Occupational identity and competence, occupational environment and quality of life among people with paraplegia post neurological rehabilitation

Abstract

Introduction People with paraplegia (PWP) are assumed to achieve community reintegration, return to work and engage in their previous roles and interests following neurological rehabilitation. This study determined PWP’s experience of change in occupational identity, competence and of the occupational environment after discharge from Tshwane rehabilitation hospital and if these variables influenced each other and their Health-related quality of life (HRQoL). Methodology This cross- sectional quantitative study used a demographic questionnaire, European Quality of life 5- dimensions and 3- levels (EQ-5D-3L) tool and the Occupational Performance History Interview- 2nd Version (OPHI II) tools to collect the data in a semi-structured interview from purposefully selected participants. The data were analysed using STATISTICA 13.2; descriptive statistical and inferential statistical results were obtained. Results Most participants' occupational identity and competence were found to be disrupted. Furthermore, the participants' occupational environment was found to be disrupted, creating a hindrance to their occupational performance. Most individuals reported some difficulty in all HRQoL aspects, indicating a lower overall HRQoL. A significant correlation was found between occupational identity and competence and occupational environment while no correlation was found between each of the five HRQoL dimensions and occupational identity, occupational competence and occupational environment. Conclusion The results suggest strengthening occupational therapy services at the primary health care level, so community reintegration is better facilitated, focusing on the re-establishment of occupational identity and competence and accessibility within the environment. The in-patient rehabilitation should not only consider the activities of daily living but also other aspects of one’s occupational identity and competence.