Well-being and occupational rights: an imperative for critical occupational therapy

From patient to maker - a workflow including people with cerebral palsy in co-creating assistive devices using 3D printing technologies

PURPOSE

Digital fabrication, like 3D printing, is a new opportunity for rehabilitation professionals to produce customized assistive devices. It allows for empowerment and collaboration in device procurement, but practical implementations are scarcely described. We describe the workflow, discuss feasibility and propose directions for future work.

METHODS

We showcase a process of co-manufacturing a custom spoon handle together with two people with cerebral palsy. Our digital manufacturing process was centered around videoconferencing to remotely control the processes from design to final 3D printing. Device functionality and satisfaction were assessed using standard clinical questionnaires: the Individual Priority Problem Assessment Questionnaire (IPPA) and the Quebec User Satisfaction Assessment with Assistive Technology (QUEST 2.0).

RESULTS

IPPA was instrumental in assessing user needs and device effectiveness. QUEST revealed where to focus future design efforts.

CONCLUSION

Involving people with disabilities in co-creation of assistive devices opens for new opportunities for healthcare providers that should be explored in depth using the described methodology. There may also be therapeutic benefits and we envisage specific actions to take in order to make it clinically viable.

Experiences of meaningful occupation among diverse populations - A qualitative meta-ethnography

BACKGROUND

Few studies synthesising knowledge about meaningful occupation are available. Meta-ethnography allows the synthesising of a variety of empirical findings and translational knowledge may be developed.

AIM

Investigate how individuals from diverse cultures and contexts experience meaningful occupation as described in qualitative research, applying meta-ethnographic approach.

MATERIAL AND METHODS

The study was based on 44 qualitative articles, selected by following a systematic procedure. Articles published between 2003-2021 were included. Studies on children, intervention and review articles were excluded. All authors conducted the analysis and synthesis, in several steps, and reached a consensus interpretation of the data.

RESULTS

Five categories explaining why and how people experienced meaning emerged. They were represented in all contextual settings. The main category was 1) Constructing identity and self-actualising throughout life. The other four categories were 2) Cultivating valued feelings 3) Spiritualising by being energised or disentangled 4) Connecting and belonging 5) Rhythmizing and stabilising by being occupied.

CONCLUSION AND SIGNIFICANCE

The synthesis provided novel insights into how people experience meaning in occupation in various contexts as part of their process of constructing identity and self-actualisation throughout life. This knowledge is valuable as expanding and nuancing the understanding of meaningful occupation.

Mindfulness and therapeutic relationships: A phenomenological inquiry into paediatric occupational therapists' practices

BACKGROUND

A growing body of literature points to the potential of mindfulness to support therapeutic relationships, and the importance of the therapeutic relationship when working with children and youth, yet little attention has been paid to this topic in occupational therapy.

AIMS/OBJECTIVES

The aim of this study was to inquire into occupational therapists' experiences of mindfulness in the therapeutic relationship with children and youth.

MATERIALS AND METHODS

Hermeneutic phenomenology was the methodological approach, with Heidegger's concepts of being-with and care as theoretical underpinnings of the study. Eight North American occupational therapists participated in semi-structured interviews that elicited first-hand accounts of mindfulness in the therapeutic relationship with children and youth. Interviews were transcribed verbatim and analysed using a phenomenological approach.

RESULTS

Four key themes were identified: fostering a safe space, enhancing presence, being authentic, and cultivating acceptance.

CONCLUSIONS AND SIGNIFICANCE

The findings offer insights regarding the potential affordances of mindfulness to support clinicians in the development of therapeutic relationships with children and youth. Further, this study highlights research priorities for future inquiry.

Transforming Occupational Therapy for the 21st Century PAIRE: Recognize Privilege, Acknowledge Injustice, and Reframe Perspective to Reach Equity

Theories, models, and frameworks provide the foundation for occupational therapy education, research, and clinical practice. While most have a systems approach focus, other factors, such as societal influences and structural inequities, also contribute to health. Using a cross-sectional design, this study identified the gaps in occupational therapy models of practice and presents a novel approach, the PAIRE (Recognize Privilege, Acknowledge Injustice, and Reframe Perspective to Reach Equity) Model. PAIRE is focused on achieving occupational equity through the reciprocal and intersectional impact of the provider/team, the person/people seeking occupational therapy, and the occupation-in-context, with continuous influences of access, context, and justice. We describe the components of PAIRE and illustrate its functionality in education, research, and clinical practice contexts as well as case examples.

Bridging the transition from homelessness: Developing an occupational therapy framework

BACKGROUND

Occupational therapists support individuals experiencing homelessness in traditional roles, and occupational therapy positions focussed specifically on homelessness appear to be growing.

OBJECTIVES

To develop and refine a framework to guide occupational therapy practice and research in homelessness.

METHOD

We developed a framework and refined it through a stakeholder consultation process conducted with 17 international occupational therapy experts using an online survey. In this survey, we presented an initial framework and requested qualitative feedback. We analyzed this qualitative data using content analysis.

RESULTS

Stakeholder feedback was categorized into eight recommendations: (1) Revision to the 'four processes'; (2) Emphasizing social justice and systems-level advocacy; (3) Reflecting intersectionality; (4) Emphasizing meaningful activity; (5) Emphasizing peer support; (6) Incorporating a focus on independent living skills; (7) Increasing a focus on an activity for addressing substance misuse; and (8) Acknowledging cognitive and physical health. Each of these recommendations was incorporated into a refined version of this framework. These recommendations and a refined version of the framework are presented in this paper.

CONCLUSIONS

We have developed and refined a framework aimed at guiding practice and research in occupational therapy in homelessness that will be evaluated in future research.

SIGNIFICANCE

Though a range of frameworks exists for guiding the practice of occupational therapists more generally, this framework represents the first that is focussed specifically on guiding occupational therapy practice and research with individuals who experience homelessness. Research and practice implications are discussed.

