“Lived experiences of Malaysian adults with visual impairments: A comparison between the Kawa Model and the Canadian Model of Occupational

Performance”

A Bachelors Thesis Presentation

Prepared by:

Teoh Jou Yin (Matric. No. A 118729)Final year undergraduate, Occupational Therapy Programme,Faculty of Health Sciences, Universiti Kebangsaan Malaysia.

Under supervision of:

Pn. Saraswathy Venkataraman (Universiti Kebangsaan Malaysia)Pn. Siti Arbi Kamso (Universiti Kebangsaan Malaysia)Dr. Michael K. Iwama (University of Toronto, Canada)

ABSTRACT

The lived experiences of Malaysian adults with visual impairments have not known to be widely explored, particularly from an occupational therapy point of view. In this pilot study using qualitative methods adapted from narrative inquiry, phenomenology and ethnography, two occupational therapy frameworks, the Kawa Model and the Canadian Occupational Performance Measure (representative of the Canadian Model of Occupational Performance) are applied to elicit the narratives of lived experience from five (n=5) randomly selected Malaysian adults of various age, race and religious backgrounds to determine what this specific population regards as being important to them. The findings show that besides the life activities of work, education, leisure activities and community management, Malaysian adults with visual impairments also regarded self worth, being able to live life on their own terms, concerns that develop alongside typical life processes as well as social factors (social activities and social environments) as being important to them. The findings also provide a basis of comparison as to the effects of applying different frameworks can influence the focus of occupational therapy on a specific population. Each framework has their strengths and limitations and can be used complementary to one another for a more overall comprehensive approach. In order for occupational therapy to be truly relevant and applicable to a specific client population, we must consider holistically their life perspectives embedded within the context surrounding them.

CHAPTER ONE

INTRODUCTION

CHAPTER TWO

LITERATURE REVIEW

CHAPTER THREE

METHODOLOGY

STUDY LOCATION: BRICKFIELDS

INSTRUMENTATION

RESEARCH

FL0WCHART

CHAPTER FOUR

FINDINGS

CHAPTER FIVE

DISCUSSION

CHAPTER SIX

CONCLUSION

What is important to people with visual impairments:

Not just activities that they want and need to do everyday,

But also dynamic interactions that influence decision making processes and motivations behind their actions.

Influences originate from various sources:

Social environments, past experiences, values, beliefs, attitudes and principles, etc.

Kawa Model acknowledges and captures dynamic interactions.

COPM focuses exclusively on performance of activities.

In order for occupational therapy to be truly relevant and applicable to a specific client population, we must consider holistically their life perspectives embedded within the context surrounding them.

Ideally, both frameworks can be used complementary to one another for a more overall comprehensive approach.

References  Alexis, J. (2007) How to do guerrilla research. www.businesspov.com AOTA. (2008). Occupational Therapy Practice Framework: Domain & Process 2nd Edition. American Journal of Occupational Therapy, 62(6): 625-682.Bachelder, J. M., Harkins, D. (1995) Do occupational therapists have a primary role in low vision rehabilitation? The American Journal of Occupational Therapy, 49(9): 927-929.Baum, C. M., & Christiansen, C. H. (2005). Person-environment-occupation- performance: An occupation-based framework for practice. In C. H. Christiansen, & C. M. Baum (Eds.), Occupational therapy: Performance, participation, and well-being (3rd ed.). (pp. 242-266). Thorofare, NJ: SlackBlakeney, A. B., & Marshall, A. (2010). Water Quality, Health, and Human Occupations. American Journal of Occupational Therapy, 63(1), 46-57.Brace, M., Herriotts, P., Mccullagh, A., & Nzegwu, F. (2007). Why research -- what research should be done?: report of a collaborative workshop in the UK to discuss social research priorities on visual impairment. British Journal of Visual Impairment, 25(2): 178-189.Bolt, D. (2005). From Blindness to Visual Impairment: Terminological Typology and the Social Model of Disability. Disability & Society, 20(5): 539-552.Carey, K. (2002). The colour of sound and the soundness of colour The colour of sound and the soundness of colour. British Journal of Visual Impairment. 20(2): 80-83Chiang, P. P. C.; Keefe, J.E. ; Le Mesurier R. T. ; Taylor, R. (2006). Global burden of disease and visual impairment. The Lancet, 368(9533): 365-366.Chapparo, C., & Ranka, J. (1997). The Occupational Performance Model (Australia): A description of constructs and structure. NSW: Monograph1Christiansen, C. H., Baum, C. M., & Bass- Haugen, J. (2005). Occupational therapy: Performance, participation, and well-being (3rd ed.). Thorofare, NJ: Slack.Cleveland, P. M. (2008). Be Unreasonable. Knock on the Big Doors. Knock Loudly! American Journal of Occupational Therapy, 62(6): 737-742.Colendrander, A., Fletcher, D. C., (1995) Basic concepts and terms for low vision rehabilitation. The American Journal of Occupational Therapy, 49(9): 865-869.Copolillo, A., & Teitelman, J. L. (2000). Acquisition and integration of low vision assistive devices: understanding the decision-making process of older adults with low vision. The American journal of occupational therapy. 59(3): 305-13.Depoy, E., & Gitlin, L., (2005) Introduction to research: understanding and applying multiple strategies (3rd ed.) Missouri: Elseiver-Mosby Duckett, P., & Pratt, R. (2007). The emancipation of visually impaired people in social science research practice. British Journal of Visual Impairment, 25(1): 5-20.Dunn, W., Brown, C., McGuigan, A. (1994) The ecology of human performance: a framework for considering the effect of context. American Journal of Occupational Therapy 48(7): 595-607

