The experience of occupational identity disruption post stroke: a systematic review and meta-ethnography

Purpose: 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. Methods: 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. Findings: 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. Conclusions: 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.

Automated summary

The experience of occupational identity disruption post-stroke involves factors such as fragmented body, loss of control, changed social interactions, and participation loss. The three stages of this experience include occupational identity loss, de-valued self, and threat to identity continuity. Coping strategies for individuals include protecting oneself, social isolation, and re-inventing one's occupational self.