The Redesigning Daily Occupations (ReDO)-Program: Supporting Women With Stress-Related Disorders to Return to Work—Knowledge Base, Structure, and Content

Experiences of the Redesigning Daily Occupation programme - a qualitative study among persons with neurological diseases

BACKGROUND

The Redesigning Daily Occupations (ReDO) is a programme targeting persons who need to restructure activities and routines to achieve a healthier balance in everyday life. Issues that often is needed for persons with neurological diseases.

AIMS/OBJECTIVES

To describe how persons with neurological disease experienced the ReDo-programme and to investigate how their occupational patterns and fatigue changed during the programme.

MATERIAL AND METHODS

A mixed method study with a convergent parallel design including ten participants. Questionnaires and individual semi-structured interviews have been used and data analysed by descriptive statistics and thematic analysis.

RESULTS

The findings indicated an increased participation in everyday life after the intervention. Furthermore, the main theme showed that the intervention enabled reflections and new insight. Sub-themes included: feeling pressured to perform, being part of a group and changing occupational pattern.

CONCLUSIONS

Participants valued being a group; however, they experienced the intensity as being too high. The content of the intervention enabled reflections and new insights regarding their occupational pattern, which was experienced as a starting point towards behavioural changes and re-prioritisation of occupations in everyday life.

SIGNIFICANCE

A modified version with lower intensity and careful goal setting might be valuable for persons with neurological diseases.

Developing and testing the feasibility of a new internet-based intervention-A case study of people with stroke and occupational therapists

INTRODUCTION

Internet-based interventions are called for within rehabilitation to meet the limited access to support for self-management after stroke. Therefore, a new intervention program, "Strategies for Empowering activities in Everyday life" (SEE) was developed. The aim of this study was to explore and describe how clients with stroke and their occupational therapists experienced the SEE intervention process and whether SEE has the potential to promote an active everyday life.

METHODS

A qualitative descriptive case study was designed. Four people with stroke (two of each sex, mean age 66,5 years) and their two occupational therapists (one of each sex) were included. A mix of data collection methods as interviews, assessments, registration forms and fieldnotes was used to uncover the participants' experiences and potential changes. Data were analysed with pattern matching.

FINDINGS

The analysed data formed three categories: "Not being able to take on the internet-based intervention", "Being facilitated in the change process of everyday life through the internet-based intervention", and "Providing a new internet-based intervention is a transition from ordinary practice". These categories included two to four subcategories that reflected aspects of SEE feasibility and acceptability with a focus on content and delivery.

CONCLUSION

The first test of the intervention indicates that the content and delivery of SEE can be feasible and acceptable both for clients and occupational therapists. The findings suggest that SEE has the potential to support clients' self-reflections and their adoption of strategies that influence engagement in daily activities and satisfaction with life in various ways. Further research with large-scale studies is needed.

Occupational therapy and stress-related exhaustion - a scoping review

BACKGROUND

Sick leave due to long-term stress is increasing in Finland and other Western countries. Occupational therapists might contribute to the prevention of and/or recovery from stress-related exhaustion.

AIMS/OBJECTIVES

To describe what is known about occupational therapy for stress-related exhaustion.

MATERIAL AND METHODS

A five-step scoping review included papers published in six databases from 2000 to 2022. Extracted data was summarized to show the occupational therapy contribution within the literature.

RESULTS

There were 29 papers meeting the inclusion criteria, of which a limited number described preventive interventions. Most articles described recovery-oriented occupational therapy with group interventions. The occupational therapists contributed with prevention measures, mostly targeting recovery in multi-professional interventions in terms of stress reduction or return-to-work.

CONCLUSIONS

Occupational therapy involving stress management both prevents stress and supports recovery from stress-related exhaustion. Occupational therapists internationally use craft, nature activities or gardening as stress management measures.

SIGNIFICANCE

Occupational therapy appears to be a potential treatment option for stress-related exhaustion internationally in conditions that could also work in Finland, for example in occupational healthcare.

