Occupational balance and sleep among women

Psychometric properties of the Arabic Occupational Balance Questionnaire (OBQ11-A)

BACKGROUND

Occupational balance (OB) is a desirable outcome of rehabilitation because it is related to various health indices. The Occupational Balance Questionnaire (OBQ) is a self-report measure of occupational balance.

AIMS/OBJECTIVES

To examine the test-retest reliability, participant-level content validity, construct validity, internal consistency, and convergent validity of an Arabic occupational balance questionnaire (OBQ11-A).

MATERIALS AND METHODS

A total of 103 participants were recruited through convenience sampling. Test-retest reliability was examined using intraclass correlation coefficients, participant-level content validity using percentage of agreement in survey questions, construct validity using factor analysis, internal consistency using Cronbach's alpha, and convergent validity by examining associations with quality-of-life.

RESULTS

Intraclass Correlation Coefficient values for the total OBQ11-A scores and individual items were greater than 0.7 between the test and retest. The majority of respondents endorsed the relevance, comprehensiveness, and comprehensibility of the OBQ11-A. Cronbach's alpha for the OBQ11-A total score was 0.899. Nine of the 11 OBQ11-A items had factor loadings greater than 0.7. Moderate associations were found between the total OBQ11-A scores and physical health (n = 101; ρ = .52, p < .001), psychological health (n = 101; ρ = .49, p < .001), social relationships (n = 101; ρ = .36, p < .001), and environmental domains (n = 101; ρ = .57, p < .001) of the quality-of-life measure.

CONCLUSIONS

OBQ11-A demonstrates acceptable psychometric properties for research purposes.

Occupational balance and stroke impact among community-dwelling stroke survivors 65 years or older: a cross-sectional study

INTRODUCTION

Occupational balance has been investigated in different populations but less in stroke survivors. Previous studies have focussed on occupational balance among stroke survivors of working age (15-64 years of age), showing they did not perceive they had occupational balance. There is, therefore, a lack of knowledge of how older stroke survivors perceive their occupational balance. The aims of this study were to describe occupational balance in community-dwelling stroke survivors 65 years or older and to investigate if there were any associations between their perceived stroke impact and occupational balance.

METHODS

A cross-sectional study was performed with 58 stroke survivors, with a median age of 75 years at stroke onset and a median time since stroke onset of 11 months. The participants were recruited from a local stroke register and answered questionnaires on occupational balance and stroke impact. Data were analysed with descriptive statistics, correlations and logistic regression.

RESULTS

The participants had a median score of 29 (min 12 to max 33), indicating a very high occupational balance, a low stroke impact, and a good recovery (median 82.5; min 0 to max 100). An association between participation and occupational balance (OR 1.13; 95% CI 1.04-1.23) was found.

CONCLUSION

The stroke survivors perceived a low stroke impact and a high occupational balance. It is possible that older community-dwelling stroke survivors, of whom many have retired, juggle less occupations leaving them with more time to engage in those occupations they want to, leading to a better occupational balance.

An RCT META analysis based on the effect of tai chi exercise therapy on the outcome of elderly patients with moderate-to-severe sleep disorders-A systematic review study

Background

According to statistics, about one-fifth of the world's elderly people suffer from sleep disorders, and the problem of sleep disorders in the elderly is extremely serious, and this problem is one of the important causes of chronic diseases such as hypertension, hyperlipidemia, diabetes mellitus, and coronary heart disease in the elderly. The positive effect of Tai Chi exercise therapy on sleep problems has been confirmed, but at present, the effect of the specific duration of Tai Chi exercise on the improvement of elderly people with moderate to severe sleep disorders varies.

Objective

META analysis was used to investigate and find that long-term Tai Chi exercise therapy has the best effect on improving sleep in elderly patients with moderate to severe sleep disorders. Methods: META analysis was performed using Revman 5.3 after searching Web of science, Pubmed, Scopus, The Cochroae Library, OVID, CBM, CNKI, VIP, and other databases, and then filtering and extracting.

Results

A total of seven papers were included. Meta-analysis showed that tai chi exercise was more effective in improving sleep problems in elderly patients with sleep disorders compared to the control group, and the difference was significant. This was demonstrated by a decrease in the global Pittsburgh Sleep Quality Index (PSQI) score [SMD = -0.66, 95 % CI (-0.91, -0.41), P < 0.00001], as well as its subdomains of subjective sleep quality [SMD = -0.79, 95 % CI (-1.06, -0.52), P < 0.00001], sleep latency [SMD = -0.80, 95 % CI (-1.21, -0.40), P < 0.00001], sleep duration [SMD = -0.38, 95 % CI (-0.72, -0.04), P = 0.03], habitual sleep efficiency [SMD = -0.58, 95 % CI (-0.84, -0.31), P < 0.0001], sleep disturbance [SMD = -0.51, 95 % CI (-0.78, -0.25), P = 0.00001] and daytime dysfunction [SMD = -0.33, 95 % CI (-0.59, -0.07), P = 0.01]. Improvement was also observed in the Epworth Sleepiness Scale (ESS) and Insomnia Severity Index Scale (ISI). The results showed that the optimal duration and frequency of Tai Chi exercise therapy for improving moderately severe elderly patients with sleep disorders was long-term.

