Graduation Year

2019

Document Type

Capstone Project

Project Type

Qualitative Study

Degree Name

Master of Science in Occupational Therapy

Program

Occupational Therapy

Program Chair

Julia Wilbarger, PhD, OTR/L

Faculty Advisor

Karen McCarthy, PhD, OTR/L

Abstract

Purpose: In 2016, there were 22.5 million refugees worldwide (UNHCR, 2017). California resettled just over 5,000 of those 85,000 (Igielnik & Krogstad, 2017). Limited research has been conducted in the United States (U.S.) focusing on the refugee experience; furthermore, there is a significant gap in research regarding the impact of the refugee experience on the occupations of refugees as they transition to living in the U.S. Smith (2012) explored the adaptation of cultural weaving among Karen refugees to maintain their previous occupations and the impact of daily weaving on their lives within Western culture; however, the study focused only on work occupations. This study sought to capture the experience of refugees and the impact of their transition on a broad array of occupations. Adding to occupational science literature regarding the occupational impact of the refugee experience, as well as aiding in addressing issues of occupational justice (Townsend, & Wilcock, 2004).

Methods: This research was a qualitative-descriptive, phenomenological study. Data was collected through semi-structured interviews. Questions were guided by Person-Environment-Occupation model (Law, et al., 1996) and Transitions Theory (Blair, 2000), to address personal and cultural values, environments where occupations are performed, and occupational patterns to identify changes in meaningful occupations due to the refugee process. Participants have legal status as refugees, have been in the U.S. between one and five years, resettled in Northern California, are at least 18 years old and were not required to speak English. As this study aimed to capture a broad experience of transition and limit confounding factors influencing how the participant responded to changes in occupations, participants could be of any ethnicity, country of origin, or gender. Two participants were recruited through snowball sampling. Interviews were audio taped and transcribed. Interviews were coded using Thematic Analysis to generate common themes across cases (Braun & Clarke, 2006). Rigor was strengthened through member checks and peer review.

Findings: Through analysis of the interviews, the researchers found five major themes: contextual barriers, internal factors, adaptation, belonging, and transition. The first four themes form a loop and influence each other both positively and negatively and, ultimately, affect engagement in occupations. Transition is the theme that envelops and influences the whole. Using these five themes, the researchers developed the Transition-related Effects on Refugee Occupations (TERO) Model. Key findings include that refugees may experience more meaning and role change/loss in their occupations, rather than adoption of new occupations. Additionally, the researchers found social network to be important for positive occupational engagement throughout country transition.

Implications: As occupational therapists, the tendency towards working with refugee populations may be to focus on their transitions to new occupations. However, data from this study indicates that it may be more pertinent to address role and meaning change/loss in current occupations.

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