"Justice Becomes Our Agency." Occupational Therapists in Germany Reflect on Their Practice Processes in and with Communities

Community development and population-oriented approaches are emphasized to advance the occupational therapy profession's scope of practice to meet the increasing demands created by socio-cultural-political and economic changes. This study explored the practice processes of occupational therapists in community settings outside existing health care structures in Germany. Data was gathered through five individual qualitative interviews and one focus group and analyzed using thematic analysis. Three main themes were identified: navigating parallel processes within the larger context or system; building community connections through occupation; growing professional identity. The utilization of occupational science concepts was essential to work successfully on a community level.

Accessing public space in the digital society: relationship between the use of everyday technology and places visited outside the home after acquired brain injury

PURPOSE

In the digital society, people need to make use of a range of everyday technology (ET) when engaging in activities in various places outside home. The aim of this study was to describe and compare the use of ET and places visited outside the home and, also, to describe the relationship between them in people with different severity of disability after acquired brain injury (ABI).

MATERIALS AND METHODS

Instruments addressing ET use, places visited outside the home and severity of disability were used to assess 74 individuals with ABI. Relationships were analyzed statistically.

RESULTS

A significantly higher use of personal ET related to public space and public space ET, a higher ability to use ET and more places visited outside the home was found in those with good recovery (GR) compared to those with moderate disability/severe disability (MD/SD). The use of ET was significantly correlated with places visited in the total sample and in those with MD/SD, but for those with GR, no significant correlations were found.

CONCLUSIONS

To facilitate participation after ABI, the relationship between the use of ET and places visited outside the home needs to be assessed in rehabilitation.Implications for rehabilitationDigitalization has increased the need of everyday technology (ET) when visiting various places in society.The use of ET was positively significantly correlated with the total number of places visited outside the home in the sample of people with acquired brain injury (ABI).Those with severe or moderate disability after their ABI used significantly fewer ET and visited fewer places compared to those with good recovery.Evaluation of the use of ET and places visited outside the home is important in rehabilitation to support participation after ABI.

'I'm institutionalised … there's not much I can do': Lived experience of housing related delayed discharge

INTRODUCTION

Delayed discharge from inpatient mental health units is the continued hospitalisation of consumers after being assessed as ready to be discharged. This is common in adult inpatient mental health services and is usually due to a lack of appropriate housing for discharge. Research indicates a range of possible negative impacts, but no studies have explored consumers' perspectives on this issue. This study explores consumers' perspectives of the experience of housing related delayed discharge (HRDD).

METHOD

Using a grounded theory approach, in-depth interviews were conducted with 10 consumers. All consumers were experiencing HRDD from inpatient mental health units in one Sydney local health district. The data were analysed using constant comparative analysis.

FINDINGS

A lack of choice and control was the central theme that characterised participants' experiences. The combined experience of being delayed in hospital and being homeless led to a lack of choice and control over the basics in life, how consumers spent their time and with whom, and their futures. This lack of autonomy was shaped by the features of the hospital and participants' personal circumstance. The hospital features included rules and routines, physical and social environments, resources, and support from staff. Personal circumstances included individual situations, social networks, and support from community organisations. Participants described a variety of impacts, including reduced mental and physical well-being, and anticipated difficulty transitioning back into the community.

CONCLUSION

This study is the first of its kind and provides consumer perspectives on the impacts of HRDD on their well-being and recovery. The inability to participate in meaningful and necessary occupations is an occupational injustice and implies the need for occupational therapists to advocate for both the prevention of HRDD through government investment in affordable and readily available housing and the mitigation of its effects through modified hospital environments and practices.

Healthcare professionals’ perceptions and experiences of the influence of the COVID-19 pandemic on their personal and work performance

BACKGROUND: Healthcare workers are known to experience higher stress levels compared to other industry workers due to challenges presented in their work environment. The global pandemic of COVID-19 has seen many countries’ healthcare systems struggle to meet the demands of healthcare seekers. OBJECTIVE: The aim of the article is to explore healthcare professionals’ perceptions and experiences of the influence of the COVID-19 pandemic on their personal and work performance. METHODS: Twelve individuals working in the health sector participated in this study. The researchers used a qualitative exploratory and descriptive research design. Semi-structured interviews were used to collect data. RESULTS: Theme one “A feeling of ambivalence”, describes the positive and negative influence that the COVID-19 pandemic has had on HCWs. Theme two “Unfortunately, the support from the government is not as much as it’s said to be in the news”, describes the support required from government services during the pandemic. Theme three “Changes experienced by the individual related to his or her personal and work routine”, describes the changes experienced by healthcare professionals in their daily tasks during the pandemic. CONCLUSION: The study found that the work environment contributed to experiences of burnout and anxiety due to staff shortages, lack of personal protective equipment (PPE) and an increase in work pressure. More research needs to be conducted to inform policies and organizations on how to best support healthcare workers to prevent burnout and anxiety.

Who is safe at work? Problematizing employment volatility during the 2008-2018 Spanish socioeconomic crisis from a critical occupational perspective

Abstract Introduction The Spanish socioeconomic crisis context has impacted on the population’s work conditions, which generates instability and workers’ fear of losing their job. Despite the recent research which addresses the work as an occupation in Critical Occupational Therapy and Science, little is known about the volatility of employment in relation to the job instability resulting from contextual changes. Objectives To explore the relationship between employment volatility, participation in daily occupations, and the health and wellbeing of workers during the Spanish socioeconomic crisis. Method A narrative qualitative methodology was conducted. Two open interviews and a personal diary were used as data generation methods. Two experiences were analyzed by adopting a thematic analysis. Results Three thematic categories illustrate how workers orchestrate their occupations in a context of employment volatility and they situate the multidimensional context of work in such circumstances as restrictive of occupational opportunities. Uncertainty generates a normalized instability in the daily life of workers, which impact occupational choices, health, and wellbeing. In addition, participants reflect on future perspectives of work associated with precarity and resignation. Conclusions The study of the employment volatility contributes to broadening the conceptualization of work as an occupation and contribute to the development of occupational justice-based practices.

