The adaptation process after acquired brain injury

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In daily life, people normally experience a harmonious interaction with the environment in the performance of daily occupations. This interaction is, however, commonly changed when a person acquire a brain injury (stroke or TBI) and a need of adaptation occurs. The adaptation may take place through increasing ability, change in evnrionmental demands and/or in own expectations in daily occupations. Adaptation can be viewed as a short term or long term process or as an adaptive system in which different parts interact in order to obtain functioning and wellbeing in daily life. In this project different aspects of adaptation in daily occupation are examined. One project focuses adaptation in form of occupational gaps. Another project focuses adaptation in form of recapturing self care after neurological injury and a third project fouceses the long term adaptation process of elderly people participating in home rehabilitation after stroke.

Project leader

Kerstin Tham, PhD, Professor


Lena von Koch, professor, PhD; Jörgen Borg, Professor, Rehabilitation medicine, Uppsala Akademiska hospital; Anders Kottorp, PhD; Brittmari Uppgard, M.sci.

Doctoral students

Gunilla Eriksson, Lisa Ekstam, Anette Eriksson, Susanne Guidetti.


1) To identify when, where and how people with acquired brain injury, and their close relatives, adapt in daily occupations in their new life situation,

2) To describe the lived experience of adaptation in daily occupations,

3) To develop and evaluate assessment instruments measuring aspects of adaptation.


In this project different designs and methods are used. In some studies a longitudinal design with both quantitative and qualitative methods are used. Another study is based on data from questionnaires included in a survey and a third study is based on data from interviews, which are analysed using different qualitative approaches.

Long term goals

To develop the theoretical basis for evidence based rehabilitation interventions after acquired brain injury.

Financial support

National scientific board, Vardal Foundation, SLL, CfV, National research school in healt care sciences.

Publications in the project

Tham, K., Borell., L., & Gustavsson, A. The discovery of disability: A phenomenological study of unilateral neglect. (2000). The American Journal of Occupational Therapy, 4, 398-406.

Guidetti, S. & Tham, K. (2002). Therapeutic strategies used by occupational therapists in self-care training: A qualitative study, Occupational Therapy International, 9, 257-276.

Tham, K., & Kielhofner, G. (2003). Impact of the social environment on occupational experience and performance among persons with unilateral neglect. American Journal of Occupational Therapy, 57, 403-412.

Eriksson, G., Tham, K., & Fugl-Meyer, A.R. (2005). Couples happiness and its relationship to functioning in everyday life after acquired brain injury. Scandinavian Journal of Occupational Therapy, 12: 40-48.

Johansson, U., & Tham, K. (2006). The meaning of work after acquired brain injury. American Journal of Occupational Therapy, 60-69.

Eriksson, G., Tham, K, & Borg, J. (2006). Occupational gaps in everyday life one to four years after acquired brain injury. Journal of Rehabilitation Medicine, 00:1-7.

Erikson, A, Karlsson, G., Borell, L. & Tham, K. (in press). The lived experience of memory impairment in daily occupation after acquired brain injury  One year of rehabilitation. OTJR: Occupation, Pariticipation and Health.

Guidetti, S., Asaba, E, & Tham, K (accepted). The lived experience of recapture self care after stroke or spinal cord injury. (American Journal of Occupational Therapy).

Ekstam, L., Uppgard, B., von Koch, L, & Tham, K (accepted). Functioning in everyday life after stroke: A longitudinal study of elderly people receiving rehabilitation at home. (Scandinavian Journal of Caring Sciences)

Occupational Therapy