The impact of flood disaster on occupational engagement among women flood survivors / Ahmad Zaidin Othman

Introduction: Flood disaster is a common natural disaster in Malaysia. The disaster had caused millions of losses in monetary value, life, disruption and difficulties in engaging in occupations especially amongst women. However, to date, the information about which occupations are most or least affected by flood disaster is scarce and limited. Hence, the objective of the study is to determine the overall level of difficulty in engaging in occupations, to determine the most or the least occupation affected among women flood disaster survivors, to identify the significant differences in the level of difficulty in engaging in occupation with demographic variables, and to explore the impact of flood disaster on occupation. Method: The study underwent 4 stages, whereby stage 1 focused on development of the content of the questionnaire, as well as rating and scoring method, involving the survivors and experts. Stage 2 focused on pilot testing of the questionnaire, and stage 3 test the reliability of the questionnaire (test-retest). Stage 4 (main study), used the mixed method study design (concurrent embedded). A total of 131 participants from Kuala Selangor and Kelantan who met the inclusion and exclusion criteria of the study were chosen to participate in this cross-sectional study (quantitative). To identify the level of difficulty in engaging in occupations, a structured questionnaire was developed based on the OTPF (3rd edition). For the qualitative part of the study, 10 participants were interviewed through purposive sampling and the findings were analyzed using IPA method. Results: Descriptive analysis found that most of the women flood survivors (n = 109, 83.20%) had moderate level of difficulty (34% - 66%) in engaging in occupation. The most affected occupation among women flood survivors is ADL, IADL, and work, which have the highest median = 7.00. Number of health problem was found to be the predictive factor for ADL (R2=0.08) and IADL (R2=0.07). Furthermore, total number of flood experienced was the predictive factor for work (R2=0.04). Rest and sleep was the least affected occupations among women flood survivors with median = 4.00, and was found that number of person staying together as the predictive factor (R2=0.09). There is a positive significant relationship in level of overall difficulty with age, number of health problem and total number of flood experience (p < 0.05). One super-ordinate themes “Difficult, yet life must goes on” emerged, describes the experience of survivors which include challenges, and coping strategies. Eight master themes emerged based on the eight component of occupations in OTPF (3rd edition) comprise of ADL, IADL, Rest and Sleep, Work, Education, Play, Leisure, and Social Participation. Conclusion: The impact of flood disaster on women occupations varies across the demographic variables. These findings will assists the government and NGOs to delegate the necessary steps and focuses on major issues (occupations) affecting them, in order to help them build their life after flood and for occupational therapists, to provide the necessary intervention through meaningful and purposeful activity. The questionnaire developed in this study will guide occupational therapists to focus on affected occupations, hence, gain future footing in disaster management. Recommendation can be made by developing a more comprehensive questionnaire on affected occupations on flood survivors.