"The Effects of Culture and Gender on Occupational Therapy Practice for Adults: From Palestinian Therapists' Perspective"

As the occupational therapy profession is rooted in Western ideals, it may encounter complexities in culturally traditional settings like Palestine, especially for adults. This study reveals the challenges faced by occupational therapists in Palestine. A phenomenological qualitative approach was used, interviewing six experienced female therapists using semi-structured interviews. Purposive sampling ensured a diverse participant selection. Thematic analysis revealed several key themes, such as the continuous adaptation to Western practices to fit the Palestinian context, the value of interdependence, and the unique life balance. Results show that cultural and gender norms significantly shape occupational therapy practices in Palestine. The discussion emphasizes the theoretical necessity for cultural sensitivity in occupational therapy, advocating alignment with local values and addressing resource limitations for effective service delivery.

Potential of virtual reality to meaningfully engage adults living with dementia in care settings: A scoping review

INTRODUCTION

Older adults living with dementia in residential aged care homes receive physical care but may have limited access to meaningful engagement. Due to its multimodal and versatile nature, virtual reality (VR) is speculated to be an effective means of meaningfully engaging residents individually and/or in groups. However, there is little evidence regarding its efficacy as a means of meaningfully engaging older adults living with dementia. The objective of this scoping review is to identify and synthesise published research investigating the use of VR technology in promoting the meaningful engagement of older adults living with dementia in residential aged care facilities.

METHODS

A scoping review following Arksey and O'Malley's (2005) established process was conducted and included identifying and selecting relevant studies from seven databases (i.e., AgeLine, CINAHL, Medline, Cochrane, Embase, PsycINFO and Scopus), data charting, and collating, summarising and reporting findings. Two independent reviewers used Covidence and Excel to support data extraction and analysis.

RESULTS

The 20 eligible studies revealed discrepancies in the classification of VR and strengths, weaknesses, opportunities and threats associated with its implementation. Findings indicate that the most influential factor in eliciting meaningful engagement is when VR use facilitates interpersonal interactions and opportunities for human connection.

CONCLUSION

Although VR seems to be a promising medium in engaging older adults living with dementia, the efficacy of implementing VR technology within care facilities should be considered alongside potential environmental enablers and barriers. The apparent strength of implementing VR as a means of encouraging restoration, pleasure and productivity in older adults living with dementia lies in the fact that it creates opportunities for meaningful engagement on social and occupational levels.

Wellness in children's rehabilitation - what does it mean?

PURPOSE

Rehabilitation research on wellness promotion for children and youth with disabilities is limited and tends to narrowly focus on physical aspects of health. An overarching sense of wellness includes multiple, overlapping dimensions (e.g., physical, social, emotional, occupational). This study's main objectives were to explore what wellness means for young people with disabilities, and what contributes to their sense of wellness.

METHODS

A qualitative design involving World Café-style focus groups was used to explore the perspectives of youth with disabilities (14-25 years old, n = 3), parents (n = 6) and healthcare providers (n = 10) on how wellness is understood and addressed at a Canadian children's rehabilitation hospital. Themes were identified through an inductive analysis of focus group transcripts and notes written by participants and research team members.

RESULTS

Having a variety of relationships and social connections, meaningful activity opportunities, becoming as independent as possible, and having stable medical health contributed to wellness for young people with disabilities.

CONCLUSIONS

Rehabilitation care can promote wellness by co-creating personalized care pathways across multiple wellness dimensions with young people with disabilities and their families, focusing on strengths rather than deficits, and improving access to a variety of activities and communities.IMPLICATIONS FOR REHABILITATIONRehabilitation professionals in children's rehabilitation have unique, ongoing opportunities to promote and support wellness with young people with disabilities and their families.Rehabilitation professionals can embed personalized, strengths-focused wellness pathways across multiple dimensions into the care of children with disabilities.Helping children and families address barriers to meaningful activities and promoting social connections can foster an overarching sense of wellness.

Changes in Daily Occupations Patterns, Optimism, and Positive Affect During COVID-19 Lockdown

Background. The COVID-19 outbreak caused an initial 2-week lockdown throughout Israel. Purpose. To identify (1) changes in time-usage patterns of daily occupations during the first COVID-19 lockdown, by gender and employment status, and (2) correlations among optimism, positive affect, and daily occupations during the lockdown. Method. In a voluntary, anonymous, retrospective, online cross-sectional survey, 481 participants completed the Life Orientation Test, Positive Affect Questionnaire, and Occupational Questionnaire. Findings. During lockdown, participants spent more time in recreation, rest, and sleep regardless of their employment status, and more women than men lost their employment. Both before and during lockdown, women spent significantly higher percentage of time performing everyday tasks but reported less rest and sleep than men. Recreation was associated with positive affect. Conclusion. The COVID-19 pandemic created a temporary occupational disruption. Although people devoted their time differently, the lockdown forced people to find ways to continue engaging in their occupations.

