Caring dynamics as perceived by staff supporting daily occupations for developmentally disabled adults
Irena Dychawy-Rosner MSc, OT, University Lecturer
Lund University Department of Clinical Neuroscience, Division of Occupational Therapy, Lund, Sweden
Department of Health Sciences, Kristianstad University, Sweden
Search for more papers by this authorMona Eklund PhD, Assistant Professor
Department of Health Sciences, Kristianstad University, Sweden
Search for more papers by this authorÅke Isacsson PhD, Associate Professor
Department of Health Sciences, Kristianstad University, Sweden
Search for more papers by this authorIrena Dychawy-Rosner MSc, OT, University Lecturer
Lund University Department of Clinical Neuroscience, Division of Occupational Therapy, Lund, Sweden
Department of Health Sciences, Kristianstad University, Sweden
Search for more papers by this authorMona Eklund PhD, Assistant Professor
Department of Health Sciences, Kristianstad University, Sweden
Search for more papers by this authorÅke Isacsson PhD, Associate Professor
Department of Health Sciences, Kristianstad University, Sweden
Search for more papers by this authorAbstract
Caring dynamics as perceived by staff supporting daily occupations for developmentally disabled adults
This study addresses caring staff experiences of hindrances and help in the support of daily occupations among people with developmental disabilities. Data were collected by means of a questionnaire consisting of open-ended questions about the staff perceptions of their work experiences. The respondents (n=81), corresponding to 94.1% of all care staff employed in a geographically defined care area in southern Sweden, worked in various day activity units supporting the daily occupations of their clients. A constant comparative method of data analysis was used. Staff expressions were classified in two main categories of caring dynamics: an operational level and a managerial level. Four areas were identified at the operational level: encountering realities of practice, attitudes to the clients and work demand, using the potential of knowledge and strategies and applying helping actions to the client. The managerial level included two areas, generalized work strategy and individualized work strategy. It is suggested that to develop the quality of interventions for supporting daily activities among persons with developmental disabilities, efforts should be made to identify caring dynamics as experienced by the caring staff.
References
- 1 Bogdan R & Taylor S. The judged, not the judges. An insider’s view of mental retardation. Am Psychol 1976; 31: 47–52.
- 2 Hume C. What is rehabilitation? In Hume C, Pullen I, eds, 2nd edn. Rehabilitation for Mental Health Problems: An Introductory Handbook. Edinburgh: Churchill Livingstone, 1994: 1–17.
- 3 Dailey WF, Allen GJ, Chinski JM, Veit SW. Attendant behaviour and attitudes toward institutionalized retarded children. Am J Ment Def 1974; 5: 586–91.
- 4 Berryman J, Evans IM, Kalbag A. The effects of training in nonaversive behaviour management on the attitudes and understanding of direct care staff. J Behav Ther & Exp Psychiat 1994; 3: 241–50.
- 5 Rusch FR, Wilson FG, Hughes C, Meal L. Interactions of persons with severe mental retardation and their nondisabled co-workers in integrated work settings. J Beh Modif 1995; 1: 59–77.
- 6 Howard M. Adult training centres – the trainees and their instructors. J Adult Educ 1975; 2: 88–94.
- 7 Seys D, Kersten H, Duker P. Evaluating a ward staff program for increasing spontaneous and varied communicative gesturing with individuals who are mentally retarded. Behav Resid Treat 1990; 4: 247–57.
- 8 Granlund M. Intervention with the multiply impaired child in an integrated setting. Stockholm: Stiftelsen ALA, 1991.
- 9 Göransson K. De liknade varandra men inte mer än andra. Begåvningshandikapp och interpersonellt samspel. (They looked alike, but no more than others do. Intellectual disability and interpersonal interaction). Dissertation. Studies in educational sciences 3. Stockholm HSL Förlag, 1995.
- 10 Bannerman M & Lindsay M. Evolution of services. In Shanley E, Starrs TA, eds, 2nd edn. Learning disabilities. A Handbook of Care. Edinburgh: Churchill Livingstone, 1993: 19–39.
- 11 Walton M. Managing yourself on and off the ward. Oxford: Blackwell Science, 1995: 95–134.
- 12 Schwartzberg SL. Tool of practice: therapeutic use of self. In Hopkins HL, Smith HD eds, 8th edn. Willard and Spackman’s Occupational Therapy. Philadelphia: J. B. Lippincott Company, 1993: 269–274.
- 13 Alvesson M. Organisation: from substance to image. Org Stud 1990; 11: 373–394.
- 14 Ahrne G. Social organisations. Interaction inside, outside and between organisations. London: Sage Publications, 1994.
- 15 Lövgren G, Sandman PO, Engström B, Nordberg A, Eriksson S. The view of caring among patients and personnel. Scand J Caring Sci 1998; 12: 33–41.
- 16 Goodwin VL & Ziegler L. A test of relationships in a model of organisational cognitive complexity. J Org Behav 1988; 19: 371–386.
- 17 Silvester J & Chapman AJ. Asking ‘Why’ in the workplace: Causal attributions and organisational behaviour. Trend Organ Behav 1997; 4: 1–14.
- 18 Baker EL. Managing organisational culture. Manag Rev 1980; 7: 8–13.
