Examining the Shift in Occupational Identity after a Brain Injury

Occupational identity is defined by Kielhofner (2002) as a sense of who we are as an occupational being, based on our past, current, and future occupational roles. When a life disruption occurs such as a brain injury (BI) and the disruption impacts the ability to conduct an occupation deemed meaningful an important process of transition occurs (Muenchberger, Kendall, & Neal, 2008). In turn occupational identity may shift to reflect the current health and economic status of the individual and what occupations are judged as meaningful. The current study examined the shift in occupational identity in BI survivors in a two part mixed methods study. Study 1 involved a qualitative analysis of occupational identity and participant’s description of the process underscoring the shift in occupational identity. Nine BI survivors were interviewed and data were analyzed by the use of grounded theory methodology. Study 2 involved the administration of the Occupational Performance and History Interview-II (OPHI-II) reviewed by brain injury survivors for the purposes of the current study. The OPHI-II was administered to 16 BI survivors to ascertain the difference between survivors who returned to paid or unpaid work and those who did not return to work. Results of Study 1 indicated survivors articulated a process which unfolded after the BI occurred and was impacted by occupational choices. The process, marked by the comparison of self to others, involved gaining an awareness of limitations, grappling with the negative BI label, and finally disconnecting into a BI lifestyle. Study 2 analyses found BI survivors who returned to work scored higher on the occupational identity scale compared to those who did not return to work. There was also a correlation found between the OPHI-II scales (Occupational Identity, Occupational Competence, and Occupational Settings). Suggesting that BI survivors can re-develop an occupational identity upon the re-engagement in occupational roles and there is a relationship between the development of occupational competence and occupational identity and the occupational environment