Caregivers' perspectives on the social and physical environmental factors associated with the play of their children with palliative care needs: A Q methodology study

Children living with palliative care needs are less engaged in play, despite its importance in their lives. The environment may have a crucial role in supporting these children's play. Understanding the importance and impact of environmental factors on children's play is essential to being able to support their participation in play. Data were collected from caregivers (mostly parents) of children living with life-threatening/limiting conditions, who were between 5 and 11 years old. Thirty-nine participants were recruited from two children hospitals and two hospices in Kuwait and in the United Kingdom. The participants' perspectives were explored using Q methodology. By-person factor analysis was used to explore the ranking of each statement. Content analysis was used to analyse the participants' verbal comments. The most important environmental factors were the need for others to share play and get assistance to facilitate play. However, this is not always possible as these conditions, the life-threatening/limiting conditions, may be socially isolating. Children also experience limitations in accessing play resources that match their abilities and meet their play needs. Being aware and responsive to children's play needs is essential for building appropriately supportive play environments for children living with life-threatening/life-limiting conditions.

Intergenerational live-in student programmes for meaningful engagement: Creating cohesive and supportive collectives in aged-care facilities

BACKGROUND AND OBJECTIVES

Older adults in residential aged-care facilities (RACFs) experience segregation from society and face limited opportunities to meaningfully engage on a social and/or occupational level due to various structural and systemic challenges. An occupational therapy-coordinated intergenerational live-in student programme (ILiSP) with allied health students was successfully pioneered across Sydney (Australia) to facilitate ongoing intergenerational contact. We explored how ongoing intergenerational contact influenced meaningful engagement of older adults in RACFs by investigating routinely collected clinical data and exploring stakeholders' perspectives.

RESEARCH DESIGN AND METHODS

We employed a concurrent nested mixed-methods design. Residents' attendance in weekly organisational activities and students' monthly volunteer hour reports were analysed to produce statistics for demonstrating the changes in residents' activity attendance alongside ongoing intergenerational contact. Qualitative data from discussions directed by the nominal group technique (NGT) with staff, management and students, individual interviews with relatives and residents, and narrative clinical documentation were thematically analysed.

RESULTS

The Wilcoxon signed-rank test indicated that residents' activity attendance increased during intergenerational contact. Qualitative data yielded three main themes-interdependence, meaningful engagement, and kinship-all associated with intergenerational contact as part of established ongoing relationships. The NGT highlighted consensus on on-site living for maintaining a cohesive and supportive collective.

CONCLUSION

Despite structural and systemic challenges within RACFs that dissuade community integration, ILiSP created opportunities for students to connect/reconnect residents to new/established networks and to support residents to maintain or re-engage with previous lifestyle preferences. Therefore, ongoing intergenerational contact fostered a cohesive collective in support of the social and occupational needs of residents, which should be capitalised on by policymakers (e.g., the National Aged Care Mandatory Quality Indicator Program) and interested organisations.

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.

Co-designing with adults with acquired neurological disability in the community: a scoping review protocol

INTRODUCTION

Co-designing healthcare research and health services is becoming increasingly prominent. Co-design invites people with disability to leverage their lived experience knowledge to improve service provision, as well as ensuring meaningful and relevant research. Given the emerging nature of the use of co-design with adults with neurological disability, well-defined guidelines on best practice are yet to be developed. The aim of this scoping review is to synthesise available peer-reviewed literature which investigates the use of co-design in research and/or service development with adults who have an acquired neurological disability and live within the community. The findings of this review will help to guide future co-design practice, ensuring people with acquired neurological disability are best supported and engaged in the process.

METHODS AND ANALYSIS

This review will follow methodology proposed by Arksey and O'Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis: Extension for Scoping Reviews. Systematic electronic database searches will be conducted between the years 2000 and 2022, via MEDLINE, CINAHL, PsycINFO, Scopus and Embase. Article screening and selection will follow the five-stage framework of Arksey and O'Malley, using Covidence software to support review of each retrieved article by two independent reviewers. Final selected qualitative and/or mixed-methods studies that meet the inclusion criteria will be charted, data collated, summarised and reported. Thematic synthesis will be applied to the qualitative data extracted from these studies.

