceptions of occupational performance as OTs (or build rapport and just ask them yourselves!). If we understand how a person perceives their condition/therapy/performance, we may be able to uncover motivators that will help us as OTs to improve the care that we provide.

Question of the Week: How do you think perceptions of occupational performance might impact motivation in OT? Comment below!

Citation: Bergqvist, L., Ă–hrvall, A. M., Himmelmann, K., & Peny-Dahlstrand, M. (2019). When I do, I become someone: experiences of occupational performance
in young adults with cerebral palsy. Disability and Rehabilitation, 41(3), 341-347, DOI:
10.1080/09638288.2017.1390696

Thanks for reading!

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