Occupational Therapy Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
School of Health Sciences, University of East Anglia, Norwich, UK.
Disabil Rehabil. 2021 Apr;43(8):1044-1055. doi: 10.1080/09638288.2019.1645889. Epub 2019 Aug 2.
After a stroke, most individuals cannot participate in some of their valued occupations, disrupting their occupational identity. The aim of this interpretive synthesis is to systematically review the existing body of research to develop an understanding of the experience of occupational identity disruption post-stroke.
A systematic review of the literature that included nine electronic databases, reference lists screening and grey literature checking was completed. Ten studies published between January 2012 and October 2018 were included. Meta-ethnography was used for the interpretive synthesis.
A three-staged process model was created. Stage 1 illustrates the four factors involved in occupational identity disruption: "A fragmented and externalized body", "losing control, freedom and independence", "changed social and familial interactions", and "occupational participation loss". Stage two explains the experience of occupational identity disruption: "Occupational identity loss", "a de-valued self", and "threat to identity continuity". Stage three shows the individual's coping strategies: "protecting one's self", "social isolation", and "re-inventing one's occupational self".
Stroke impacts on an individual's occupational identity, compromising the continuity of a stroke survivor's sense of self. However, occupational identity is fluid; this can be used to support individuals to re-invent the occupational self. A conceptual model was developed to support the application of these results in clinical practice.Implications for rehabilitationOccupational identity disruption impacts on stroke survivors' self-value and sense of self continuity.Health care professionals' understanding of stroke survivors experience of occupational identity disruption could contribute to realign stroke survivors and clinicians' rehabilitation goals.Occupational participation and social interaction should be core aspects of stroke rehabilitation.Occupation-focus rehabilitation could provide opportunities for stroke survivors to pursue their desired occupational identity.
中风后，大多数人无法从事一些有价值的职业，从而破坏了他们的职业认同。本解释性综合研究的目的是系统地回顾现有研究文献，以了解中风后职业认同中断的体验。
对包括九个电子数据库、参考文献筛选和灰色文献检查的文献进行了系统回顾。纳入了 2012 年 1 月至 2018 年 10 月期间发表的 10 项研究。采用元民族学方法进行解释性综合。
创建了一个三阶段过程模型。第 1 阶段说明了导致职业认同中断的四个因素：“身体碎片化和外化”、“失去控制、自由和独立”、“社交和家庭互动改变”和“职业参与丧失”。第 2 阶段解释了职业认同中断的体验：“职业认同丧失”、“自我贬值”和“对身份连续性的威胁”。第 3 阶段展示了个体的应对策略：“自我保护”、“社交孤立”和“重塑职业自我”。
中风会影响个体的职业认同，破坏中风幸存者自我连续性的感知。然而，职业认同是流动的，可以用来支持个体重新塑造职业自我。开发了一个概念模型，以支持将这些结果应用于临床实践。
职业认同中断会影响中风幸存者的自我价值感和自我连续性。
了解中风幸存者职业认同中断的体验可以帮助调整中风幸存者和临床医生的康复目标。
职业参与和社会互动应成为中风康复的核心方面。
以职业为重点的康复可以为中风幸存者提供追求理想职业认同的机会。