ETHICS AND DISSEMINATION

Ethics approval will not be required to conduct this scoping review. It is the authors' intention for the findings of this scoping review to be made available to relevant stakeholders through open-access peer-reviewed publication and disseminated with other healthcare and research networks via translation pieces, including the development of short video summaries and practice resources.

Occupational therapists' application of the Do-Live-Well framework: A Canadian health promotion approach

Background. The Do-Live-Well (DLW) framework is an occupation-focused health promotion approach. Online and in-person DLW educational workshops were offered to encourage occupational therapists to apply the DLW concepts. Purpose. The purpose of this study was to understand workshop participants' experiences of and perspectives on using the DLW framework to support its application in the future. Method. Interpretative description was used to understand workshop participants' perspectives on benefits, facilitators, and challenges of using DLW. Semi-structured interviews were conducted and analysed using a thematic analysis. Findings. Eight themes were identified as follows: (a) environmental factors of practice settings, (b) co-workers' support, (c) DLW enhanced occupational therapy practice, (d) confidence in using DLW, (e) nature of the DLW framework, (f) DLW promoted healthy occupational engagement, (g) DLW was not suitable for everyone, and (h) pandemic effects. Implications. The DLW framework supports occupationally focused practices, and continuous learning support will be needed.

Expanding Occupational Therapy Perspectives with Family Caregivers

Background. Family caregivers are ever-present and crucial collaborators in the work of occupational therapists but are rarely the focus of their efforts. Purpose. This lecture will discuss the greater inclusion of family caregivers in occupational therapy and the exciting possibilities that emerge from this change. Key issues. Family caregivers are a unique client population. This position statement is supported by recent research on occupational therapists’ values and shifts towards an occupational participation approach in the profession. Working with this client population requires a nuanced understanding of their experience. Caregiving can be burdensome, but it can also create positive effects many of which can be identified and understood through a relational lens. Implications. Through a three-fold approach, occupational therapists can work with caregivers to locate and mitigate negative caregiving effects, discover, and build on positive effects, and further develop positive outcomes by encouraging and balancing caregiving and non-caregiving occupations.

The experience of meaning and value in occupations for forced migrants seeking asylum, and factors that facilitate occupational engagement: A meta-ethnography using a strength-based approach

Introduction

Asylum-seekers face significant barriers to meaningful occupation, leading to negative health and wellbeing outcomes. This study provides a strength-based approach to enhance understandings about the meaning of occupation for those seeking asylum.

Method

A systematic search of the literature identified seven qualitative research studies. A meta-ethnographic approach was used to synthesise the findings.

Results

Examination of the selected studies generated three third-order interpretations as follows: keeping busy as a coping mechanism; maintaining continuity with past life by preserving identity, roles, values and culture; and building a new future with a drive to be a productive member of society. The study also identified factors that support meaningful occupational engagement during asylum.

Conclusion

This study shows that occupations are essential to existence for asylum-seekers. They help preserve identity and life-continuity; help people make sense of disorder in their life; and provide opportunity for reflection, leading to motivation toward goal-directed occupation. Finally, engaging in occupation helps people adjust and cope with trauma. The study highlights that a lack of meaningful occupations may limit the long-term benefits of occupational engagement while seeking asylum. Recommendations are made for further research to challenge restrictive policies and promote the rights and wellbeing of this population.

Perceptions, feelings, and the routine of older adults during the isolation period caused by the COVID-19 pandemic: a qualitative study in four countries

OBJECTIVE

To evaluate the knowledge, routine, and perception of older adults from four countries about dealing with COVID-19 in the social isolation period.

METHODS

Qualitative study with semistructured interviews. Older persons (≥60 years old), who lived in the urban centers of four different countries (Brazil, United States, Italy, and Portugal), were asked about the changes experienced during the pandemic, new habits or restrictions during isolation, sources of social and emotional support, and their knowledge about COVID-19 pandemic. Data was transcribed, codified, and submitted to content analysis.

RESULTS

Twenty-five older persons (10 from Brazil, 5 from Italy, 5 from Portugal, and 5 from the United States) were interviewed. Participants reported feeling restricted in their daily life activities and emotional instability. Described adaptations in habits, coping strategies, and greater understanding of the diseased based on information available in the media. There was homogeneity in the statements of the elderly, showing that the pandemic affected them in a similar way, even though they lived in different cultures and contexts.