Resources and transversal competencies to reconcile child and parental responsibilities: A mini-review of the impact of COVID-19 on the Italian sandwich generation

Longer life spans and the delayed economic and psychological independence of children mean that middle-aged parents find themselves caring for parents and children at the same period in their lives, at times this care may extend to grandchildren and grandparents. The type of care varies depending on each person's need but also on the gender of the individual who looks after their parents while taking care of their own children. Cultural factors can also come into play. Complications in the lives of those who are part of the Sandwich Generation (SG) may arise affecting the quality of their time, their psyche, physical and financial situation. Having the necessary skills and strategies to cope with these complications is extremely important.

Validity and Reliability of the Occupational Balance Questionnaire (OBQ11) in a U.S. Sample of Adults With Type 1 Diabetes

IMPORTANCE

Although occupational balance (OB) is a construct of importance to occupational therapy, existing OB assessments have not been validated in clinical populations.

OBJECTIVE

To examine the validity and reliability of the 11-item version of the Occupational Balance Questionnaire (OBQ11) in U.S. adults with Type 1 diabetes.

DESIGN

Data were analyzed from adults with Type 1 diabetes enrolled in a larger longitudinal study examining the relationships among blood glucose, emotion, and functioning. Dimensionality of the OBQ11 was assessed with item response theory (IRT); convergent validity was tested by examining whether associations between the OBQ11 and other constructs were consistent with a priori hypotheses.

SETTING

Three outpatient clinical sites in the United States.

PARTICIPANTS

Data from 208 U.S. adults with Type 1 diabetes were included in the analyses (42% Latino, 29% White, 14% African American, 7% multiethnic, and 8% other).

OUTCOMES AND MEASURES

Assessments administered include the OBQ11, Patient Health Questionnaire (depression), and Diabetes Self-Management Questionnaire.

RESULTS

Overall, results from IRT models and correlational tests supported the reliability and validity of the OBQ11. For instance, higher scores on the OBQ11 were significantly associated with better self-ratings of diabetes management behaviors (r = .28, p < .001), lower depression symptoms (r = -.53, p < .001), and greater positive affect (r = .32, p < .001). A single-factor generalized partial credit model fit the OBQ11 acceptably well, supporting its unidimensionality.

CONCLUSIONS AND RELEVANCE

The OBQ11 may be a reliable and valid measure of OB appropriate for use in clinical populations such as adults with diabetes. What This Article Adds: OB is not often formally assessed by occupational therapists in the United States, even though the contributions of OB to health and well-being are core components of the philosophy of occupational therapy. The current evidence supports the validity of the OBQ11 in a clinical population of adults with Type 1 diabetes and demonstrates significant associations between OB and health management behaviors. Study results may encourage greater consideration and assessment of OB in occupational therapy clinical practice in the United States.

Taking control of one's everyday life - a qualitative study of experiences described by participants in an occupational intervention

BACKGROUND

Sick leave due to stress-related ill-health is increasing and is often caused by occupational imbalance. These types of issues tend to affect both the ability to work and cope with everyday life, as well as the overall experience of health, negatively. There is still little knowledge on how to prepare people and workplaces for the return-to-work process after participation in a work rehabilitation program due to stress and occupational ill-health. Therefore, this study aimed to describe what is needed to achieve a balanced everyday life that includes paid work as experienced by individuals who had participated in a ReDO® intervention due to occupational imbalance and ill-health.

METHODS

The concluding notes from 54 informants' medical records were used for qualitative content analysis. The informants had participated in an occupational therapy group intervention to promote occupational health and regain full work capacity.

RESULTS

The analysis resulted in one major theme and four categories describing how the informants perceive that they must take control of their everyday life as a whole. By doing so, they need to work with structurization and prioritization, social interaction, boundary setting, and occupational meaningfulness.

CONCLUSION

The study indicates a highly relational process, where it is impossible to divide life into private and work, and presupposes balance in everyday life in multiple dimensions. Its contribution includes the formulation of perceived needs in the transition between intervention and return to work and could, through further research, be used to generate a more effective and sustainable return- and rehabilitation models.

Occupational value outcomes among people with mental health issues participating in activity-based interventions - The importance of internal and external factors

BACKGROUND

Perceived occupational value is an important treatment outcome but is still relatively unexplored as a phenomenon.

AIM

To evaluate whether the Balancing Everyday Life (BEL) intervention for people with mental health issues was effective compared to Standard Occupational Therapy (SOT) regarding improvement on three dimensions of occupational value (concrete, socio-symbolic and self-reward), and how internal factors (self-esteem and self-mastery) and external factors (sociodemographics) were related to occupational value.

