Free Health Dissertations - Schizophrenia Is An Example Of A Psychiatric Illness Which Can Become
Schizophrenia is an example of a psychiatric illness which can become chronic and disabling. The effects on occupational performance can get really complex here. Not only are there varying manifestations of the illness with exacerbations sometimes accompanied by ultimate deterioration over time but there is often effects of the medication, substance abuse and disordered living arrangements.
Chronic pain may affect occupational performance by limitation of physical components of the activity in question. Some conditions appear resistant to clear diagnosis. For instance following accidents such as whiplash or back pain following lifting during paid employment there may be long drawn out background litigation and this coupled with difficulties returning to work may have significant effects on occupational performance. Because affected individuals may be young, in paid employment and with families to look after despite the fact that the physical disability may be relatively minor there may be major effects on the activities of daily living, leisure and employment.
Factors facilitating performance
Occupational performance can be split into a number of components: sensorimotor, cognitive integration, cognitive, psychosocial and psychological. In addition the performance cannot be taken out of context.
The individual’s personal characteristics will affect quality of performance. There must be a good fit between the individual’s knowledge, skills and attitudes, the task must be appropriate, contributing to well-being and the environment must be conducive with regard to physical, cultural and social aspects; (Hagedorn, 2001). Context is important (Dunn 1994) for instance it is easy to speak with friends but public speaking is another matter entirely performance nearly always suffering substantially and yet the basics of the task are the same.
The following factors are associated with occupational dysfunction (Hogedorn, 2001) thus their avoidance may enhance performance:
Deprivation of occupation
Occupation alienation (the task seeming pointless)
Occupational imbalance focussing on one aspect to the exclusion of others
Difficulties with relationships and participation
Lack of resources
Negative self-image; expectation or fear of failure
Poor ability to adapt to different roles
The performance itself may be adequate in its component parts but be poor overall since it takes too long to complete.
Ottenbacher describes in Crepeau, 2003 to optimise performance requires an appreciation of the dicstinctions between body systems, impairment, activity and participation defined by the WHO 2001.
To facilitate performance various compensation mechanisms can be utilised. Training in compensatory movements can occur alongside provision of adaptative equipment and environmental adaptation.
An enhancing factor is the purpose and meaning of the task for the participant.
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