CONCLUSION

The social isolation caused by the COVID-19 pandemic changed the structure for the performance of many occupations, having an impact in the perception social participation and wellbeing of elders. This data can aid health professionals to outline strategies to deal with the impact of the social isolation in older persons.

Physical activity for a meaningful and purposeful life in typical adults: a cross-sectional study

Abstract Introduction Physical activity is a part of life and an essential element for health and well-being. Investigating the meaning and purpose that physical activity adds to life will guide occupation-based interventions. Objective This cross-sectional study aimed to examine the relationship between physical activity level and meaning and purpose in life in typical adults. Method The study included a total of 300 typical adults (181 female, 119 male). Demographic characteristics of the participants, such as age, gender, and educational status, were recorded. The International Physical Activity Questionnaire, the Life Attitude Profile-Revised, and the Purpose in Life Test were used as measurement tools. Spearman correlation coefficient was used to analyse the relationship between nonparametric variables. Results A weak positive correlation was found between the physical activity total scores, meaning in life sub-scores and total scores (r=0.25, p<0.01), and purpose in life total scores (r=0.16, p<0.01). Conclusion Our findings revealed that people engaging in more physical activity had a sense of meaning and purpose in life. Physical activity must take place in occupational therapy practices as an occupation that adds meaning and purpose to an individual's life. Further research is needed on this subject.

Rheumatic disease and fatigue: Participants' experiences of an activity-pacing group

BACKGROUND

Fatigue is a common symptom of inflammatory rheumatic disease and has a great impact on everyday life. Activity-pacing is proposed as an intervention to increase participation in meaningful activities.

AIMS

To explore participants' experiences with an activity-pacing group, how participants perceived self-managing everyday life after group attendance, and their reflections on unmet needs that could enhance self-management of everyday life with fatigue.

MATERIALS AND METHODS

Semi-structured interviews were conducted with 10 participants who had attended an activity-pacing group. Thematic analyses were conducted.

FINDINGS

Prior to group attendance, the participants expressed an awareness of their lack of knowledge of fatigue. Through group attendance, they increased their understanding of fatigue and their ability to apply strategies to better manage everyday life. Participants found it difficult to balance their energy use and realised that implementing activity-pacing strategies takes time. Therefore, they requested follow-up sessions with the activity-pacing group. They also desire that rheumatologists pay more attention to and acknowledge fatigue.

CONCLUSIONS AND SIGNIFICANCE

Enhancing the understanding of fatigue and how to manage everyday life with fatigue, appears to be important. Group interventions led by occupational therapists and with a focus on activity-pacing may be a suitable approach. Follow-up sessions are recommended.

Exploring well-being services from the perspective of people with SCI: A scoping review of qualitative research

Objective

Well-being after spinal cord injury is affected by a range of factors, many of which are within the influence of rehabilitation services. Although improving well-being is a key aim of rehabilitation, the literature does not provide a clear path to service providers who seek to improve well-being. This study aimed to inform service design by identifying the experience and perspective of people with SCI about interventions targeting their well-being.

Method

The scoping review of qualitative literature used thematic analysis to identify and categorize themes related to service activities, valued aspects, limitations and perceived outcomes.

Results

Thirty-eight studies were selected, related to a range of service types. Most studies did not adopt a well-being conceptual framework to design and evaluate the services. People with SCI particularly valued being treated with dignity, positive expectations, increased autonomy and peer support. Improvements to well-being were reported, including many years post-SCI. However, people with SCI reported limited opportunities to engage in such services.

Conclusions

Rehabilitation services can improve well-being across the lifetime of people with SCI, but gaps in service provision are reported. The review identified valued aspects of services that may inform service design, including staff approach and positive expectations, having own skills and worth valued, peer support and interaction, autonomy in valued occupations, and long-term opportunities for gains.

Building back better: Imagining an occupational therapy for a post-COVID-19 world

INTRODUCTION

The COVID-19 pandemic, which has disrupted occupations and lives of people around the world, has simultaneously exposed deeply rooted social inequities and structural injustices that have negated the facile claim that "we're all in this together." But the pandemic has also opened up opportunities to imagine other ways of living and doing in the future. This paper imagines some possibilities for shaping occupational therapy's future practices and seeks to illustrate why it is both timely and necessary to re-imagine occupational therapy in 2021.