METHODS

The study was a cluster RCT (n = 226) and used self-report questionnaires on three occasions (baseline = T1, completed intervention = T2, six-month follow-up = T3).

RESULTS

No differences between the groups were seen in occupational value change scores. Within-group analyses (T1-T3) indicated a change in the BEL group on concrete value and self-reward value. No change was indicated in the SOT group. Associations showed that self-esteem and self-mastery were correlated with all three aspects of occupational value. Having children was negative for experiencing occupational value, whereas having a friend was positive. None of the correlates could predict changes in occupational value.

CONCLUSION

Self-related factors appeared to be integral in occupational value.

SIGNIFICANCE

Since occupational value is essential for a meaningful life, therapists should consider such factors and peer support when supporting people with mental health issues.

Daily life coping-Helping stress-afflicted people manage everyday activities

BACKGROUND

Symptoms of stress are widespread in the working population and associated with long-term sickness absence and poor work functioning. Occupational therapy (OT)-based interventions are effective in improving return-to-work (RTW)-rates in stress-afflicted long-term sickness benefit beneficiaries (SBBs). No Danish standard on OT-RTW for stress-afflicted SSBs exists.

AIMS

To describe and evaluate the feasibility of a seven-week OT-RTW intervention for stress-afflicted SBBs.

MATERIALS AND METHODS

Daily Life Coping (DLC) utilizes peer-learning and salutogenetic perspectives to address occupational imbalances experienced by long-term SBBs. Stress-afflicted SBBs (n = 54) in the municipality of Hilleroed were enrolled. Self-efficacy and well-being were measured before and after intervention using the general self-efficacy (GSE) scale and WHO-5 Well-Being Index (WHO-5). RTW-rates were measured at one-year follow-up. Participant feedback was collected using standardized evaluation forms.

RESULTS

Following the intervention, WHO-5 improved by 13.7 ± 16.5 points and GSE improved by 4.3 ± 4.8 points. Participant feedback was positive. At one-year follow-up, employment status data were available for 51 SSBs of these 58.8% achieved employment. High post-test GSE and WHO-5 scores were associated with employment at follow-up.

CONCLUSION

DLC led to significant improvements in self-efficacy and well-being. Preliminary results indicate benefits on RTW-rates.

SIGNIFICANCE

This study provides evidence of the feasibility of DLC in a municipal setting.

How does ReDO®-10 work? Understanding the mechanisms of action of an intervention focused on daily activities and health from the perspective of participants

Evaluation of a complex healthcare intervention should include careful exploration of the mechanisms through which it brings about change. This paper describes a qualitative evaluation of the Redesigning Daily Occupations (ReDO®-10) programme as it was implemented for the first time with women with stress-related issues in a primary care setting in Ireland. The ReDO®-10 is a 10-week group intervention designed to support participants make changes to their daily activity patterns to have a more satisfying and balanced daily life. Fourteen women were interviewed after completing the programme. The aim was to explore changes that participants perceived they experienced and to understand how the content of ReDO®-10 was thought to bring about this change (if it did). Directed content analysis was used to analyse the qualitative data using the Behaviour Change Wheel and Theoretical Domains Framework as a coding framework. Overall, four BCW functions of ReDO® -10 were identified: Education, Persuasion, Modelling and Enablement. Participants described improved belief in their own capabilities, knowledge and goals around life changes. Many behaviour changes were also described, particularly in relation to doing more restorative activities in daily life. Behaviour change techniques that were identified as important for change were practicing new, restorative occupations in group sessions and as homework and the use of self-analysis activities to understand the relationship between activities and health for these participants. Modelling, support and other effects of group dynamics were also vital in changes that occurred.

The BELE program: The development of a holistic interdisciplinary health-promoting program enhancing work-life balance among female employees working in human service organizations in Sweden

BACKGROUND

Despite an increase in work-life balance literature, the development of successful support to help employees manage their work -life balance is slow. Moreover, there are few interventions with a comprehensive approach to workplace health promotion focusing on work-life balance.

OBJECTIVE

This paper aims to present the development and building blocks of a holistic interdisciplinary health-promoting program, the BELE program, to enhance female employees working in human service organizations health and well-being with a focus on work-life balance.

