Bartlett Chelsea, Hughes Julie L, Miller Laura
Australian Catholic University (ACU), Brisbane, Australia.
Br J Occup Ther. 2022 Apr;85(4):241-250. doi: 10.1177/03080226211020656. Epub 2021 May 27.
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a poorly understood, highly stigmatised health condition that has widespread impacts on the individual. Currently, there is limited understanding of the ME/CFS experience from an occupational perspective within Australia. This study aimed to explore the lived experience of ME/CFS and subsequent disruption to occupational participation for adults living in Australia.
Using descriptive case study design, five participants with ME/CFS in Australia completed semi-structured interviews. Reflexive thematic analysis was used to analyse the qualitative data.
Themes identified were organised using the Person-Environment-Occupation model. Participants reported systemic changes to previous levels of physical, cognitive and affective functioning, resulting in significant occupational disruption and poor well-being. Occupational prioritisation was followed by a loss of occupations starting with leisure, then productivity and eventually self-care. Environmental barriers to participation included stigma and misunderstanding of ME/CFS, financial hardship, lack of appropriate health services and strains on personal support networks and relationships.
Changes to occupational performance following the onset of ME/CFS caused significant occupational disruption and resulted in limited participation which narrowed over time. There is a clear role for occupational therapy to intervene early to prevent significant negative impacts on occupational participation for people with ME/CFS.
肌痛性脑脊髓炎/慢性疲劳综合征(ME/CFS)是一种人们了解甚少且备受污名化的健康状况,对个人有着广泛影响。目前,在澳大利亚,从职业角度对ME/CFS经历的了解有限。本研究旨在探索澳大利亚成年ME/CFS患者的生活经历以及随后职业参与受到的干扰。
采用描述性案例研究设计,对澳大利亚五名ME/CFS患者进行了半结构化访谈。运用反思性主题分析法对定性数据进行分析。
所确定的主题依据人-环境-职业模型进行组织。参与者报告称,其身体、认知和情感功能水平较之前出现了系统性变化,导致职业受到严重干扰且幸福感较差。职业优先级排序之后是职业丧失,首先是休闲活动,接着是生产活动,最终是自我护理。参与的环境障碍包括对ME/CFS的污名化和误解、经济困难、缺乏适当的医疗服务以及个人支持网络和人际关系的压力。
ME/CFS发病后职业表现的变化导致职业受到严重干扰,参与受限且随着时间推移范围缩小。职业治疗在早期进行干预,对预防ME/CFS患者职业参与受到重大负面影响方面有着明确作用。