METHODS

Drawing from epidemiological research, the paper explores the inequitable impacts of COVID-19, environmental degradation, and multiple social determinants on people's real opportunities for health, wellbeing, and occupational engagement.

FINDINGS

Evidence presented in this paper challenges occupational therapy's individualised approach towards wellbeing and contests the limited parameters of occupations "that matter" that are prioritised and promoted within the profession. In response, the paper seeks to expose the specific, political, economic, and ableist ideology that has effectively shaped the occupational therapy profession's assumptions, models, theories, and the practices these inform.

CONCLUSION

Drawing from the "Build back better" approach to post-disaster recovery-with its dual attentions to wellbeing, equity, and inclusivity and to physical, social, cultural, economic, and environmental vulnerabilities-this paper imagines an occupational therapy for a post-COVID-19 world; an occupational therapy that takes seriously the premise that occupations and people are inseparable from their environments; a profession that no longer colludes in individualising problems that are inherently social or in depoliticising the systemic social and economic inequalities that create stress and illness; an occupational therapy that no longer promotes the values of neoliberal ableism; and an occupational therapy dedicated to expanding people's just and equitable opportunities to engage in meaningful occupations that contribute positively to their own wellbeing and the wellbeing of their communities.

Acting as Change Agents: Insight Into Québec Occupational Therapists' Current Practice: Actions menées à titre d'agents de changement : aperçu des pratiques actuelles parmi les ergothérapeutes du Québec

BACKGROUND.

Change agents' actions have been studied mainly from a theoretical perspective.

PURPOSE.

This study aimed to empirically identify occupational therapists' actual change agent actions.

METHOD.

As part of a research partnership with the Canadian Association of Occupational Therapists-Québec chapter, we conducted this cross-sectional pilot study using an online survey.

FINDINGS.

The change agent practices of our 103 participants involve many types of actions but show underinvestment in mass communication. Mass communication actions are more frequent when participants have greater experience, additional academic degrees, and training in change agency. Also, occupational therapists with additional academic degrees and change agency training tend to use a wider variety of actions. Finally, our participants' actions principally target actors in the clinical context, rarely political actors.

IMPLICATIONS.

Our results suggest that occupational therapists can and will invest in the full range of change agent actions provided they can acquire the necessary knowledge and skills.

Catching sight of well-being despite a stress-related disorder

BACKGROUND

Stress-related disorders cause suffering and difficulties in managing occupations and relationships in everyday life. A previous study of women with stress-related disorders, who photographed well-being and talked about the photographs in interviews, showed that moments of well-being still exist but further knowledge is needed about their perceptions of participating in such a study.

AIM

To describe how people with stress-related disorders experience taking photographs related to well-being in everyday life and reflecting on and talking about these photographs.

MATERIAL AND METHODS

Twelve women, 27-54 years with stress-related disorders were recruited from primary healthcare centres. They participated in interviews based on the photographs and qualitative content analysis was used.

RESULTS

One theme 'catching a glimpse of and momentarily capturing well-being' and four categories were identified: 'Photographing moments of well-being visualizes well-being', 'Using photographs could either facilitate or complicate the narrative', 'Changing perspective in everyday life' and 'Creating recollections of well-being'.

CONCLUSIONS AND SIGNIFICANCE

Introducing a focus on well-being in everyday life despite living with a stress-related disorder might contribute a valuable complement to stress rehabilitation for occupational therapists and other health professionals. Using photographs as a basis for reflections about everyday life and health/well-being also seems positive for this group.

Health and support service needs of individuals with disability from culturally and linguistically diverse backgrounds: a scoping review protocol

BACKGROUND

All individuals should have the right to engage meaningfully in occupations that meet their aspirations and life goals as well as promote their health and well-being. For individuals with disability, meaningful engagement in occupations is supported by timely, effective, and adaptive health and support services. However, research has revealed multiple barriers preventing utilization of these services by individuals with disability from culturally and linguistically diverse (CALD) backgrounds. This review aims to identify gaps and solutions in health and support services of individuals with disability from CALD backgrounds to meaningfully engage in occupations.

METHODS

A scoping review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews. A detailed search strategy will be used to search CINAHL, PubMed, Embase, Scopus, PsycInfo, JBI, and Cochrane Library, as well as grey literature in Trove, Mednar, and OpenGrey from January 1974 onwards. Two reviewers will independently screen all citations and full-text articles for eligibility against specific inclusion and exclusion criteria. Potential conflicts will be resolved through discussion. Data will be extracted and presented in a diagrammatic or tabular form accompanied by a narrative summary.