METHODS

The planning and development of the program was done through an intervention mapping and research circles methodology.

RESULTS

The planning- and development process of the program resulted in a theoretical framework, and a program structure with a program content. The intervention program was named "The Balance in Everyday Life Empowerment program" (BELE program).

CONCLUSIONS

The BELE program adds to the existing body of work-life balance knowledge, so far often based on a conflict approach. Interventions focusing on a comprehensive approach to health and work-life balance with a salutogenic approach are rare. Furthermore, the integration with occupational therapy and health promotion in a workplace health promotion framework is innovative. In a previous study, the BELE program has shown that it enhances women's well-being and balance in their everyday life.

Occupational Reflection as Intervention in Inpatient Psychiatry

IMPORTANCE

The recovery model in mental health involves person-driven care and informed decision making to enhance engagement in meaningful activities and inclusion in society. To facilitate the recovery process, occupational therapy practitioners must support their clients in understanding how their participation in meaningful occupation is intimately related to their health and well-being.

OBJECTIVE

To explore whether engaging in an occupational reflection intervention on an inpatient psychiatric unit can support the recovery of adults living with serious mental illness (SMI).

DESIGN

Using a phenomenological design, we conducted semistructured interviews to assess whether participation in an occupational reflection intervention supported recovery.

SETTING

An inpatient psychiatric unit at a university medical center.

PARTICIPANTS

We recruited 10 adults living with SMI using purposive sampling.

INTERVENTION

Participants engaged in a structured occupational reflection intervention using the Occupational Experience Profile (OEP). The OEP is a time-use diary that captures respondents' subjective experiences of pleasure, productivity, restoration, and connection in relation to their participation in occupations over 24 hr. Study participants engaged in collaborative analyses regarding their OEP results to explore their subjective experiences in relation to their occupational participation. Outcomes and Measures: Participant self-report during interviews.

RESULTS

Engaging in structured reflection affected participants' experiences of recovery by promoting insight into and awareness of how occupations affect mental health, encouraging positive reframing of occupational experience, and facilitating identification of strategies to support recovery and meaningful participation after discharge. Conclusions and Relevance: Occupational reflection can promote the recovery of adults living with SMI. What This Article Adds: A structured occupational reflection intervention can help adults living with SMI in inpatient psychiatric units to understand the close relationship between their participation in occupations and their health. This process provides valuable insight to clients regarding how to support their recovery through engagement in meaningful occupation.

Exploring risk factors for developing occupational ill health - departing from an occupational perspective

BACKGROUND

Sick leave due to stress-related mental ill health increases in society. In occupational therapy, occupational balance is considered important for experiencing health and well-being. Thus, knowledge regarding occupational balance and occupational value constitute essential parts of occupational therapists' work with people suffering from occupational ill health.

OBJECTIVE

The aim of this study is to analyse the relationships between sociodemographic factors, occupational value, occupational balance and perceived health in people suffering from occupational ill health.

METHODS

In a quantitative cross-sectional study data from a total of 218 individuals were included, 192 women, 22 men and 4 individuals who did not specify their gender. Data were collected by means of surveys prior to an occupational therapy intervention. The instruments used included OVal-pd, OBQ, EQ5D and a sociodemographic questionnaire. Data were analysed using regression and decision tree analysis.

RESULTS

The results show that individuals who experience an imbalance in their everyday life and who have few or no experiences of daily occupations imprinted by socio-symbolic occupational value experienced lower perceived health.

CONCLUSIONS

Low level of experiences of balance in daily life and occupational value seems to be the main risk factors for the development of occupational ill health, rather than sociodemographic factors.

A feasibility study of the Redesigning Daily Occupations (ReDOTM-10) programme in an Irish context

BACKGROUND

Despite high demand, mental health services in primary care in Ireland are underdeveloped. People with mild/moderate anxiety, depression and unspecified psychological distress are frequently seen in primary care settings, mostly by general practitioners (GPs). Occupational therapists have the potential to contribute to service-provision with interventions specially designed for the targeted group e.g. the Redesigning Daily Occupations programme (ReDO-10).

AIMS/OBJECTIVES

This study aimed to explore the feasibility of a future RCT of the ReDO-10 programme in Ireland and the contextual factors that would influence future implementation.

