Impact of the social environment on occupational experience and performance among persons with unilateral neglect.
OBJECTIVE
The purpose of this study was to gain an understanding of social environmental influences on occupational experience and performance over the course of rehabilitation of four persons with unilateral neglect.


METHODS
The Phenomenological Psychological Method (Karlsson, 1993) was used to gather and analyze qualitative data on four women over a 4-month period. Four women were interviewed five to seven times each and observed during their rehabilitation process. Analysis focused on how these persons with unilateral neglect experienced and responded to their interactions with others in their everyday lives.


RESULTS
As perceived by the study participants, rehabilitation professionals and relatives demonstrated a sequence of strategies for dealing with and helping the women perform despite their unilateral neglect. The sequence of strategies reflects the changing experience of neglect over time. The strategies used by professionals and family members during the rehabilitation process enabled these women to reclaim and occupy the neglected half of the world. Moreover, the women with neglect learned to incorporate others as extensions of their bodies in order to compensate for their ongoing inability to directly experience the left half of the world.


CONCLUSIONS
The results suggest that it is important for others (e.g., therapists, nurses, or relatives) to understand the client's changing experience of neglect and adjust their support and collaboration accordingly. Occupational therapy intervention for persons with neglect could potentially become more effective by systematically incorporating the kinds of strategies identified in this study. Moreover, therapists could consult with others to increase their understanding and effectiveness in interacting with persons who have unilateral neglect.
Tham
Kerstin
K
Division of Occupational Therapy, Neurotec Department, Karolinska Institutet, Alfred Nobels Allé, 23,141 83 Huddinge, Sweden. kerstin.tham@neurotec.ki.se
Kielhofner
Gary
G
D000368:Aged; D005260:Female; D006801:Humans; D008016:Life Change Events; D008875:Middle Aged; D010468:Perceptual Disorders / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D012931:Social Environment; D013548:Sweden