Date Presented 03/27/20
One-third of the survey respondents reported engaging in new leisure activities after stroke, as a response to lifestyle change. These new leisure activities represented a greater emphasis on physical, mental, and spiritual health, supported by family and friends. During client-centered goal-setting, OT practitioners may consider incorporating new leisure activities to promote health for stroke survivors.
Primary Author and Speaker: Yen-Pu Liao
Additional Authors and Speakers: Chinyu Wu
Contributing Authors: Chia-Yi Lee
PURPOSE: Assisting clients in engaging in meaningful occupations is the ultimate goal of occupational therapy (OT). Information for client-centered goal setting is commonly derived from the clients’ occupational history. However, some stroke survivors participate in new leisure activities, which is a piece of information that may not reflect in their occupational history. Few studies have addressed new leisure activities after stroke. Hence, the prevalence, types of new leisure activities, and the subjective experience remain unknown. The purposes of this study were: (1) to investigate the prevalence and types of new leisure activities among stroke survivors; (2) to gain understanding of stroke survivors’ subjective experience in the formation of new leisure activities.
DESIGN: This was a cross-sectional survey study, with a mixed-methods design that collected both quantitative and qualitative data. Participants were recruited from an outpatient OT clinic at a medical center in Taipei city between November 2017 and July 2018. The inclusion criteria were: (1) a diagnosis of ischemic or hemorrhagic stroke; (2) a duration of more than six months post stroke; and (3) capable to comprehend written or verbal instructions involved in the study.
METHOD: A total of 51 participants were interviewed face-to-face by a senior occupational therapist. The research instruments of the study included a demographic sheet and the Leisure Participation Questionnaire (LPQ). The latter consists of 31 leisure activities commonly participated by community-dwelling elderly people in Taiwan. The study participants responded if they engaged in any LPQ activities one year before the stroke onset and three months prior to the interview. New leisure activities were identified if the participant engaged in an LPQ activity in recent three months but not before the stroke onset. The senior occupational therapist then further explored participant’s subjective experience of engaging in new leisure activities. Descriptive statistics were used to report demographic characteristics of the study participants, as well as results of the LPQ. Content analysis was used to categorize subjective experience of participation in new leisure activities.
RESULTS: One-third of the participants (17 out of 51) reported participating in one to four new leisure activities (mean: 1.5 activities). Examples of the reported new leisure activities included taking a walk, religious activities, Tai chi or Qigong, using a smartphone or computer, hanging out with friends, going to a movie theater, and playing a musical instrument or singing. The 19 reportedly new leisure activities can be categorized into physical activities, religious activities, social activities, in-home activities, and use of mobile devices. Results of content analysis revealed that most new leisure activities were a result of adjusting to a new lifestyle after stroke. Some of the new activities represented a greater emphasis on physical, mental and spiritual health, while some of the new activities represented a strong support system that participants had from their family and friends.
CONCLUSION: Occupational adaptation for stroke survivors is a process of seeking fit to a new lifestyle after stroke. Preliminary results based on a small sample in this study showed that participants engaged in new leisure activities to promote health after stroke, supported by family and friends. Further research with a larger sample size is needed. When working with stroke survivors, it is important that occupational therapy practitioners consider possible lifestyle change after stroke and incorporate new yet culturally relevant leisure activities that promote health and well-being for the clients.
References
Norlander, A., Carlstedt, E., Jönsson, A. C., Lexell, E. M., Ståhl, A.,... Iwarsson, S. (2016). Long-term predictors of social and leisure activity 10 years after stroke. PloS one, 11(2), e0149395.
Singam, A., Ytterberg, C., Tham, K., & von Koch, L. (2015). Participation in complex and social everyday activities six years after stroke: Predictors for return to pre-stroke level. PloS one, 10(12), e0144344.