MATERIAL AND METHODS

Using a multi-phase, mixed-method design, qualitative and quantitative data were gathered from key stakeholders: ReDO-10 participants (n = 10), GPs (n = 9) and occupational therapists (n = 2). Acceptability, satisfaction, cultural fit and demand were explored, as well as methodological issues such as appropriateness of recruitment methods, outcome measures and randomization.

RESULTS

ReDO-10 was acceptable to participants who reported improvements in their occupational patterns and valued the group-based format. GPs and occupational therapists welcomed the intervention, but acknowledged the limitations of time and resources in the Irish primary care context.

CONCLUSIONS

ReDO-10 is feasible to explore in a future RCT in Ireland and this study provides important context for future implementation and/or research.

Effectiveness of Balancing Everyday Life (BEL) versus standard occupational therapy for activity engagement and functioning among people with mental illness - a cluster RCT study

BACKGROUND

Many with a mental illness have an impoverished everyday life with few meaningful activities and a sedentary lifestyle. The study aim was to evaluate the effectiveness of the 16-week Balancing Everyday Life (BEL) program, compared to care as usual (CAU), for people with mental illness in specialized and community-based psychiatric services. The main outcomes concerned different aspects of subjectively evaluated everyday activities, in terms of the engagement and satisfaction they bring, balance among activities, and activity level. Secondary outcomes pertained to various facets of well-being and functioning. It was hypothesized that those who received the BEL intervention would improve more than the comparison group regarding activity, well-being and functioning outcomes.

METHODS

BEL is a group and activity-based lifestyle intervention. CAU entailed active support, mainly standard occupational therapy. The BEL group included 133 participants and the CAU group 93. They completed self-report questionnaires targeting activity and well-being on three occasions - at baseline, after completed intervention (at 16 weeks) and at a six-month follow-up. A research assistant rated the participants' level of functioning and symptom severity on the same occasions. Non-parametric statistics were used since these instruments produced ordinal data.

RESULTS

The BEL group improved more than the CAU group from baseline to 16 weeks on primary outcomes in terms of activity engagement (p < 0.001), activity level (p = 0.036) and activity balance (p < 0.042). The BEL group also improved more on the secondary outcomes of symptom severity (p < 0.018) and level of functioning (p < 0.046) from baseline to 16 weeks, but not on well-being. High intra-class correlations (0.12-0.22) indicated clustering effects for symptom severity and level of functioning. The group differences on activity engagement (p = 0.001) and activity level (p = 0.007) remained at the follow-up. The BEL group also improved their well-being (quality of life) more than the CAU group from baseline to the follow-up (p = 0.049). No differences were found at that time for activity balance, level of functioning and symptom severity.

CONCLUSION

The BEL program was effective compared to CAU in terms of activity engagement. Their improvements were not, however, greater concerning other subjective perceptions, such as satisfaction with daily activities and self-rated health, and clustering effects lowered the dependability regarding findings of improvements on symptoms and functioning. Although the CAU group had "caught up" at the follow-up, the BEL group had improved more on general quality of life. BEL appeared to be important in shortening the time required for participants to develop their engagement in activity and in attaining improved quality of life in a follow-up perspective.

TRIAL REGISTRATION

The study was registered with ClinicalTrial.gov. Reg. No. NCT02619318 .

Viewpoints of working sandwich generation women and occupational therapists on role balance strategies

Occupational therapists need to be cognizant of evidence-based role balance advice and strategies that women with multigenerational caring responsibilities can implement independently or with minimal assistance, as role balance may not be the primary goal during many encounters with this population. Hence, this study aimed to identify the viewpoints on the most helpful role balance strategies for working sandwich generation women, both from their own perspectives and from the perspective of occupational therapists. This was achieved through a Q methodology study, where 54 statements were based on findings from interviews, sandwich generation literature and occupational therapy literature. In total, 31 working sandwich generation women and 42 occupational therapists completed the Q sort through either online or paper administration. The data were analysed using factor analysis with varimax rotation and were interpreted through collaboration with experts in the field. The findings revealed similarities between working sandwich generation women and occupational therapists, particularly in terms of advocating strategies related to sleep, rest and seeking practical assistance from support networks. Differences were also present, with working sandwich generation women viewpoints tending to emphasize strategies related to coping with a busy lifestyle attending to multiple responsibilities. In contrast, occupational therapy viewpoints prioritized strategies related to the occupational therapy process, such as goal setting, activity focused interventions, monitoring progress and facilitating sustainable outcomes.