- 19 Latour B. The powers of association. In Law J, ed. Power Action and Belief. A new sociology of knowledge? London: Routledge and Kegan Paul, 1986: 264–280.
- 20
Allard-Poesi F.
Representations and influence processes in groups: Towards a socio-cognitive perspective on cognition in organisation.
Scand J Mgmt
1998; 14: 395–420.
10.1016/S0956-5221(98)00018-9 Google Scholar
- 21 Argyris C & Schön DA. Organizational learning II. Theory, method and practice. Addison-Wesley Publishing Company, 1996.
- 22 Prop 1992/93:159. Regeringens proposition. Lag om stöd och service för vissa funktionshindrade. (Framework for public low. Support and Service for Persons with Certain Functional Impairments Act 1992/93:159). Gotab, Stockholm.
- 23 Landstinget Kristianstadslän. Omsorger: Kristianstadsomsorgsdistrikt. Information från sociala nämnden. [Kristianstad County Council. Information from the Department of Social Care: Kristianstad care district], 1993.
- 24 Grossman HJ (ed). Classification of mental retardation. Washington DC: American Association on Mental Deficiency, 1984.
- 25 Strauss AL. Qualitative analysis for social scientists. Cambridge: Cambridge University Press, 1987.
- 26 Corbin J. Qualitative data analysis for grounded theory. In Chenitz WC Swanson JM, eds. From practice to grounded theory. Addison–Wesley Publishing Company, 1986; 91–101.
- 27 Miles MB & Huberman AM. 2nd edn. Qualitative Data Analysis. London: Sage Publications, 1994.
- 28 Stern PN. Grounded theory methodology: Its uses and processes. Image 1980; 12: 20–23.
- 29 Reid DH & Whitman TL. Behavioral staff management in institutions: a critical review of effectiveness and acceptability. Anal Intervent Dev Disabil 1983; 3: 131–149.
- 30 Eklund M & Hansson L. The ward atmosphere of a psychiatric day care unit on the basis of occupational therapy: Characteristics and development during a 5-year period. Nord J Psychiatry, 1996; 50: 117–125.
- 31 Peloquin SM. The patient–therapist relationship in occupational therapy: Understanding visions and images. AJOT 1990; 44: 13–21.
- 32 Dahlberg K. Qualitative methodology as caring science methodology. Scand J Caring Sci 1995; 9: 187–191.
- 33 Kvale S. The social construction of validity. In Gottfries I, Persson BEB, eds, Humaniora och medicin. [The Humanities and Medicine]. Lund: Studentlitteratur, 1996: 252–275.
- 34 Glaser BG. Theoretical sensitivity. The Sociology Press: University of California, 1978.
- 35 Goffman E. Asylums. Essay on the social situation of mental patients and other inmates. Penguin: Harmondsworth, 1961.
- 36 Alaszewski A & Ong BN. From consensus to conflict: the impact of sociological ideas on policy for people with mental handicap. In Baldwin S, Hattersley J, eds. Mental Handicap: Social Science Perspectives. London: Tavistock/Routledge, 1999: 1–11.
- 37 Mosey AC. Psychosocial components of occupational therapy. New York: Raven Press, 1986.
- 38 Benner P. From novice to expert. Excellence and power in clinical nursing practice. Addison-Wesley Publishing Company, 1984: 47–93.
- 39 Schön DA. The reflective practitioner. How professionals think in action. Great Britain: Arena, 1983.
- 40 Jensen UJ. Sjukdomsbegrepp i praktiken [Conception of Illness in Practice]. Esselte Studium, 1983.
- 41 Waerness K. Omsorgsrationalitet. Reflexioner över ett begrepps karriär. In Eliasson R ed. Omsorgens skiftningar; begreppet, vardagen, politiken, forskningen. [Shifts in Care. Concept, everyday reality, policy, research]. Lund: Studentlitteratur, 1996: 203–220.
- 42 Eliasson R. Perspectives and outlooks in social science research. In Eltzinga A, Nolin J, Pranger R, Sunesson S, eds. In Science We Trust? Lund: University Press, 1990; 256–271.
- 43 Dychawy-Rosner I, Eklund M, Isacsson Å. Direct care staff’s need for support in their perceived work role in day activities units. J Nurs Manag 2000; 8: 39–48
- 44 Coyle D & Northway R. Promoting health: the challenge for the community learning disability nurse. Ment Health Care 1999; 7: 232–235.
- 45 Hagedorn R. Occupational therapy. Foundations for practice. Models, frames of reference and core skills. Edinburgh: Churchill Livingstone, 1992: 41–53.
- 46 Sharpton WR & West MD. Severe and profound mental retardation. In Laughlin PJ, Wehman P, eds. Developmental disabilities. Boston: Andover Medical Publishers, 1992: 16–29.
- 47 Burke RJ. Sources of managerial and professional stress in large organisations. In Cooper CL, Payne R, eds. Causes, coping and consequences of stress at work. Chichester: John Wiley & Sons Ltd, 1988: 77–114.
- 48 Walsh JT, Taber TD, Beehr TA. An integrated model of perceived job characteristics. Organ Behav Hum Perform 1980; 25: 252–267.
- 49 Parkington JJ & Schneider B. Some correlates of experienced job stress: a boundary role study. Acad Manag J 1979; 22: 270–281.
