Deriving an Occupational Profile From Older Adults’ Reflections

PURPOSE: This poster describes qualitative findings from a Retirement Research Foundation grant entitled “Testing an Occupation-Based Cultural Group Intervention for Residents in Long-Term Care Settings” to demonstrate the development of occupational profiles from interview data with older adults.

METHOD: This study used a mixed methods repeated measures design with pre, post, and 1-mo follow-up measures. Four long-term care settings were recruited, and participants within each site were randomized in blocks of six at a 50:50 ratio to either the control or treatment group. The qualitative tradition used to elicit the lived experiences of these older adults was phenomenological. Methods for the qualitative portion of the study included administering the Life Narrative/Cultural Heritage Interview Guide, developed and tested by the research team in previous studies, resulting in 18 transcripts that were analyzed by team members and then entered into NVivo (QSR International, Melbourne, Australia), a qualitative software package for organization, sorting, and analysis of nonnumerical data.

RESULTS: The sample included 21 participants (66.7% female) who demonstrated mild depression, low physical health scores, and average mental health scores on the SF–12; the intervention group tended toward less education than the control group. For the qualitative interviews, 18 transcriptions were entered verbatim into NVivo (Baseley & Jackson, 2013). Three resident interviews were incomplete and were not included in the analysis.

Being able to respond to the questions asked in the Life Narrative/Cultural Heritage Interview Guide allowed the participants to reflect on their cultural heritage, challenges, and strengths during the time of relocation to their new setting. Their responses were insightful and demonstrated an articulated awareness of their own adaptive skills. Themes that emerged were organized into three categories: person, environment, and occupation. Person themes included positive memories of childhood and strengths derived from living in rural areas, experiencing the Depression years, and a sense of resiliency and humor. Environment themes included experience of the setting, staff, and other residents; balance of the losses and benefits of being “in this place”; and presence of family support. Occupation themes included various life roles, pride in their work, leisure activities past and present, and current social participation. We developed client cases with occupational profiles to illustrate information that can be included to describe a client’s personal interests and values and occupational history.

CONCLUSION: This study demonstrated ways to develop occupational profiles on the basis of rich data in older adults’ life stories. Occupational therapy practitioners can demonstrate the importance of client narratives by using qualitative interviews in practical ways to develop client-centered interventions, share with other health care workers the value of clients’ lives, and communicate with clients the strengths and opportunities within themselves they can tap into to enhance their quality of life.

References

Bazeley, P., & Jackson, K. (2013). Qualitative data analysis with NVivo. London: Sage.

Hersch, G., Hutchinson, S., Davidson, H., Wilson, C., Maharaj, T., & Watson, K. B. (2012). The effect of an occupation-based cultural heritage intervention in long-term care: A two-group control study. American Journal of Occupational Therapy, 66, 224–232. https://doi.org/10.5014/ajot.2012.002394

Hutchinson, S., Hersch, G., Davidson, H. A., Chu, A. Y.-M., & Mastel-Smith, B. (2011). Voices of elders: Culture and person factors of residents admitted to long-term care facilities. Journal of Transcultural Nursing, 22, 397–404. https://doi.org/10.1177/1043659611414138

Kirchen, T. M., & Hersch, G. (2015). Understanding the person and environment factors that facilitate veteran adaptation to long-term care. Physical and Occupational Therapy in Geriatrics, 33, 204–219. https://doi.org/10.3109/02703181.2015.1037979

Kirchen, T., Hersch, G., & Pickens, N. (2014). Occupational engagement of veterans in LTC: Testing the effectiveness of a military cultural intervention. Physical and Occupational Therapy in Geriatrics, 32, 321–335. https://doi.org/10.3109/02703181.2014.939801