Working Sandwich Generation Women Utilize Strategies within and between Roles to Achieve Role Balance

Increasingly, women simultaneously balance the roles of mother, parental carer and worker. However, individual role balance strategies among these working 'sandwich' generation women have not been thoroughly explored. Eighteen women combining these three roles were interviewed about their individual role balance strategies. Findings were identified through the framework analysis technique, underpinned by the Model of Juggling Occupations. Achieving and maintaining role balance was explained as a complex process accomplished through a range of strategies. Findings revealed the women used six within-role balance strategies: living with integrity, being the best you can, doing what you love, loving what you do, remembering why and searching for signs of success. The women also described six between-role balance strategies: maintaining health and wellbeing, repressing perfectionism, managing time and energy, releasing responsibility, nurturing social connection and reciprocating. These findings provide a basis for health care providers to understand and potentially support working 'sandwich' generation women.

A longitudinal study of the working relationship and return to work: perceptions by clients and occupational therapists in primary health care

BACKGROUND

The working relationship between client and therapist can be important to enhance outcomes from vocational rehabilitation for women with stress-related disorders in primary health care. The aim was to investigate the working relationship, as perceived by clients and therapists in the Redesigning Daily Occupations (ReDO™) program, and its relationships to return to work and satisfaction with the rehabilitation. Another aim was to compare the ReDO™ group and a "care-as-usual" (CAU) group regarding perceptions of the working relationship with the social insurance officer.

METHOD

Forty-two ReDO™ clients and 42 matched controls receiving CAU participated. The study included four measurements (baseline, after 16 weeks rehabilitation and follow-ups after 6 and 12 months). 37 + 37 clients completed. Return to work data was obtained from the Social Insurance Offices (SIO), and the working relationship and client satisfaction were assessed by self-report questionnaires.

RESULTS

The clients rated the working relationship higher than the therapists (mean rating 101.1 vs. 93.9; p < 0.001). The therapists' rating showed a statistically significant association with return to work at the 12-month follow-up, and the clients' perceptions were statistically significantly related to how they rated satisfaction with the rehabilitation received. The ReDO™ and the CAU groups did not differ regarding how they rated the relationship with the SIO officer (mean ratings 83.9 vs. 77; p = 0.189). The working relationship with the SIO officer was not related to return to work, but an association (rs = 0.70, p < 0.001) to client satisfaction at 16 weeks appeared in the CAU group alone.

CONCLUSION

The working relationship as perceived by clients and therapists seemed to be partly separate phenomena, the client perceptions being linked with satisfaction with the rehabilitation and the therapist perceptions with the clients' return to work. The relationship to the SIO officers was of no importance to return to work but was of some significance for satisfaction with the rehabilitation among the CAU clients. Therapists should strive to improve the relationship with clients to whom they feel the relationship is fragile since that might enhance the chances for those clients to return to work.

TRIAL REGISTRATION

Registered at ClinicalTrials.gov (identifier NCT01234961) 2 November 2010.

The use of coaching in occupational therapy: an integrative review

BACKGROUND/AIM

Coaching has been identified as a core enablement skill of occupational therapists. Occupational therapists have begun to embrace the use of coaching as a therapeutic tool to promote client-centeredness in their practice. As the use of coaching becomes more popular it is important to examine and evaluate coaching use in occupational therapy practice to clarify what is meant by coaching and inform future research and practice in this area.

METHODS

An integrative literature review was conducted to examine how coaching is being used by occupational therapists, identify the similarities and differences between coaching interventions and to identify the empirical evidence for the use of coaching in occupational therapy.

RESULTS

The literature search resulted in 24 articles describing 11 different interventions that reported use of coaching methods by occupational therapists with various populations. Similarities among interventions included goal setting, problem solving and an educational component. Differences in the directiveness of the occupational therapist were evident. The level of research evidence for individual interventions ranges from low to moderate.

