Space, Place, and Objects: A Cross-National Study of Environmental Barriers and Enablers that Influence the Self-Care Participation of Disabled Community-Dwelling Older Adults

Background and Significance: Most research about the occupation of self-care focuses on the individual level of performance and/or how technology impacts performance. Yet occupations occur within a sociocultural context that frames how spaces, places, and objects are designed, used, and hold meaning for the individual. Even so, sociocultural aspects of human occupations and environmental design are often barely addressed or missing in current research because these dimensions are usually hidden and taken for granted aspects of participation in occupations. Examining how sociocultural contextual dimensions are salient to human participation in occupations can deepen the study of occupation and inform practice that is “culturally responsive”, incorporating cultural factors and issues into the design and/or modification of spaces, places, and objects of meaning. Aim: The purpose of this study is to identify, compare, and describe, from an occupational and cross-national perspective, the physical and sociocultural enablers and barriers in participants’ environments and contexts that supported or hindered their self-care occupations, specifically: toileting, bathing, and hygiene/grooming. Methodology: This research project is one part of a larger collaborative on-going longitudinal study to do with the impact of home modifications involving researchers in occupational therapy departments from the Karolinska Institutet, Stockholm, Sweden; and the University of Illinois in Chicago. This cross-national study uses a mixed method design being primarily led by a qualitative ethnographic approach and supported and informed by quantitative research methods. The sample consists of approximately 40 persons each in the Stockholm and Chicago sites. All participants are community-dwelling older disabled adults who are experiencing difficulty participating in self-caring occupations that occur in the bathroom. Data were collected between the Fall of 2002 and the summer of 2004. At both sites, qualitative and quantitative data collection used the same standardized and non-standardized instruments on their respective samples concerning demographics, functional abilities, and barriers and strategies related to the performance of self-care occupations performed in the bathroom. Data analyses is currently underway using descriptive statistics, and qualitative analyses for photo and fieldnote data. Results: Results will be ready for presentation at conference