Float to grow: nurturing the roots of socially inclusive and just practice in occupational therapy students

Abstract Models of practice and theoretical frameworks that seek to deemphasize impairment and focus on the implications of societal attitudes, norms, and culture are significant and relevant to the practice of occupational therapy. As an underpinning of client-centered practice, there is a need to highlight and embrace the intersection of impairment-deemphasizing theories and move from conceptual understanding to true application of those theoretical models in practice. This article describes the inclusion of the Salamander Workshop; an experiential learning activity designed to facilitate the development of students’ therapeutic self-awareness and initiate a starting point for incorporating social frameworks into authentic practice. Student reflections conceptualize the discussion about professional growth and development against the backdrop of disability experiences, social change, and empowerment. The article begins with an introduction to how the profession of occupational therapy and disability studies interconnect. This is followed by a description of both the occupational therapy education program where the experiential learning activity took place, and details of the workshop itself. The final two sections of the article articulate and discuss student reflections of the experiential learning exercise and conclude by framing the discussion within the larger context of occupational therapy pedagogy. The Salamander Workshop facilitated an opportunity for students to immerse themselves in the lived experience of others, while enhancing their own self-awareness, which in turn may translate to their growth and development as inclusive practitioners.

“¿Quién está seguro en el trabajo?” Problematizando la estabilidad laboral durante la crisis socioeconómica española 2008-2018 desde una perspectiva ocupacional crítica

Resumen Introducción El contexto de crisis socioeconómica en España ha repercutido en las condiciones laborales de la población, generando situaciones de incertidumbre y miedo a perder el empleo por parte de los/as trabajadores/as. A pesar de las emergentes líneas de investigación que abordan el empleo como ocupación en Terapia y Ciencia de la Ocupación crítica, poco se sabe sobre la volatilidad del empleo en relación a la amenaza de pérdida del mismo derivada de cambios contextuales. Objetivos Explorar la relación entre la amenaza de pérdida de empleo, derivada de cambios contextuales, y la participación en ocupaciones cotidianas, la salud y el bienestar durante la crisis socioeconómica en España. Metodología Se llevó a cabo un estudio cualitativo exploratorio con diseño narrativo. Las técnicas de generación de datos fueron dos entrevistas semiestructuradas en profundidad y un diario personal. Se analizaron las experiencias de dos participantes mediante análisis temático. Resultados Emergieron tres categorías temáticas que ilustran cómo los/as trabajadores/as orquestan sus ocupaciones en un contexto de empleo volátil y sitúan el trabajo en un contexto multidimensional que restringe sus posibilidades ocupacionales. La inseguridad laboral genera una inestabilidad normalizada en la vida diaria, lo cual impacta en las elecciones ocupacionales, salud y bienestar de trabajadores/as. Los/as participantes reflexionan sobre sus perspectivas futuras de trabajo asociadas a la precariedad y resignación. Conclusión El estudio de la situación de amenaza de pérdida de empleo permite ampliar la conceptualización del trabajo como ocupación y contribuir en el desarrollo de prácticas basadas en la justicia ocupacional.

A qualitative study of child participation in decision-making: Exploring rights-based approaches in pediatric occupational therapy

Background

According to Article 12 of the United Nations Convention on the Rights of the Child, therapists are duty-bound to include children in decisions that impact them. Although occupational therapists champion client-centred, collaborative practice, there remains a paucity of studies detailing children’s rights and experiences of decision-making in pediatric occupational therapy.

Purpose

This qualitative study described the decision-making experiences of children, parents and therapists in occupational therapy.

Methods

Semi-structured interviews were conducted with 17 participants (six children, five parents and six occupational therapists), and data analysed using thematic analysis.

Findings

Three themes emerged: 1) Goal-setting experiences; 2) Adults: child-rights gatekeepers or defenders? and 3) Decision-making in context. Findings suggest that decision-making is mostly adult directed, and children’s voices are subsumed by adult-led services, priorities, and agendas.

Implications

Children’s rights need to be embedded as an aspect of best practice in providing services that are child-centred in occupational therapy practices and education.

Exploring the Praxis of Occupational Therapy-Community Development Practitioners

Background. A growing body of occupational therapy knowledge and practice focuses not on health but on social transformation, and couples occupational therapy with community development. A tension in both these fields is the disconnect between what practitioners espouse and what they do, limiting the potential of practice. To address this, practitioners are encouraged to engage in praxis-the critical synthesis of theory and practice. Purpose. To explore whether and how Australian occupational therapy-community development practitioners engage in critical praxis. Method. A critical dialogical method was employed to complete multiple in-depth interviews with four occupational therapy-community development practitioners. Interviews were transcribed and analyzed using thematic analysis. Findings. Practitioners appeared capable of praxis but were not consistently employing it. Findings were grouped into themes: disjointed praxis, authentic praxis, supporting praxis, and praxis challenges and solutions. Implications. Occupational therapists need to be supported to develop, use, and maintain skills in critical praxis.

Social and Structural Determinants of Health: Exploring Occupational Therapy's Structural (In)competence

Background: In high-income countries, such as Canada, 50% of health outcomes are attributable to social determinants. Occupational opportunities are also structurally determined, yet these inequities are obscured by the White, Western assumptions and ableist neoliberal ideology in which the profession is deeply rooted. Purpose. To highlight the impact of structural injustices and other social determinants of health and occupation; explore the occupational therapy profession's structural competence; and build on existing knowledge to advance an agenda for action on injustice and inequity for the occupational therapy profession. Key issues. Occupational therapy's failure to prioritize education, research and action on systemic injustices and other social determinants of health and occupation reflects a lack of commitment to achieving the World Federation of Occupational Therapists' Minimal Standards. Implications. If occupational therapy is to advance knowledge and practices that address inequities in the social and structural determinants of health and occupation, we must strive towards structural competence.

