Looking to the future

This main theme draws upon the reactions of stroke participants who anticipated their future directions when preparing to cope with a health condition and the therapy processes. Importantly, OTs should seek to understand stroke survivors’ and family members’ health expectations and needs when planning for the future. The theme comprises of the relationship between the clients’ sense of development competencies of body function and skill abilities. These are: future hope in health

expectation, and self-development and encouragement.

5.11.1 Future hope in health expectation

Stroke participants described their health in the future and their long term OT both in hospital and as home-based practice. Individual stroke participants expressed their feelings and the difficult things that they will confront in the future including limitations and predications after replying to the question, ‘How are you going to

sustain your health in the future?’

Kanchana and Thitipan talked about their affected upper limbs and hand functions and their desire for recovery leading to better performance of favourite activities.

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These accounts reveal the positive thinking and hope stroke participants have for their future health, as interpreted in the following interview extracts:

‘I hope to see my hand to be skilful and recover more than this; I want to return to cook food, so that I must be tolerant and continually practise both hospital and home area.’ (Kanchana)

‘I hope to move my hand more than this. I need to draw my ability and care my health, now I quit my drink already.’ (Thitipan)

As demonstrated in the above quotes, there is a powerful sense of hope and expectation in stroke participants. They need to practise hand functions to perform various activities in order to live satisfying and productive lives. Thitipan’s account shows that his consideration of the future included quitting drinking alcohol and turning attention to stroke healthcare. Interestingly one negative health event can lead to positive well-being changes.

Suchart’s was optimistic for the future in logical way. His account reveals a willingness to accept his stroke condition and he estimated that his future health hinged upon what he did today in OT practice. The reasonable ideological thinking of this stroke participant can be seen in his estimate of the skills and limitations of his body function which will respond to long periods of practice, as highlighted in the following interview extract:

‘I think that if I look after my health I can be like this! Presumably, I got energy now around 60%; I must keep this level. But if I boost up to 70%, I profit. I view that my ability can be developed skill even though it is not reaching 100%, but can be possibly up to 10 – 20 % from 60% which will take time.’ (Suchart)

Meanwhile Jirasak’s account expresses the need for an OT-MCS approach to be continually operated in his regional hospital. He thought that OT-MCS is essential to practise and ensure good health. He describes a powerful inspiration from his religious faith reflecting his goal in life. OT-MCS helped him to navigate and

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address his needs and cultural practice for the future, as highlighted in the extract below:

‘I hope to see this new approach in our hospital not only in this period, but I need to practise this approach continually. I want to see my health get better and can go to the temple to make merit and pay homage to the Buddha image.’ (Jirasak)

5.11.2 Self-development and encouragement

This sub-theme presents the positive influence that stroke participants expressed in the sense of self-development and the encouragement of themselves and family members. It shows the emotion of the self-driving force of stroke participants, in relation to their self-development.

Suchart’s account mainly presents a need to develop himself by motivations from OTs and his family. He acknowledged the occupational therapist working to initiate him in the benefits of the OT-MCS approach. His wife is part of the OT-MCS approach and encourages and supports him to practise OT:

‘I think that occupational therapist motivate me to build the understanding and cooperation to participate a new approach including the support from my wife, which leads me to encourage my self-development for the future.’ (Suchart)

Sombat’s account was slightly similar to Suchart’s in the sense that he seemed to appreciate OTs in the use of OT-MCS as they inspired him to think about self- development. He felt warm and confident with their support and the connection of between OT-MCS from hospital to home and environmental settings, as shown in the following section:

‘I think that the new approach is supported by the understanding from therapists to initiate me to practise continually both hospital and home. To be honest, I’m passionate to practise when this programme has been set up at the hospital. I believe that it isn’t only me who enjoys this recovery programme, but also many stroke patients here.’ (Sombat)

As demonstrated in the above quote, Sombat was conscious of there being a positive side to knowing that his friends, living with stroke, were also benefitting from the

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OT-MCS that he had received. Installing OT-MCS influences stroke patients who can then learn and practise with real objects supported by the collaborative team.

However, Apai’s account reflected a slightly different view on an unpredictable future. He said that ‘I’m not sure how far I am going to reach it’. He worries about his recovery and changeable development, which reflects his vision based on his real world, which has changed. He is still however encouraged to develop himself through OT practice for a better health and life. Positive thinking and self-effort everyday and in the long term period are crucial for the development.

‘I encourage myself every day to practise OT and hope to see my ability to recover much more. But I’m not sure how far I am going to reach it. It might take a long time, I will be tolerant because I want to be healthy that’s why I come to practise OT every day and learn new things in my life.’ (Apai)