Conclusion

This study systematically assessed the efficacy of Tai Chi exercise therapy for elderly patients with moderate-to-severe sleep disorders. Through a meta-analysis of relevant randomized controlled trials (RCTs), it aims to determine the effectiveness of Tai Chi exercise in improving sleep quality in elderly patients with moderate-to-severe sleep disorders, as well as to compare its effects with those of traditional treatments; to analyze the safety of Tai Chi exercise for this patient population and assess its feasibility as a non-pharmacological therapy; and to fill the research gaps and provide more comprehensive and systematic evidence support. This study provides a practical approach to reducing the risk of medication side effects in older adults with sleep disorders and offers a potentially effective non-pharmacological treatment option, especially for those who are unable or unwilling to use medication. Tai chi exercise may not only improve sleep, but also improve coordination, muscle strength, balance, and reduce stress and anxiety in older adults. It also helps older adults socialize and enhances their social connections and emotional support. This study suggests that community centers or activity centers for the elderly can organize tai chi classes to promote the participation of older adults, and can be used as a scientific exercise rehabilitation tool in clinical treatment, incorporating tai chi practice into daily life, such as tai chi practice at a fixed time every day or every week, which not only helps to improve the sleep disorders of older adults, but also improves their overall quality of life.

Weighted blankets for sleep problems - prescription, use and cost analysis

BACKGROUND

Weighted blankets (WBs) have been suggested as a treatment option for insomnia and are commonly prescribed despite lack of evidence of efficacy.

AIM

To investigate prescription pattern, return rate and cost of WBs.

MATERIAL AND METHODS

This observational cohort register-based study in western Sweden included every individual who, in a 2.5-year period, was prescribed and received at least one WB (n = 4092). A cost evaluation was made by mapping prescription processes for WBs and sleep medication.

RESULTS

Individuals diagnosed with dementia, anxiety, autism or intellectual disability (ID) retained the WB longer than others. Individuals younger than six and older than 65 years had shorter use time. The cost evaluation showed that the prescription process for WBs was longer and resulted in a higher cost than for sleep medication.

CONCLUSIONS

Some individuals had longer use time, indicating a possible benefit from using a WB. Due to low risk of harm but high economic cost, a revision of the WBs prescription process could be recommended to identify those who might benefit from WB.

SIGNIFICANCE

Our result points towards a need for revision of the prescription process, to implement standardized sleep assessments, and create a more efficient prescription process to lower the cost.

A new tool to measure occupational balance: Adolescent Occupational Balance Scale (A-OBS)

BACKGROUND

The concept of occupational balance in adolescents is not clear enough.

AIM

The current study aims at developing a valid and reliable scale to measure occupational balance in adolescents.

METHOD

We conducted online interviews with the participant adolescents via semi-structured interview forms. We applied the Davis technique twice to 10 expert panellists and the test form to 600 individuals. Two weeks later, we re-tested 153 of the participants. We then carried out item analysis to evaluate the internal consistency of the scale. We also conducted explanatory factor analysis (EFA) and confirmatory factor analysis (CFA) to examine the construct validity of the scale.

FINDINGS

The content validity index of the scale was found to be 0.986. EFA showed that the scale consisting of 27 items had a six-factor structure explaining 56.7% of the total variance. Model fit indices about the structure created by factor combination technique in CFA were CMIN/df = 2.135; RMSEA = 0.06; GFI = 0.866; NFI = 0.81, CFI = 0.887, TLI = 0.868; IFI = 0.89. The analysis to test the reliability of the scale resulted in ICC: 0.993 and Cronbach's alpha: 0.997. Pre-test and post-test analyses showed very strong correlational coefficients (p < 0.005).

CONCLUSION

A-OBS is a valid and reliable scale consisting of 27 items and 4 sub-dimensions. It can be used in studies that will focus on occupational balance in healthy adolescents. It is the first occupational balance scale developed for adolescents in the occupational therapy literature. We recommend further studies to validate the scale and adapt it to different languages and cultures.

The Effect of Occupational Engagement on Lifestyle in Adults Living with Chronic Pain: A Systematic Review and Meta-analysis

Background

Healthy lifestyle is important to decrease health risks in individuals living with chronic pain. From an occupational therapy perspective, human health and lifestyle are linked to occupational engagement in meaningful everyday activities. This study is aimed at investigating the effect of including occupational engagement in chronic pain interventions on lifestyle.

Methods

In this systematic review (PROSPERO reg. CRD42020159279), we included randomized controlled trials (RCTs) on interventions involving occupational engagement (i.e., occupational performance based on involvement, choice, positive meaning, and commitment) and assessing modifiable lifestyle factors: physical activity, body anthropometrics, alcohol consumption, smoking, stress, and sleep. We sought the databases Ovid MEDLINE, Embase, PsycINFO, CINAHL, Cochrane, Scopus, Web of Science, OTseeker, ClinicalTrials.gov, OpenGrey, and the web engine Google Scholar and citations and references of relevant publications. We evaluated methodological quality with the Cochrane risk-of-bias tool 2.0, determined the overall evidence certainty using the GRADE methodology, and performed meta-analysis when two or more trials reported on the outcomes.