Developing an International Occupational Therapy Service: Perspectives and Implications

Mali is one of the poorest countries in sub-Saharan Africa. Limited infrastructure renders access to health care difficult. There is a need to establish functional ways to improve Malian people’s health and treat disability. From this point of view, our project aims to implement a remote occupational therapy service for the beneficiaries of the Kalana clinic in Mali through international cooperation. Using a spiral iterative model, a proposal for a remote occupational therapy service was developed and refined for a multidisciplinary context. The International Classification of Functioning, Disability, and Health (ICF) was used as a means to work from a multidisciplinary approach to treat all needs. The results are exemplified with a case report and qualitative impressions of the services.

Occupation in Natural Environments; Health Equity and Environmental Justice : L'occupation dans les environnements naturels ; équité en matière de santé et justice environnementale

Background. Occupations undertaken in natural environments can positively impact physical and mental health, improve cognitive functioning, contribute spiritual and cultural benefits, and increase belonging, self-worth, and the meaningfulness of occupations. However, occupational opportunities in healthy natural spaces are inequitably distributed; and the deleterious effects of climate change and environmental degradation are borne disproportionately by socioeconomically disadvantaged people. Purposes. To highlight evidence that occupational engagement in nature is a determinant of health, foreground environmental injustices and identify some implications for occupational therapy. Key issues. Cross-disciplinary, cross-cultural research and critical environmental justice scholarship indicate that healthy nature is an inequitably distributed determinant of occupation, wellbeing, and human health. This merits critical attention from occupational therapy. Implications. By researching, identifying, and addressing occupational and health inequities arising from environmental degradation, climate change and inequitable access to health-promoting natural environments occupational therapists could contribute valuable, occupational perspectives to initiatives addressing human rights and environmental justice.

Play of children living with HIV/AIDS in a low-resourced setting: Perspectives of caregivers

Background

Although play is viewed as a childhood occupation that is spontaneous, it can be limited in children with HIV/AIDS. This study explored the perspectives of caregivers from Zimbabwe on the play of children with HIV/AIDS.

Methodology

A descriptive qualitative research approach was used to explore the perceptions of caregivers on play of children living with HIV/AIDS. Fifteen caregivers of children aged 4–9 years diagnosed with HIV/AIDS were purposively sampled. Two interviews were carried out with each of the caregivers. Findings were analysed thematically.

Findings

Four major themes were generated from the study: ‘Ubuntu is no more’, ‘Survival is primary (chikuru kurarama)’, ‘Play affirms that my child is still like other children’ and ‘More is required for this child’. Although issues of survival were paramount, caregivers were able to highlight the importance of play in affirming childhood, identifying the specific needs for play of children with HIV/AIDS.

Conclusion and Significance

Play, like all other human occupation, is contextually situated. Poverty and health status are key in shaping how families prioritise play. However, the ability to play for a child with HIV/AIDS also seems to mitigate stigma and may disrupt the ‘HIV is death’ narrative.

"A Legitimate Place in the Profession": Author Reflections on the 2005 Disability Studies Special Issue

IMPORTANCE

In 2005, the American Journal of Occupational Therapy published a special issue focused on disability studies. Contributing authors challenged readers to reflect on their practices and recommended ways to change the field, yet literature on the current state of the integration of disability studies into occupational therapy is scarce.

OBJECTIVE

To engage the original authors of the 2005 special issue in an examination of perspectives on how disability studies perspectives have contributed to changes within occupational therapy and what work remains.

DESIGN

The research team conducted semistructured interviews with 11 authors who published an article in the special issue. Interview transcripts were analyzed using thematic analysis. Triangulation of coders, multiple phases of data analysis, and member checking were used to establish trustworthiness.

RESULTS

Five themes emerged from the data: (1) exposure to disability and disability studies, (2) impact of the special issue on occupational therapy, (3) changes observed in occupational therapy beyond the special issue, (4) challenges integrating disability studies into occupational therapy, and (5) disability studies-informed recommendations for occupational therapy.

CONCLUSIONS AND RELEVANCE

Although the original contributing authors acknowledged the transformative impact of disability studies on their own practice and scholarship, the results suggest that disability studies remains outside mainstream occupational therapy scholarship. Exploring the connections and divergence between disability studies and fields such as occupational science could improve understanding of how disability studies concepts are defined and used in theory and practice. What This Article Adds: Since the publication of the original special issue in 2005, the field of disability studies has continued to influence occupational therapy, although more often in individual than in systemic ways. Work is needed to embrace a disability studies-informed critical and intersectional foundation for the profession and explore the ways in which occupational therapy can better partner with populations through a disability studies lens.

Becoming Anti-Racist Occupational Therapy Practitioners: A Scoping Study

The ongoing racism pandemic in the United States negatively impacts the health, safety, and occupations of Black, Indigenous, and/or People of Color. Although occupational therapy (OT) practitioners have a pressing obligation to actively address racism's causes and consequences, they lack guidance on what to do. This scoping study sought to identify and synthesize existing knowledge on ways OT practitioners and the profession can engage in anti-racist actions. Six databases were searched for content related to OT and anti-racism. The 31 included articles indicated that OT practitioners should: engage in reflexivity on ways their power and privilege impact therapeutic relationships, use inclusive models, consider how racism can impact client occupations and health care access, and address structural racism through advocacy and occupations as means. Although being anti-racist is a lifelong process, strategies within this study can support OT practitioners and the profession to initiate concrete anti-racist actions.

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.

Participation in Community Gardening: Sowing the Seeds of Well-Being: Participation au jardinage communautaire : pour semer les graines du bien-être

Background.

Sustaining well-being challenges people with serious mental health issues. Community gardening is an occupation used to promote clients’ well-being, yet there is limited evidence to support this intervention.

Purpose.

This paper examines how facilitated community gardening programs changed the subjective well-being and social connectedness of people living with mental health issues.

Method.

