La participación ocupacional como vía de inclusión social en personas con discapacidad física. Analizando la relación entre ocupación, entorno y bienestar.

Student thesis: Doctoral thesis

Abstract

Given the complexity of the concept of disability, which in recent years has evolved into an interactive relationship between health conditions and personal and environmental factors, people with disabilities require the provision of resources so that they can live a full and healthy life. From the perspective of occupational therapy, participation in meaningful activities is key, since it is a powerful tool for the promotion of health, prevention of affective disorders and the secondary consequences of living with a disability. However, this group who needs to participate in activities is living in a physical and social environment full of barriers, which instead of promoting participation fosters isolation and reduction of participation in activities. This scenario is what motivates this study, whose purpose is to explore in detail the relationship between people with physical disabilities, the environment and their occupations to generate tools that are useful for professionals working in the health and social fields and the different agents of change responsible for generating a more inclusive environment. In the first phase of this study, the objective was to measure the influence of having a physical disability on the relation between occupation and well-being and to identify variables that could measure the different dimensions implicit in the occupation. To achieve this, cross-sectional quantitative methodology was used. In the second phase, the objective was to describe the type of supports that people with physical disabilities have when participating in activities, to identify which aspects of the environment, according to this group, facilitate and/or limit participation in activities, and finally to collect their proposals for change so that the environment facilitates participation in activities. To collect the perspective of people with physical disabilities, a phenomenological qualitative methodology was chosen. The conclusions derived from the first phase of this study reaffirm previous research on the relationship between occupation and well-being, concluding that people with physical disabilities who perform a greater number of roles, and with less intensity, who spend more time performing, demonstrate higher life satisfaction. Moreover, in the second phase of the study, a picture of the current care model emerged, which identifies a lack of continuity between health services, more typical of the rehabilitation phase, and social services, more present when the person has returned home. On the other hand, there is a break in the supports that exist in activities that happen in the home, such as activities of daily living, and the lack of them in activities that happen abroad, such as productive and recreational activities. Despite the existence of services aimed at providing support in the home, the family continues to play a very prominent role and, outside of it, the third social sector, especially the specialized associations, is the only one that offers opportunities and support for participation in occupations. Finally, it should be noted that the existing services are based mainly on the biomedical model and therefore have a care character, promoting the stereotype of a person with a physical disability as not being capable and not providing any value to society. As a final contribution, an improvement of the care model is proposed, based on the foundations identified by the participants in the second phase: inclusive education, universal design, integrated care and a person-centered care model.
Date of Award15 Sept 2017
Original languageSpanish
SupervisorSandra Ezquerra Samper (Director) & Jordi Fernandez Castro (Director)

Keywords

  • Human occupation
  • Physical disability
  • Environment

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