Coming to terms with the shift in one's capabilities: a study of the adaptive process in persons with poliomyelitis sequelae

PURPOSE: The main purpose of this paper was to investigate the process of adaptation in persons with poliomyelitis sequelae with reference to daily occupations. In addition, changes in ability in activities in daily living (ADL) and in the use of assistive devices over a 4-5 year period will be described. METHOD: Qualitative interviews with 22 persons with poliomyelitis sequelae were content analysed according to grounded theory. Ability in personal and instrumental ADL was assessed. RESULTS: The core category 'coming to a changed approach' towards the shift in one's capabilities describes two integrated processes: one deals with the process of realization and reorganization; the other consists of six patterns of behaviour in daily occupations. The persons had a high degree of independence in personal ADL, whereas the dependence in cleaning, shopping and transportation was extensive. CONCLUSIONS: Flexibility in choosing strategies facilitated participation in daily occupations. Requirements for this adaptive pattern were time, energy and ability to solve problems, accessible environments, access to information and support, and readiness to compensate with assistive devices.