A community-based participatory research approach and qualitative methods were used with 23 adults living in supported housing and participating in supported community gardening programs. A constructivist approach guided inductive data analysis.

Findings.

Participation in community gardening programs enhanced well-being through welcoming places, a sense of belonging, and developing positive feelings through doing. The connection to living things and responsibility for plants grounded participants in the present and offered a unique venue for learning about gardening and themselves.

Implications.

Practitioners and service-users should collaborate to develop leadership, programs, places, and processes within community gardens to enhance well-being.

Participación ocupacional de las personas sin hogar: una cuestión de justicia y derechos humanos

Resumen Introducción Las personas sin hogar además de una falta de vivienda propia, carecen de todo aquello que les supone vivir en un verdadero hogar. Estas personas necesitan buscar cada día donde comer, dormir y, sobre todo, cómo poder sobrevivir, mismo sin los suficientes recursos para moverse por la comunidad para poder vivir con dignidad. Estas carencias se relacionan con procesos de exclusión, injusticias ocupacionales y sociales, vulnerabilidad, entre otros. Objetivos Presenta-se una investigación, cuyo objetivo fue conocer los modos de vida de las personas sin hogar y así poder avanzar en prácticas cuya finalidad sea promover ocupaciones significativas vinculadas a la salud en condiciones de vida en la calle en contextos de injusticia y exclusión social. Método Para comprender cuáles eran las ocupaciones más significativas de las personas sin hogar se realizaron entrevistas semiestructuradas de carácter cualitativo a diferentes personas que de un modo u otro están vinculadas a esta situación. Las entrevistas analizadas y codificadas. Este proceso fue contrastando entre las investigadoras. Resultados Se ha observado que las personas sin hogar carecen de la mayoría de los derechos que una sociedad debería garantizar. Los resultados obtenidos fueron presentados en cinco apartados: La participación en ocupaciones significativas, las relaciones sociales, los recursos de la comunidad, las expectativas de futuro y el autoconcepto. Conclusión Las personas sin hogar se encuentran en una situación de injusticia social que da lugar a una falta de oportunidades para participar en ocupaciones significativas en la comunidad y promotoras de ciudadanía.

Construyendo y entendiendo la ocupación en contextos privados de libertad: experiencias de familias con hijos en situación de discapacidad en campamentos de refugiados

Resumen Introducción Desde la Terapia Ocupacional se ha prestado una especial atención a la descripción y el análisis de las ocupaciones que tienen lugar en contextos de mayor vulnerabilidad y precariedad social en los que el desempeño y la participación ocupacional en condiciones de salud, bienestar y sentido personal pueden verse comprometidos de forma significativa. Objetivo Describir y explicar la ocupación desde un enfoque cultural en familias con hijos en situación de discapacidad que residen en un contexto privado de libertad como son los campamentos de refugiados saharauis. Método Estudio descriptivo transversal, de naturaleza etnográfica, realizado en los campamentos de refugiados saharauis de Tindouf (Argelia). Resultados En los campamentos, el tiempo invertido en el desarrollo de las actividades de la vida diaria dista mucho de occidente, partiendo de que el propio concepto ‘tiempo’ presenta un significado muy distinto. Los quehaceres diarios de los saharauis están marcados por tres “tiempos”: (1) la luz del sol, (2) el rezo y (3) la hora del té, siendo las dos últimas las ocupaciones más significativas de la población refugiada. El significado de la cultura parecía ser una parte integral de la práctica profesional, así como las circunstancias vitales con las que convivían las familias con miembros en situación de discapacidad. Conclusión La Terapia Ocupacional debe verse interpelada a ofrecer oportunidades de vida cotidiana más digna para todas las personas, apoyando y protegiendo los derechos de participación ocupacional de todos los sujetos, especialmente de aquellos que experimentan situaciones de mayor vulnerabilidad.

Occupational justice health questionnaire: reflections on its application

ABSTRACT Introduction Occupational justice concept is defined as the equal access and participation in all occupations, including the resources required for participation and opportunities for social inclusion. Occupational justice not only remains conceptually ambiguous for occupational therapy practice but also lacks critical examination of its applicability to non-Western cultures. Objective This article describes the reflexive process exercised by the researchers during and after using the Occupational Justice Health Questionnaire (OJHQ) as an occupational therapy tool in a substance addiction rehabilitation setting in the Philippines. Method This qualitative study gathered transcriptions from field notes and focus group discussions of the authors. These transcriptions were characterized by the authors’ reflections on their experiences using the OJHQ on four distinct periods: 1) OJHQ translation, 2) pilot testing, 3) OJHQ-Filipino version administration, and 4) project conclusion. Data were analyzed through thematic analysis. Results Qualitative data revealed four themes: tool usefulness; administration guidelines; contextualized use of the tool; and nuances of occupational injustices in substance addiction and rehabilitation setting. Conclusion Findings expanded OJHQ’s purpose to enhance clinical reasoning, promote justice-oriented health care, activate reflective practice, and recognize the interweaving and evolving nature of injustices. This article offers an understanding of how reflections can facilitate cultural adaptation of practice tools used in occupational therapy and justice practice.

Extended smartphone-aided program to sustain daily activities, communication and leisure in individuals with intellectual and sensory-motor disabilities

BACKGROUND

Smartphone-aided programs were recently developed to support leisure engagement and communication with distant partners in individuals with special needs. This study evaluated an extended smartphone-aided program that supported daily activities in addition to communication and leisure in individuals with intellectual and visual or visuo-motor disabilities.

METHOD

Six participants were involved who had been exposed to an earlier smartphone-aided program supporting communication and leisure. The extended program (a) relied on the use of a Samsung Galaxy J4 Plus smartphone, which was fitted with Android 9.0 operating system and MacroDroid, and (b) alternated periods in which the participants could engage in communication and leisure with periods in which they were provided with instructions for daily activities.