Fearing, V. G. & Clark, J. (2000) Individuals in context: a practical guide to client-centred therapy practice. NJ: Slack.Fourie, R. J. (2007). A qualitative self-study of Retinitis Pigmentosa. British Journal of Visual Impairment, 25(3): 217-232.Franits, L. E. (2005). Nothing about us without us: searching for the narrative of disability. The American journal of occupational therapy. 59(5): 577-9.Franks, J. (2000). Blindfolds Off : The Current State of Rehabilitation. British Journal of Visual Impairment, 18(1): 19-25.Iwama, M. (2003) The issue is … Toward culturally relevant epistemologies in occupational therapy. The American Journal of Occupational Therapy, 57(5): 582-588Iwama, M. (2006) The Kawa Model; Culturally Relevant Occupational Therapy, Edinburgh: Churchill Livingstone-Elsevier Press.Jones, D. (2006). Voices of experience Coping with sight loss : Getting used to glaucoma. British Journal of Visual Impairment. 24(44): 44-45.Kielhofner, G. (2002) A Model of Human Occupation: Theory and application (3rd ed.). Baltimore: Williams & Wilkins.Kielhofner, G., (2004) Conceptual foundations of occupational therapy (3rd ed.). Philadelphia: F. A. Davis CompanyKielhofner, G. (2005). Rethinking disability and what to do about it: disability studies and its implications for occupational therapy. The American Journal of occupational therapy. 59(5), 487-96.KL Vision 2011 (2010) http://www.klvision.org.my Kronenberg F., Algado S. S. & Pollard N. (Eds.), Occupational therapy without borders: Learning from the spirit of survivors. Philadelphia: Elsevier.Law, Mary; Polatajko, Helene; Pollock, Nancy; Mccoll, Mary Ann; Carswell, A. B. (1994). Pilot Testing of the Canadian Occupational Performance Measure: Clinical And Measurement Issues. Canadian Journal of Occupational Therapy, 61(4), 191-197.Maley, T. (2005). Voices of experience: Growing up with retinoblastoma. British Journal of Visual Impairment, 23(2): 92-94.Meads, C. (2003). What is the cost of blindness? British Journal of Ophthalmology, 87(10): 1201-1204.Nelsen D. (1988) Occupation: form and performance. The American Journal of Occupational Therapy, 42(10): 633-641.Pepper, W. (2006). Voices of experience Growing up with Sorsby’s Fundus Dystrophy. British Journal of Visual Impairment, 24(1): 40-43Roberts, AEK; Drew, James A., Moreton, S; Thompson, R. & Dickson, M. (2008). Measuring occupational performance and client priorities in the community: The COPM. International Journal of Therapy and Rehabilitation, 15(1): 22-30.Rosenthal, S. B. (1995) Living with low vision: a personal and professional perspective. The American Journal of Occupational Therapy, 49(9): 861-863.Saleh, G. M. (2004) Consent of the blind and visually impaired: a time to change practice. British Journal of Opthalmology. 88(2): 310–311.Schieman, M. (2002) Understanding and Managing Vision Deficits: A Guide For Occupational Therapists. NJ: Slack.Schieman, M., Schieman, M., Whittaker (2007) Low vision rehabilitation: a practical guide for occupational therapists. NJ: SlackScheinholtz, Marian K. ; Warren, Mary; Nobles, Linda Baker; Sokol-McKay Debra; Grover, L. (2004). Occupational Therapy Services for Individuals With Visual Impairment. American Occupational Therapy Association. Taylor, R. R. (1990). Can the social model explain all of disability experience? Perspectives of persons with chronic fatigue syndrome. The American Journal of occupational therapy. : official publication of the American Occupational Therapy Association , 59(5): 497-506.Teitelman, J., & Copolillo, A. (2005). Psychosocial issues in older adults' adjustment to vision loss: findings from qualitative interviews and focus groups. The American journal of occupational therapy: official publication of the American Occupational Therapy Association , 59(4): 409-17. Tenberken S. & Kronenberg P. (2005). The right to be blind without being disabled. In F. Kronenberg, S. S. Algado, & N. Pollard (Eds.), Occupational therapy without borders: Learning from the spirit of survivors (pp. 1–13). Philadelphia: Elsevier.

Warren, M. (1995) Including occupational therapy in low vision rehabilitation. The American Journal of Occupational Therapy, 49(9): 857-859.Wilcock A. (1993) A theory of the human need for occupation. Journal of Occupational Science (Australia), 1(1): 17-24.World Health Organisation (2006). FIFTY-NINTH WORLD HEALTH ASSEMBLY. Prevention of avoidable blindness and visual impairment. World Health Organisation, (April),. 59-61

THE END