DISCUSSION

The scoping review will present the health and support service needs of individuals with disability from CALD backgrounds and will extend the current reviews as it focuses the engagement in meaningful occupation. Findings from this review have the potential to inform local policy discussions and practice-based disability care.

SYSTEMATIC REVIEW REGISTRATION

Open Science Framework ( 10.17605/OSF.IO/HW2FB ).

Recreation and collaboration within the Expanded Chronic Care Model: working towards social transformation

Assisting people to live well with a chronic physical or mental health condition requires the creation of intersectoral community-based supports for chronic condition self-management. One important but underutilized resource for supporting chronic condition self-management in the community is recreation, which refers to relatively self-determined and enjoyable physical, social or expressive everyday activities. The Expanded Chronic Care Model (ECCM) provides a framework for identifying systems-level strategies to support self-management through increased access to community recreation opportunities. In this article, an occupation-based social transformation approach, which involves examining assumptions, considering contexts of daily activities and partnering to create meaningful social change, is used to examine the ECCM. Recommendations related to strengthening social change with a specific focus on collaborations and networks through recreation are provided. Through such collaborations, self-management of chronic conditions in community recreation contexts is advanced. Health providers and community-based recreation services providers are invited to be part of these intersectoral changes that will promote health amongst those living with chronic conditions.

Cross-Cultural Adaptation, Validation and Reliability of the Spanish Satisfaction with Daily Occupations-Occupational Balance (SDO-OB): An Evaluation Tool for People with Mental Disorders

Occupation can be defined as all activities that occupy a person's time. The Satisfaction with Daily Occupations and Occupational Balance instrument evaluates the perceived satisfaction with performance and the balance in time dedicated to different occupations. The main aim was to translate the original instrument to Spanish and examine and establish the psychometric properties. This is a quantitative, cross-sectional study conducted in two stages: translation and cultural adaptation (forward translation, expert panel, back-translation, second expert panel and pre-testing and cognitive interviewing) and collecting data to evaluate psychometric properties (homogeneity, construct validity, known-groups validity, and floor/ceiling effects). One hundred participants took part in the study, adults with a diagnosis of a mental health disorder and adults without any known health problems. The Spanish version showed known-groups validity, acceptable internal consistency, and construct validity, although the relationships with some of the indicators of discriminant validity were somewhat higher than expected. The instrument shows promise as a useful screening tool for assessing activity level and satisfaction with daily occupations among a Spanish speaking population.

Assessing environmental barriers by means of the swedish craig hospital inventory of environmental factors among people post-stroke

BACKGROUND

When occupational therapists address environmental barriers to occupational engagement, some barriers might not be possible to reduce for single individuals, because decisions have to be taken at community or societal level, for example changes in public transport. Investigating environmental barriers by means of the Swedish Craig Hospital Inventory of Environmental Factors (CHIEF-S) may increase our understanding of the environmental impact on occupation engagement and the methodological challenges to assess environmental barriers.

AIMS

To investigate and describe the magnitude of encountered environmental barriers in a group of people post-stroke and to assess psychometric properties of the CHIEF-S.

MATERIAL AND METHODS

In total, 34 participants, who had sustained a stroke in Sweden were recruited.

RESULTS

The participants reported in average 2,7 barriers and the total frequency-magnitude score of barriers (CHIEF-S score) was 0.45. The Cronbach's α for the total CHIEF-S was 0.80 and the analysis of test-retest reliability revealed ICC = 0.86. The entire instrument demonstrated better psychometric properties than the single sub-scales.

CONCLUSION

In this study, the frequency-magnitude of environmental barriers encountered by people post-stroke are reported at a group level and adds information to the cumulative knowledge generation on perceived environmental barriers in the society. However, to inform which interventions are needed at a more detailed level, other data collection methods have to be added.

Examining the Occupational Therapy Definition of Self-Care: A Scoping Review

Self-care practices such as exercise and meditation are commonly identified as strategies to address stress and chronic disease. However, in occupational therapy, the term self-care has traditionally referred to basic activities of daily living (ADL), potentially limiting the profession's ability to promote wellness among clients. This scoping review aimed to clarify how the term self-care has been used in select occupational therapy literature. We found that of 1,254 included articles, 54.9% use the term self-care ambiguously and that authors primarily apply the term to basic ADL. This understanding contrasts with the evidence from the wellness literature and the concept's use by the general population and other health professions. Findings serve as a call to redefine the term self-care to articulate clearly the profession's value in promoting population health and well-being.