RESULTS

During the baseline (i.e., with the earlier smartphone-aided program), the participants engaged in communication and leisure, but did not start any activity. During the post-intervention phase (i.e., with the extended smartphone-aided program), the participants maintained successful communication and leisure engagement and started and carried out daily activities successfully. Staff rated the extended program largely preferable to the original program.

CONCLUSIONS

The extended program can be a useful tool for widening the functional occupation of individuals like the participants of this study.

Development of occupational therapy in Grangegorman hospital, Dublin: 1934-1954

Purpose

In the early to mid-twentieth century, psychiatrist-led occupational therapy departments emerged in Irish psychiatric hospitals. This marked a transition towards establishing rehabilitative services in institutional settings. This paper aims to examine the development of occupational therapy in Grangegorman Mental Hospital and its auxiliary hospital, Portrane Mental Hospital from 1934-1954.

Design/methodology/approach

Historical documentary research methods were used to analyse primary source data from Grangegorman Committee Minutes, Inspector of Mental Hospital Reports, Boroughs of Mental Hospitals, Department of Foreign Affairs documents and newspaper archives. The archival data was analysed using both a chronological and thematic approach.

Findings

The main key event emerged in 1935 when four Grangegorman nursing staff were sent to Cardiff Mental Hospital to undergo a six month training course in occupational therapy. The following themes emerged – “establishing occupational therapy in Grangegorman and Portrane”; “the role of short-course trained nursing staff in providing occupational therapy services” and “therapeutic rationales vs hospital management rationales”.

Originality/value

This study throws light on the early practitioners of occupational therapy in Grangegorman and highlights the complexities of occupational therapy’s role origins in mid-twentieth century Ireland. In line with contemporaneous psychiatric hospitals, the occupational therapy activities promoted in Grangegorman were mainly handicraft or productivity based. The absence of patients’ voices means there are limitations to determining the therapeutic nature of this early occupational therapy service.

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.

Understanding Policy Influences on Health and Occupation Through the Use of the Life Course Health Development (LCHD) Framework

Life course health development (LCHD) is a framework that considers the transactional nature of risks and protective factors along the life trajectory and how this context influences health. Public policies, from health care to education to social services to labor laws, have many goals, including lessening and eliminating health disparities, yet inequities in health services and outcomes remain. Policy is a contextual factor that may be overlooked when examining influences on health and occupation. As such, the LCHD framework may assist occupational therapy practitioners in understanding the influences of policy-both successes and failures-on occupation. In this article, we introduce the principles of LCHD and use this framework to illustrate analysis of a policy example of paid family leave, demonstrating how gaps in or unintended consequences of policy may contribute to disparities in health and occupation for certain populations.

The potential contribution of critical theories in healthcare transition research and practice

BACKGROUND

Healthcare transition has been established as a significant topic of interest in pediatric rehabilitation. Healthcare transition research has primarily focused on barriers to self-management and achievement of a productive adulthood. Healthcare transition experts have recently called for further attention to social structural factors. Theoretical approaches are, therefore, needed to account for how such factors shape the lives of youth with disabilities, particularly those who experience marginalization and social exclusion.

PURPOSE

Taking up this call, the aim of this paper is to examine the potential contributions of two critical theories to healthcare transition research and practice.

METHODS

Review two theories - intersectionality and critical discourse analysis.

RESULTS

Intersectionality highlights how multiple intersecting social locations and social structures interact with youth's experiences, choices and health care needs. Critical discourse analysis focuses on how discourses and assumptions in healthcare transition research and practice contribute to marginalization and can be resisted and changed by youth, families, researchers, and clinicians.

CONCLUSIONS

The uptake of critical theories within health care transition research and practice can account for the complex interplay of social structures, power relations and youth's experiences. Such analysis can contribute to refining assessments and developing interventions that reflect how marginalization and exclusion impact youth's well-being.IMPLICATIONS FOR REHABILITATIONWhile critical theories have been applied in health and rehabilitation, there has been limited uptake of these theories in healthcare transition research and practice.Critical theories can promote awareness of how youth's experiences, choices and actions throughout the healthcare transition process are shaping and shaped by structural factors and assumptions about a productive adulthood.Applying critical theories in healthcare transition practice involves being responsive to the structural factors that may be shaping youth's experiences, choices and opportunities.Intersectional and critical discourse analyses can surface how to reduce social exclusion and marginalization for youth transitioning to adulthood through analyses of language, power, dominant discourse and practices amenable to change.

"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.

‘Keeping busy with purpose’: How meaningful occupation can shape the experience of forced migration

Forced migration creates multiple barriers to everyday life, including individual’s access to dignified and meaningful daily occupations. Without the activities that form family life, self-care, work, leisure, and community participation, individuals can find themselves struggling to fill the hours in their days and feeling they exist on the margins of society. This article reflects the findings of a small-scale phenomenological study exploring the meaning of everyday occupations to people seeking asylum in the UK. A series of in-depth interviews, conducted with 10 people, explored the role of daily occupation in their country of origin and in the UK. The study found that restrictions on daily activities had a significant impact on their well-being and sense of self-worth. They highlighted how limited their opportunities were and acknowledged the value of meaningful daily occupations as a means to ‘keep busy with purpose’. There is growing evidence that occupation has the potential to be of benefit to people during the post-migratory period: maintaining health, preserving key skills, retaining a sense of self, and increasing integration. This study shows the multiple gains associated with purposeful activity, including how the right kind of occupation can promote self-worth at a time when people often feel devalued. The article encourages the reader to consider how increased access to activity can promote well-being and to consider challenging the occupational injustices behind asylum policy.