Results

Of the 9526 items identified, 286 were full text screened. We included twelve articles with eleven RCTs comprising 995 adults and assessing physical activity, sleep quality, stress, and Body Mass Index. Sufficient data for meta-analysis was only available for physical activity and sleep quality. The meta-analysis suggested a moderate increase in physical activity after behavioral interventions for fibromyalgia and musculoskeletal pain (SMD = 0.69 (0.29; 1.09)) and a small increase in sleep quality up to 6 months after multidisciplinary self-management of fibromyalgia (SMD = 0.35 (95% CI 0.08; 0.61)). The overall certainty of the evidence was deemed low.

Conclusion

Including occupational engagement in chronic pain interventions may increase short-term physical activity and long-term sleep quality. Due to the few available RCTs including occupational engagement in chronic pain treatment for adults living with chronic pain, further high-quality RCTs are needed and will likely change the conclusion.

The impact of COVID-19 restrictions on occupational balance: A mixed method study of the experience of Australian occupational therapists

Introduction

COVID‐19 has seen unprecedented changes to the daily occupational lives of citizens across the globe as a result social and physical restrictions. Frontline healthcare workers health and wellbeing have been impacted but what of occupational balance? The aim of this study was to investigate if there was a change in the occupational balance of occupational therapists working in a metropolitan hospital during a COVID‐19 lockdown.

Methods

All occupational therapists working in a metropolitan hospital were invited to participate in an online survey. Occupational Balance was measured using the Occupational Balance Questionnaire‐11 (OBQ11). Participants retrospectively rated their occupational balance before COVID‐19 restrictions were in place and again rated their current status during the restrictions. Participants were also asked to comment on strategies used to help them during the COVID‐19 restrictions.

Results

Forty‐two occupational therapists completed the survey. The mean total score prior to the COVID‐19 restrictions was 19.4 and during restrictions was 19.0 (Z = −0.4, p = 0.68). There was a significant decrease in having sufficient to do during the COVID‐19 restrictions (Z = −3.6, p < 0.001). Satisfaction with how time was spent in rest, recovery and sleep significantly increased during the restrictions (Z = −3.3, p = 0.001). Strategies used included engaging in valued activities, finding alternate ways of doing and showing gratitude.

Conclusion

Occupational balance of occupational therapists remained high and satisfaction in how time was spent improved during COVID‐19 restrictions. Occupational therapists implemented their own theoretical approach of adaptation to cope with the COVID‐19 restrictions.

Translation and initial validation of the occupational balance questionnaire to Arabic—Occupational Balance Questionnaire-A

Introduction

Occupational balance (OB) is related to many health indicators, including quality of life. The Occupational Balance Questionnaire (OBQ11) was developed to measure OB, and to date, no Arabic translations of the questionnaire exist. The aim of the study was to describe the translation process of OBQ11 to Arabic and to evaluate its content validity, internal consistency, construct validity, and convergent validity.

Methods

OBQ11 was translated to Arabic (OBQ11-A) following standard guidelines. Content validity feedback was obtained from ten Arabic-speaking occupational therapists and in a cognitive debriefing with seven volunteers. In addition, OBQ11-A and the Family Quality of Life Survey-2006 were administered to 67 Arabic-speaking participants from a larger study about OB among parents.

Results

High level of agreement was found on the content of OBQ11-A from the occupational therapists. Cognitive debriefing interviews indicated that OBQ11-A was easy to understand. Cronbach’s alpha for the total OBQ11-A score was 0.864 indicating good internal consistency. Exploratory factor analysis showed acceptable factor loadings for all items. The total scores showed positive statistically significant associations with Family Quality of Life Scores ( r = 0.561, p < 0.001).

Conclusions

OBQ11-A may prove useful for assessing OB in Arabic-speaking populations. Further research is needed to establish its reliability.

Occupational Health among Swedish Occupational Therapists: A Cross-Sectional Study

The Swedish public sector is facing great challenges in recruiting and retaining healthcare professionals, due to increasing sick leave numbers. The aim of this study was to describe Swedish occupational therapists’ occupational health in terms of risk factors in the social and organizational work environment, occupational balance, and work-related mental health problems. A web survey was emailed to all working members of the Swedish Association of Occupational Therapists (n = 7600) and 3658 answered the survey. The web survey included questions on sociodemographic characteristics, social and organizational environment, occupational balance, and work-related health. The occupational therapists in general rated their workload as high, which was described as leading to increased stress, difficulties doing a good job, and increased job turnover. They also reported having difficulties maintaining occupational balance. Almost a fifth reported having symptoms related to mild incipient exhaustion or a pronounced exhaustion disorder. Almost 60 percent reported having, during the last year, seriously considered seeking new employment as an occupational therapist and 35 percent had seriously intended to leave their profession. In conclusion, there is an urgent need to improve the work situation of occupational therapists. If not, increases in mental health problems, sick leave and job turnover rates may seriously jeopardize the welfare system by eroding healthcare.