The role and scope of occupational therapy in Africa

Purpose: Occupational therapy (OT) is a global health profession that promotes participation in meaningful occupations to enhance well-being, particularly for persons with disabilities. Occupational therapy is relatively new in many African countries and there is limited research regarding the role of OT in this region. Thus, this study aims to understand the role and scope of OT in Africa by exploring its unique contribution to healthcare and cultural considerations for practicing OT in various African contexts.Methods: We conducted an exploratory qualitative descriptive study involving semi-structured interviews with 15 occupational therapists from 11 African countries. Interview questions focused on participants' work activities, rewards and challenges of their work, and perceived contribution to healthcare. We audio-recorded and transcribed interviews followed by inductive thematic analysis.Results: All participants described maintaining multiple roles. Four main themes (with sub-themes) emerged: advocacy (clients and the profession), collaboration (multi-disciplinary team, professional support, and internationally), maintaining core OT principles (occupation, function, participation, empowerment, and holistic practice), and contextual considerations (community-based services, practice approaches, sustainability, cultural norms, and spirituality).Conclusions: Occupational therapists working in African contexts have a unique and challenging role involving advocacy and collaboration. They need to maintain core OT values whilst addressing contextual considerations to ensure culturally relevant practice.Implications for RehabilitationOccupational therapists have an important role in promoting health and well-being; however, practice is influenced by the cultural context.Occupational therapists in Africa maintain multiple roles, including advocacy for their clients and the profession, and collaboration within a multidisciplinary team, for professional support and internationally.African occupational therapists need to be rooted in core OT principles whilst considering their unique context to ensure culturally relevant practice.

Doing, being, becoming and belonging at the heart of occupational therapy: An analysis of theoretical ways of knowing

Background: Theoretical ways of knowing in occupational therapy include paradigms, conceptual practice models and related knowledge. Despite the diversity of models available to guide practice, there are few examples of analyses which compare and contrast their respective core concepts.Aims: The aims of this paper are to describe how the dimensions of occupation described in the Pan Occupational Paradigm pervade conceptual practice models, and are embedded within case reports of occupational therapy.Materials and Methods: A framework analysis was undertaken, using the dimensions of occupation - doing, being, becoming and belonging - as core concepts. The alignment of concepts from four widely utilised occupational therapy conceptual practice models with these dimensions were investigated and described. Four case reports developed in reference to these specific conceptual practice models were also analysed, and their expression of the core concepts and dimensions discussed.Results: The dimensions of occupation were embedded in all reviewed conceptual practice models and case reports. The dimensions are explained in discrete, relational and embedded forms, with each conceptual practice model adopting a specific terminology and structure to describe them.Conclusions and Significance: The presence of all four dimensions of occupation, regardless of form, terminology or structural arrangement, is proposed as a hallmark of an occupational therapy conceptual practice model.

"Just one of the guys" An application of the Occupational Wellbeing framework to graduates of a Men's Shed Program for young unemployed adult males with intellectual disability

INTRODUCTION

Conceptualisation of occupation requires understanding of subjective wellbeing and experiences of occupation. Opportunities for participation in productivity activities, such as employment, may be limited for people with intellectual disability (ID). An occupational wellbeing framework was recently re-imagined to focus on the subjective meaning of a person's occupational life rather than occupational performance. This study analysed experiences and possible benefits to occupational wellbeing of young adult men with ID in an intergenerational mentoring program based on Australian Men's Sheds using this revised occupational wellbeing framework.

METHODS

A qualitative approach was used to gather individual semi-structured interviews at the end of an intergenerational mentoring program to explore occupational wellbeing experiences. Eight individual mentees and five parents of mentees (n = 13) from the different Men's Sheds sites agreed to participate in an individual interview about their experiences of the program. All mentees were male aged between 17 and 24 years. Family members included four female mothers and one male father. Data were highlighted, selected and deductively coded using content analysis according to the five occupational wellbeing domains of the framework.

RESULTS

Mentees reflected upon their experience with their mentor, the program, activities and environment of the Men's Shed. Findings were organised in relation to each of the five domains of occupational wellbeing, including contentment, competence, belonging, identity and autonomy. Experiences of mentees and their family members reflected the positive impact of participation on each domain and occupational wellbeing, including opportunities for socialisation outside of the program, mastery of skills and knowledge and validation of belief in self.