Early Hour, Golden Hour: an Exploration of Slovenian Older People's Meaningful Occupations

People are occupational beings and enabling older people to engage in meaningful occupations contributes to their health and well-being. Experiences of engagement and meaning in an occupation may differ in different socio-cultural contexts. The aim of this study was to explore Slovenian older people's individual experiences of engagement in occupation, with a particular emphasis on their meaningful occupations. The study employed a phenomenological research approach. Semi-structured interviews were conducted with ten Slovenian older adults, living independently in their home environment. Interpretative Phenomenological Analysis was used to approach and analyze the data. The findings highlighted that meaningful occupations and daily rituals represented an important part of the participants' identities. The meanings they attached to their occupations were informed by Slovenian socio-cultural, historical and physical context. A range of people and places were identified as significant in generating and maintaining these meanings. Participants gave particular significance to the role of productive, health-promoting and family-related occupations. The study contributes new occupational science knowledge and the findings support the case for increased recognition of the importance of meaningful occupation for older people.

Do occupational justice concepts inform occupational therapists' practice? A scoping review

BACKGROUND.

Occupational justice and related concepts can inform practices directed at injustice and the lack of rights in daily life. Brazilian ideas about social occupational therapy seem to be similar to these concepts about inequality.

PURPOSE.

This study aimed to answer the questions, "Do occupational justice concepts inform occupational therapists' professional actions?" and "How are occupational justice concepts connected to Brazilian ideas about social occupational therapy?"

METHOD.

A secondary analysis was undertaken of a scoping review using occupational justice and related concepts as keywords. Descriptive and categorical analyses were used to classify the extract data.

FINDINGS.

We selected 42 articles that specify occupational therapy practices, classified as individual approaches (n = 13), individual-integrated-with-social approaches (n = 22), and social approaches (n = 7). It was found that occupational justice concepts have informed individual approaches and that the second and third approaches can be connected with social occupational therapy.

IMPLICATIONS.

Dialogue for sharing knowledge, concepts, and practices of occupational therapy worldwide can be inspired by this review.

“The Bigger Picture”: Occupational Therapy Practitioners’ Perspectives on Disability Studies

OBJECTIVE. This qualitative study explored occupational therapy practitioners’ perspectives about integrating principles from the field of disability studies (DS) into clinical education and practice.

METHODS. After a conference presentation about DS, three simultaneous focus groups were conducted with 27 occupational therapy practitioners. A constant comparative, grounded-theory approach was used to identify themes across groups.

RESULTS. Identified themes included convergences and divergences between the profession of occupational therapy and the field of disability studies, influence of perspectives of disability on service delivery, clinician navigation of systemic barriers, and incorporation of DS-aligned intervention strategies into practice.

CONCLUSION. Despite points of alignment, occupational therapy has not fully addressed DS critiques. Practitioners recognized professional, systemic, and societal barriers and the need for more educational experiences, resources, and professional reflexivity and dialogue to inform the integration of DS concepts into practice.

Pre-discharge home visits: A qualitative exploration of the experience of occupational therapists and multidisciplinary stakeholders

INTRODUCTION

The evidence base surrounding occupational therapy pre-discharge home visits discusses current practices, potential beneficial outcomes and limitations. However, research is limited, regarding how clinical teams determine which patients receive this service. This study aims to explore perceptions of occupational therapists and multidisciplinary stakeholders concerning pre-discharge home visits through their experiences and current practice in the Australian context.

METHOD

A qualitative descriptive approach, using thematic analysis, was employed. Four focus groups were included, comprising 27 health professionals: novice occupational therapists (n = 6), experienced occupational therapists (n = 8), occupational therapy managers (n = 5), and multidisciplinary team members (n = 8).

RESULTS

Three key themes relating to pre-discharge home visits in clinical practice emerged. The first theme of 'Recognition of Clinical Factors' reflected that aspects of the person's occupational performance, environmental and care needs, were prime indicators considered for a pre-discharge home visit. Secondly, 'Contextual and Pragmatic Influences', described clinical setting realities as being significant considerations and strongly mediating practice. A third theme of 'Perceptions of Value' showed awareness of the utility of pre-discharge home visits, while also recognising need to enhance ongoing practice.

CONCLUSION

This qualitative study provides information on factors influencing decision-making regarding pre-discharge home visits from the hospital setting. Clinical factors were presented as key considerations, but clinicians' experiences and perceptions of contextual influences suggest an explanatory factor for practice variation. While multidisciplinary stakeholders' broadly demonstrated similar rationales for pre-discharge home visits as those of occupational therapists, therapists' decision-making processes for pre-discharge home visits were shaped by their experience level. Clinicians' experience finds pre-discharge home visits to have value and in the absence of clear evidence-based criteria for whom this element of practice should be provided, participants supported the development of a decision-making support tool to assist in decision-making.

Valeurs liées à la profession d’ergothérapeute : les répertorier pour les définir

Description.

Des imprécisions et des confusions conceptuelles caractérisent les écrits sur les valeurs liées à l’ergothérapie.

But.

Répertorier des valeurs liées à l’ergothérapie, proposer des énoncés qui les définissent et procéder à leur validation de contenu.

Méthodologie.

Une recension des écrits ( n = 52) et la consultation d’ergothérapeutes ( n = 26) ont permis de documenter et de définir une série de valeurs. Le répertoire issu de ces démarches a été soumis à un test de fonctionnalité auprès d’ergothérapeutes ( n = 5), puis présenté à des ergothérapeutes détenant une expertise en éthique ( n = 6) pour en évaluer la validité de contenu des définitions des valeurs.

Résultats.

Le répertoire proposé comprend 33 valeurs suivies de leur définition que les experts ont jugées claires et représentatives des réalités qu’elles désignent. Les résultats montrent que le répertoire est considéré comme exhaustif.

Conséquences.

Cette étude a permis de répertorier et de définir des valeurs qui constituent des idéaux susceptibles de guider la pratique ergothérapique et de soutenir les revendications ainsi que les compétences culturelles et éthiques des ergothérapeutes.

A controlled study analyzing the temporal activity patterns of individuals with stroke compared to healthy adults

Introduction

The understanding of the temporal pattern of individuals can add a wider perspective to interventions. Therefore, the present study is aimed toward analysis of the temporal activity pattern of individuals with stroke compared to healthy adults.

