title: Understanding decision-making towards housework among women with upper limb repetitive strain injury.
abstract: BACKGROUND
  Among women with upper limb repetitive strain injury (RSI), occupational therapy interventions include education to facilitate ergonomic practices in housework. From a client-centred perspective, an understanding of women's decision-making about housework is needed to design effective occupational therapy programmes. This study addresses a gap in research in this area by exploring women's views about changing housework habits.
  
  
  OBJECTIVE
  The aim was to construct a conceptual representation to explain decision-making in housework by drawing on experiences of a sample of Singapore Chinese women with upper limb RSI from one hand therapy clinic.
  
  
  METHODS
  Based on a constructivist grounded theory methodology, data were collected through in-depth interviewing with 15 women. Interviews were audiotaped and transcribed. Data were analysed with line by line coding, focussed coding and axial coding with constant comparison throughout data collection.
  
  
  RESULTS
  Decision-making in housework among these women involved three main themes: (i) emotional attachment to housework; (ii) cognitively informed decision; and (iii) emotionally influenced decision. Women with upper limb RSI had to make cognitive decisions for or against a change in housework to manage their condition. However, the women's cognitively informed decisions were shaped by their emotional attachment to housework. As such, they experienced strong emotional barriers to changing their housework practices even when they had cognitively accepted the necessity and possibility of making a change.
  
  
  CONCLUSIONS
  Therapists need to be aware that counselling to address the emotional barriers experienced by women is important during ergonomic education.
authors: Occupational Therapy Department, Singapore General Hospital, Singapore, Singapore.
authors: Therma W C
authors: TW
authors: Cheung
authors: Ageing, Work & Health Research Unit, The University of Sydney, Drummoyne, NSW, Australia.
authors: Lindy
authors: L
authors: Clemson
authors: Ageing, Work & Health Research Unit, The University of Sydney, Drummoyne, NSW, Australia.
authors: Kate
authors: K
authors: O'Loughlin
authors: School of Health and Social Development, Deakin University, Geelong, Vic., Australia.
authors: Russell
authors: R
authors: Shuttleworth
mesh_terms: D000368:Aged; D012090:Cumulative Trauma Disorders / Q000523:psychology / Q000534:rehabilitation*; D003657:Decision Making; D006804:Ergonomics / Q000379:methods; D005260:Female; D006796:Household Work / Q000379:methods* / Q000592:standards; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D009788:Occupational Therapy / Q000379:methods / Q000592:standards*; D010353:Patient Education as Topic; D018802:Patient-Centered Care / Q000379:methods / Q000592:standards*; D036301:Qualitative Research; D012846:Singapore; D014930:Women / Q000523:psychology*
keywords: behavioural change; ergonomic education; housework; occupational therapy; upper limb RSI