CONCLUSION

Mentees involved in an intergenerational mentoring program in Australian Men's Sheds report benefits of participation in activities that foster and increase occupational wellbeing experiences. The experience of such domains should be considered when attempting to understand the quality of life and function for people with disabilities.

Experience of Occupations among People Living with a Personality Disorder

Introduction

Personality disorders are common mental health disorders, with an estimated lifetime prevalence of 4 to 15%. People living with personality disorders are extensively seeking mental health services, yet few papers focus on their unique occupational needs or effective rehabilitation interventions that may alleviate the occupational issues they face. Occupational therapists are encouraged to support engagement in socially valued occupations, while preventing engagement in damaging ones, despite a lack of evidence on the meaning and the lived experiences of people.

Objectives

This paper describes the meaning attributed by people living with personality disorders to their main occupations and the underlying needs they strive to fulfill through occupational engagement, whether or not these occupations are sanctioned.

Methods

This exploratory study rests on a descriptive interpretative methodology. The participants were ten men and women, aged between 18 and 35 years old and living with a Cluster B personality disorder. A semistructured interview guide allowed participants to build narratives on occupations that are important to them and discuss how these occupations shape their identity. A thematic content analysis fostered the development of a coding structure that reflected a first-account perspective.

Results

The narratives provided by the participants depict a variety of meaningful occupations, many of which are socially disapproved. Many of these occupations serve as a coping strategy to deal with distressing situations, to connect with others who share similar life experiences, or to reestablish a fragile sense of control. Other occupations are socially disapproved due to the overinvestment of the participants' commitment. While participants described how this overinvestment allowed them to control destructive impulses, significant others perceived it as counterproductive and unnecessary. Participants perceived self-care occupations as painful and tedious chores or meaningless occupations. Engaging in productive occupations allowed some participants to gain recognition or to identify their competencies, but also confirmed their differences, creating some form of alienation or marginalisation.

Conclusion

This exploratory study invites clinicians and researchers to develop a more responsive understanding of occupational engagement for this population. The results highlight the importance of situating occupations in their context, while endorsing a first-account perspective, to better understand the forces that shape occupational engagement. Ultimately, occupational therapists should critically appraise their assumptions around healthy and unsanctioned occupations, in order to respond with sensitivity to the needs and experience of their clients, without perpetuating the marginalisation and discrimination they face.

Encounters between older adults and occupational therapists during the assistive technology application process

ABSTACTBackground: From the perspective of older adults, the assistive technology application process is complex and their perceived involvement varies. Occupational therapists find it challenging to satisfy their clients' needs while complying with the eligibility criteria of the service provision system. Research has shown that, from the perspective of both clients and occupational therapists, the application process is perceived to be challenging. However, little is known about which specific actions and experiences during the application process give rise to this perceived complexity.Aim: The aim of this study was to investigate older adults' and occupational therapists' actions and experiences of their encounters during the assistive technology application process.Material and method: Data were generated using repeated participant observations and informal interviews. Ricoeur's theory of interpretation was used to interpret and discuss the data generated.Results: Two themes emerged: Expressing needs and translating needs.Conclusion: Older adults express their needs in different ways. When the older adults' expression of needs does not correspond with the service provision system's conditions of eligibility, the occupational therapists act as mediators, by translating experienced needs so that they are expressed in a way that corresponds to the expression of the eligibility criteria.

Child and parent perspectives of life quality of children with physical impairments compared with non-disabled peers

BACKGROUND

Life quality has become a widely used concept within rehabilitation and occupational therapy practice.

AIM

This study explored child and parent perspectives of life quality of children with physical impairments compared with a group of non-disabled children.

METHOD

Data were collected with the Icelandic self- and proxy-reported versions of the KIDSCREEN-27. For children with physical impairments, reports from 34 children and 40 parents were included in the analyses, and in control group reports from 429 children and 450 parents were included.

RESULTS

Children with physical impairments evaluated their life quality within the average range on four out of five life quality dimensions. The lowest scores were within the physical well-being dimension. Self-reported scores of children with physical impairments were higher than those of their parents on all dimensions except autonomy and parent relations. Thus, the parents considered more environmental and personal factors to negatively influence their child's life quality than children did themselves.

CONCLUSION

Children with physical impairments experience their life quality similarly to non-disabled children.

SIGNIFICANCE

Focus on life quality can help occupational therapists to identify what circumstances positively or negatively influence client well-being and to focus more on contextual factors that contribute to disablement.