'When I use the electric wheelchair, I can be myself' - real-life stories about occupational identity construction.

BACKGROUND: Young and adult users of electric wheelchairs (EWs) describe how EWs have personal, functional, emotional, and symbolic values and are considered by some to be part of the self. AIM: The aim of this study was to increase our understanding of how occupational identity is constructed in the daily practices of EW users. MATERIAL AND METHODS: Context-based, in-depth oral stories and filmed sequences of daily practice enactments of persons who have used an EW since childhood were the basis for the narrative analysis. FINDINGS: The findings elucidate how the informants enact and tell about their identity-development in response to daily and relational practices, and its relevance to the informant's sense of self, belonging, competence, life-prospects, conduct, and awareness of shifting values, and this was likewise demonstrated in different appearances and roles related to social recognition. A model illustrating the findings is proposed. CONCLUSIONS AND SIGNIFICANCE: Contextual values and exploring experiences, such as possibilities to develop competences and roles, along with encountering social recognition, but also hindering regulations and adversities, influence the development of occupational identities. Findings in this study can contribute to increased understanding, conscious political decisions, as well as a more person-centred approach within healthcare.

Obstacles and risks in the traffic environment for users of powered wheelchairs in Sweden.

OBJECTIVE: According to the European Union, fatal road accidents involving Vulnerable Road Users (VRUs) are equal in proportion to fatal car road accidents (46%). VRUs include individuals with mobility challenges such as the elderly and Powered Wheelchair (PWC) users. The aim of this interdisciplinary qualitative study was to identify obstacles and risks for PWC users by exploring their behaviour and experiences in traffic environments. METHODS: Videos and in-depth interviews with 13 PWC users aged 20-66 were analysed for this study. The interviews and videos, which include real-life outdoor observations, originate from a qualitative study exploring experiences of PWC use on a daily basis in Sweden. Underlying causal factors to identified risks and obstacles were identified, based on human, vehicle (PWC) and environmental factors in accordance with the Haddon Matrix. RESULTS: The results show significant potential for improvement within all three perspectives of the Haddon Matrix used in the analysis. Participants faced and dealt with various obstacles and risks in order to reach their destination. For example, this includes uneven surfaces, differences in ground levels, steep slopes, as well as interactions with other road users and the influence of weather conditions, resulting in PWC users constantly accommodating and coping with the shortcomings of the vehicle and the environment. CONCLUSIONS: There are still major challenges with regard to preventing obstacles and risks in the traffic environment for PWC users. To discern PWC users in traffic accident and injury data bases, a start would be to register type of aid used for persons involved in an accident. Furthermore, to emphasise PWC users' role as VRUs, it may also be advantageous to describe them as drivers rather than users when navigating the traffic environment. Given the limited sample, further research covering more data from a broader perspective would be beneficial. By incorporating emerging knowledge of PWC users' prerequisites and needs, and including them in research and traffic planning, the society will grow safer and more inclusive, and become better prepared for meeting future demands on accessibility from an aging population.

Living with an electric wheelchair--the user perspective.

PURPOSE: To explore the experiences of using an electric wheelchair in daily living. METHODS: Fifteen participants, eight women and seven men, living in different parts of a Nordic country were interviewed. The interviews were conducted in the home or at the workplace. Open-ended questions were used. The data were collected and analyzed according to the grounded theory. RESULTS: Analysis resulted in one core category: "Integrating the electric wheelchair - a manifold process", describing a process commencing from initial resistance against use of an electric wheelchair, to acceptance with various extent of integration. Six categories emerged that represent this core process: incorporating the electric wheelchair into the self-identity process, calculating functional consequences, encountering the reactions of others, facing duality in movability, using proactive strategies, and being at the mercy of the system. Findings indicate that the integration process is complex and manifold. Practical, personal, and social dimensions were intertwined and significantly involved. CONCLUSIONS: Integrating an electric wheelchair is a process closely connected to symbolic value, usability, community mobility and identity. These aspects should be considered in the production, prescription, and adaptation processes. Implications for Rehabilitation Integrating an electric wheelchair is a process closely connected to symbolic value, usability, community mobility, and identity. These aspects should be considered in the wheelchair production, prescription, and adaptation processes.