CONCLUSIONS

Differences are evident in the coaching theories and methods used in occupational therapy. While evidence of effectiveness of these interventions is promising, study designs used to date are vulnerable to bias and have had small sample sizes, limiting the strength of evidence. More research using clear descriptions of the coaching approach and more robust research methods is needed to better inform clinical practice.

Effect of an occupation-focused family intervention on change in parents' time use and children's body mass index

OBJECTIVE. This study explored factors related to changes in the time parents spent with their children with obesity and associated decreases in children's body mass index (BMI) z-scores after an occupation-focused intervention. METHOD. Parents participated in a 1-yr occupation-focused intervention to promote healthy family lifestyles. Data on 40 parents of 22 children with obesity ages 4-6 yr were collected before and after intervention and analyzed using linear and multiple regression methods. RESULTS. Parents increased time spent with their children by an average of 91 min/day. Parents' finances, perceived satisfaction in daily occupations, low BMI, and mastery at inclusion were associated with increased time spent with their children. Mothers' subjective health and high mastery and fathers' perceived occupational value and education explained 67% of the variance in children's BMI z-scores. CONCLUSION. The results indicate important factors to consider in developing interventions that facilitate occupational engagement and health among children with obesity and their families.

A scoping review of time-use research in occupational therapy and occupational science

BACKGROUND

Time use is a defining interest within occupational therapy and occupational science. This is evident through the range of contributions to the disciplinary knowledge base. Indeed it has been suggested that time-use methods are amongst the most established research techniques used to explore aspects of human occupation. However, the extent and nature of such activity in occupational therapy and occupational science has not been examined to date.

AIM

This study sought to map the extent and nature of time-use research in occupational therapy and occupational science journals and the extent to which studies explored the relationship between time-use and health.

METHOD

A scoping review method was used.

RESULTS

Sixty-one studies were included. Scandinavian countries contributed the largest number of studies (n = 16, 26%). While time-use diaries were used most frequently (n = 30, 49%) occupational therapists and occupational scientists have developed a range of data-collection instruments. Forty-nine studies (80%) focused on time-use in clinical or defined population sub-groups. Ten studies (16%) included an empirical examination of the relationship between time-use and health.

CONCLUSION

Future research should examine time-use and health amongst well populations across the lifespan and in different parts of the world.

Women's perceptions of everyday occupations: outcomes of the Redesigning Daily Occupations (ReDO) programme

AIMS

The aim was to (i) assess the outcomes of the 16-week Redesigning Daily Occupations (ReDO) programme for women on sick leave due to stress-related disorders, in terms of occupational value, satisfaction with everyday occupations, and participation level; (ii) investigate the relationships between those outcomes and return-to-work rate.

METHODS

A total of 42 women receiving ReDO and 42 receiving care as usual (CAU) were included in a matched-control study with measurements before and after the rehabilitation. Seventy-eight participated on both occasions. They completed self-report questionnaires regarding the aforementioned outcomes. Return-to-work data were obtained from the registers of the Social Insurance Offices.

RESULTS

Increases in concrete, symbolic, and self-reward values were found in both groups, but no statistically significant difference between the groups was demonstrated. The ReDO group improved more than the CAU group, however, on satisfaction with everyday occupations and participation level. Occupational value, but not satisfaction with everyday occupations, was related to return to work.

CONCLUSIONS

Everyday occupations were shown to be relevant outcomes after work rehabilitation. They could play an important role in future development of profession-specific evidence of occupational therapy. Further support was obtained for viewing occupational value and satisfaction with everyday occupations as theoretically distinct phenomena.

Changes in parents' time use and its relationship to child obesity

OBJECTIVE

The aim was to explore any change in parents' time use together with their children, changes in their perceived occupational value, and its relationship to children's body mass index (BMI) over the course of a one-year occupation-focused family intervention.

METHOD

The study sample consisted of participants in one arm of a randomized controlled trial, involving mothers and fathers (n = 30) of 17 children aged 4-6 years who were considered obese. Data were collected by time-geographical diaries during the intervention and by measuring the parents' occupational value and the children's BMI before and after the intervention.

RESULTS

At the end of the intervention, an increase was shown in the amount of time parents spent together with their children during weekdays (p = .042) and the parents perceived occupational value (p = .013). Children's BMI z-score changed with -0.11 units.

CONCLUSION

Collaboration with parents may be useful in interventions aiming at facilitating a normal weight development among children.