MEANINGFUL ACTIVITIES OF CHILDREN WITH MITOCHONDRIAL DISORDER 77 3 These findings can be used in daily practice because they provide greater understanding of the children’s experiences and motivations to participate in everyday activities. The wants and needs and experiences of the interviewed children can be related to the self-determination theory (SDT). This theory proposes that people perform activities to fulfil three basic psychological needs: autonomy, competence and relatedness (Deci and Ryan 2000, 2008). Autonomy refers to volition through self-organised experiences that are consistent with a sense of self (Deci and Ryan 2000) and fits with the theme ‘I want to meet up with others whenever I want to’ and ‘I do not want to’. For example, it is clear that the children wanted to feel autonomous when they expressed their experience as ‘Because I can decide by myself’. Competence is believing that one can efficaciously interact with human and non-human environments, and it was apparent in the theme ‘I want to be able to’, with, for example, the sub-theme ‘Because I can do it on my own’. Additionally, the theme ‘How I feel about being helped’ showed that support was accepted when it supported competence. This finding fits with the SDT that states competence is one of the factors that enhances intrinsic motivation (Poulsen et al. 2006; Ryan and Deci 2000; Deci and Ryan 2008). Relatedness refers to the presence of support, warmth and affection through connections with others (Deci and Ryan 2000). It links to the theme ‘I want to meet up with others whenever I want to’ and, for example, the subtheme ‘It is more fun to do things with other people’. Although the theme ‘Dream’ does not have an obvious link to autonomy, competence or relatedness, it can still relate to the way it influences the intrinsic motivation of the child to work towards her/his dreams and goals. Therefore, the SDT and the children’s perspectives identified in this research help us understand the deeper meaning of why children choose to perform or avoid certain activities. Knowledge about the motivation to perform or avoid activities can be used by people who are involved in children’s everyday lives, including parents, teachers and health professionals. Parents, teachers and children do not mention the same goals for occupational therapy intervention. Costa et al. (2017) compared these goals and showed that whereas parents and teachers are mainly focused on the occupational performance area productivity, children mention goals in all three areas: productivity, personal maintenance and leisure. This finding fits within the large scope of activities performed by children with a mitochondrial disorder, which was already known (Lindenschot et al. 2018) and expanded in the current study. Further, the current findings revealed reasons for performing activities, for example, to have fun with others, experience the ability to do something on their own or because something happens that makes it worthwhile. These reasons were also
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