Struggling to be part of Swedish society: Strategies used by immigrants with late effects of polio.

OBJECTIVE: To explore and describe strategies in daily occupations among immigrants with late effects of polio. METHOD: The strategies were explored by interviews with 12 immigrants from Eastern Africa with late effects of polio. Sampling and data analysis was carried out according to grounded theory. RESULTS: The participants struggled for occupational participation and normality in an effort to participate in, and be part of, society. The study identified 14 strategies used by the immigrants in their daily occupations. The strategies can be presented in the following four categories: managing physical capacity; promoting occupational performance; strategies for gaining respect; and preparing the ground for one's existence. The participants struggled to find a balance between physical capacity and meaningful occupations, conception of their own and others' norms and values, and living conditions in Swedish society. The strategies were related to the participants' will to manage daily occupations, maintain social relationships, and be part of society. CONCLUSIONS: The strategies revealed that the participants strive to participate in occupations and society. This study reinforces the importance of occupation for immigrants with disability. The results highlight the need for adequate health care and rehabilitation but should also alert other social institutions.

Confidence in the future and hopelessness: experiences in daily occupations of immigrants with late effects of polio.

UNLABELLED: Sweden today may be described as multicultural. Those who are immigrants and have a disability are described as doubly vulnerable. AIMS: To explore and describe how immigrants with late effects of polio experience their daily occupations. METHOD: The experiences were explored by interviews with 12 immigrants with late effects of polio, from Eastern Africa. Data analysis was carried out according to grounded theory. RESULTS: Experiences in daily occupations affected the participants' view of the future, which in turn was influenced by the participants' conception of occupational self. This was dependent on their participation in daily occupations. Five categories influenced their experiences: rootedness in society, estimation of others, treatment by others, belonging to social networks, and the process of change in life. The social environment played an important role in determining how the participants experienced their daily occupations. CONCLUSIONS: The participants' experiences could not be seen in isolation; consequences of their disability and migration interact. The study showed that the complexity of daily life among immigrants with disability requires individual treatment and points to a need for consideration of differences in cultural background, including the therapist's own cultural lens.

Coping strategies in daily occupations 3 months after a severe or major hand injury.

Coping strategies used in performing daily occupations 3 months after a severe or major hand injury were explored. A semi-structured interview was performed with 13 participants with hand injuries based on Hand Injury Severity Scoring System and analysed using content analysis. Six groups of strategies were identified: 'Changing performance of daily occupations', 'Actively processing trauma experience', 'Changing occupational patterns', 'Receiving assistance', 'Using emotional strategies' and 'Keeping up a social network'. The problem- and emotional-solving strategies identified in this study can be used to support other patients early in rehabilitation. Patients with few coping strategies should be recognized. Information and practical handouts to patients, therapists and relatives should stimulate and help patients with hand problems enabling in meaningful occupations and preventing unnecessary stress. Furthermore, social support should be encouraged and family should be actively involved in rehabilitation. To insure trustworthiness, member checks were used on four randomly selected participants, but could possibly be used with all participants. Further research is needed in a longitudinal study to explore which coping strategies or adaptation patients use to perform daily occupations at a later stage.

Making sense of living under the shadow of death: adjusting to a recurrent breast cancer illness.

Women with recurrent breast cancer face many difficulties and challenges, from clinical symptoms of disease progression and treatment to a range of emotional responses. Guided by grounded theory methodology, we explored the main concerns of women with recurrent breast cancer, and how they were dealing with their situations. Data were collected from 40 in-depth interviews with 20 women diagnosed with recurrent breast cancer. The core category illustrated the process of "making sense of living under the shadow of death," and was based on the women's experiences of adjusting to living with a persistent life-threatening illness. Confronting a recurrence of breast cancer was a life-altering event. Moving through a difficult and challenging time, women eased their distress by letting go of losses and reassessing important values. Through a personal transition women transcended living with a life-threatening illness. These findings emphasize the importance of recognizing existential distress in clinical practice.

The Swedish Speech Interpretation Service: an exploratory study of a new communication support provided to people with aphasia.

Until recently, people with complex communication needs have had no access to professional interpreters. The Swedish Speech Interpretation Service (SSIS) is attempting to address this problem. This qualitative study reports on how 12 persons with aphasia experienced the services of a professional interpreter from the SSIS. The results are presented in two themes: (a) The purpose of using an interpreter, which addresses issues relating to autonomy, privacy, and burden on family members; and (b) perceptions of quality of service, which addresses issues relating to the skills and professionalism of and accessibility to interpreters. Results highlight the ongoing need for the SSIS and its importance to the participants. The professional interpreter as an augmentative and alternative communication (AAC) "tool" that could be used to enhance the participation of people with aphasia in the community-at-large, is also discussed; as is whether relatives and other non-professionals or professional interpreters should interpret for people with aphasia.

Disability in a 4-year follow-up study of people with post-polio syndrome.

OBJECTIVE: To evaluate changes over time in a clinically based cohort of individuals with post-polio syndrome. DESIGN: A prospective longitudinal study. SUBJECTS: A total of 106 individuals with poliomyelitis sequelae were included in the study. They were self-referred or had been referred to the post-polio clinic. After 4 years subjects were called for a follow-up and underwent the same measurements as at the initial assessment. METHODS: The following measurements were conducted at both the initial assessment, and the follow-up: questionnaires including Nottingham Health Profile, muscle strength and walking speed. RESULTS: Minor changes in disability during a 4-year period were shown. A significant reduction in muscle strength was only seen for 60 degrees flexion in the left leg and for right and left dorsal flexion. No change could be seen in the total Nottingham Health Profile score. CONCLUSION: The minor changes in disability found in this study are an indication that we still do not know which subjects are at risk for deterioration. It is difficult to say whether the small changes over time shown in this study are associated with support from the polio clinic or are an expression of the natural history of the syndrome. However, it is hoped that support from the polio clinic may result in self-selected lifestyle changes, which may positively influence the development of symptoms and functional capacity.

The Swedish Speech Interpretation Service: an exploratory study of a new communication support provided to people with aphasia.

Until recently, people with complex communication needs have had no access to professional interpreters. The Swedish Speech Interpretation Service (SSIS) is attempting to address this problem. This qualitative study reports on how 12 persons with aphasia experienced the services of a professional interpreter from the SSIS. The results are presented in two themes: (a) The purpose of using an interpreter, which addresses issues relating to autonomy, privacy, and burden on family members; and (b) perceptions of quality of service, which addresses issues relating to the skills and professionalism of and accessibility to interpreters. Results highlight the ongoing need for the SSIS and its importance to the participants. The professional interpreter as an augmentative and alternative communication (AAC) "tool" that could be used to enhance the participation of people with aphasia in the community-at large, is also discussed; as is whether relatives and other non-professionals or professional interpreters should interpret for people with aphasia.