Method

This study is a prospective, case–control, analytic research study. The study sample comprised 50 individuals with stroke and 50 individuals without disease, for 80% power with a 5% type 1 error. The Modified Occupational Questionnaire was administered to assess the temporal activity pattern. Individuals identified the activities performed at each hour of the day and data was analyzed.

Results

The temporal activity pattern of individuals with stroke differed from healthy controls; education and play activities were not part of stroke participants’ daily routines. Also, participation in work, leisure and social participation activities was significantly different for people with stroke compared to healthy controls ( p < 0.01 ). The study group assigned very low values to the activities; the value perceived by individuals differed significantly between groups ( p < 0.01 ).

Conclusion

Clinicians are in a position to enable individuals’ time use and help to engage them in meaningful activity. Individuals with stroke may benefit from a program focusing on the temporal aspect of activities.

Overview of the Assisted Decision-Making (Capacity) Act (2015)

Purpose

In Ireland, the Assisted Decision Making (Capacity) Act 2015 provides a statutory framework to adults who are experiencing difficulties with decision-making. This legislation has significant implications for all who work in health and social care. Increasing age and life expectancy, alongside the rising incidence of chronic health conditions and dementia-related diseases, indicates that more individuals are likely to experience challenges regarding decision-making capacity. Therefore, the need for more consistent, best-practice processes to assess decision-making capacity is likely to increase. To ensure occupational therapists are responsible in their contributions, and to ensure those with disabilities are supported, clinicians must be well-informed of the principles underscoring the Act. The purpose of this paper is to provide an overview of this multidisciplinary issue, including recent legislation, and consider how occupational therapy can contribute.

Design/methodology/approach

The authors reviewed current literature and considered occupational therapy’s role in decision-making capacity assessment.

Findings

Occupational therapists have potential to play a key role in multi-disciplinary assessments of decision-making capacity for clients. Further research is required to explore professional issues, identify clinical best practices and determine training and resource needs.

Originality/value

This paper seeks to provoke consideration of how occupational therapists can contribute to capacity assessment from a client-centred, occupation-based perspective that is mindful of ethical and legislative considerations.

Inclusive and emancipatory approaches to occupational therapy practice in substance-use contexts

BACKGROUND.

Occupational therapy practice is enhanced through clear understanding of its epistemological foundations. In the area of substance use, practices are strongly functionalist.

PURPOSE.

This study unearths epistemologies through analyzing practices addressing the social needs of clients with problematic substance use.

METHOD.

This study used an exploratory qualitative approach and was based on Marxist philosophies. Qualitative interviews were conducted with nine occupational therapists experienced in working with substance users. Data were analyzed through a dialectic approach to content analysis based on the Marxist theory of labour process.

FINDINGS.

The occupational therapy practices were found to follow common principles: clients are agents of transformation in health processes; creativity is a strong element of practice and underlies the whole therapeutic process; and conditions of social reproduction compose the object of occupational therapy (i.e., what is transformed through occupational therapy practices). Two different approaches using these principles were uncovered according to the labour-process purposes: inclusive and emancipatory.

IMPLICATIONS.

Systematization of practices based on epistemological foundations strengthens occupational therapists' ability to link actions to theories.

Re-imagining occupational wellbeing: Development of an evidence-based framework

BACKGROUND/AIM

Occupational therapists concern themselves with understanding engagement in everyday activity as a mode of facilitating wellbeing. However, there appears to be little consensus within the literature as to how engagement in meaningful activities contributes to wellbeing. Currently, there are no published evidence-based frameworks for wellbeing to support occupational therapy practitioners to address wellbeing with clients. The purpose of the study was to establish an evidence-based contemporary framework, domains and descriptive statements defining occupational wellbeing.

METHODS

A multiphase, exploratory sequential mixed methods design, using both qualitative and quantitative approaches was used. Two phases were identified for data collection. The first phase involved exploration of the domains of occupational wellbeing, through conducting a literature review and two focus groups. The Delphi technique was employed in the second phase to refine and corroborate the domains of occupational wellbeing with an expert panel.

RESULTS

Six new domains of occupational wellbeing were generated in the first phase of the study, namely: Competence, autonomy, contentment and pleasure, identity, hope and belonging. In the second phase, five out of the six domains reached a consensus level of 70% or more. Hope was the only domain not to reach consensus.

CONCLUSION

The framework for occupational wellbeing produced by this study was created using evidence-based, replicable methodology and garnered support from a highly regarded expert key informant group of occupational therapy and occupational science academics. Further exploration to determine whether there is widespread support and applicability for these domains with normative and vulnerable population groups is required.

The experience of older adults with anxiety and depression living in the community: Aging, occupation and mental wellbeing

Introduction

As life expectancy grows so does the need for mental health services for older people. Occupational science and therapy literature demonstrates how occupation supports older adults' wellbeing, but there has been little research into the relationship between occupation and health for those with anxiety and depression. The aim of this study was to understand the occupational experience of Irish older adults with anxiety and depression so as to inform therapeutic programmes.

Method

A qualitative research design with a phenomenological framework was adopted. A total of five community-dwelling people with diagnoses of anxiety and/or depression were purposively selected to participate in semi-structured interviews. The interviews were analysed using thematic analysis.

Findings

The themes which emerged – ‘Occupation as a marker for wellness’ and ‘Sustaining a sense of occupational identity’ – support existing literature and reveal new information about interactions between occupational identity crisis and mental health. Personally meaningful occupation which connects a person to their life worlds and sense of self has the potential to consolidate recovery from anxiety and depression.

Conclusion

The study contributes to knowledge on how occupation supports an older person's wellbeing and identity in the face of life changes, and has implications for occupational therapists working with older adults.

A case study of the development of occupational therapy at St. Patrick’s Hospital Dublin, 1935-1969

Purpose

This paper aims to examine the relationship between psychiatry and occupational therapy in Ireland through a case study of the development of the occupational therapy department in St. Patrick’s Hospital, Dublin, from 1935 to 1969. Patronage by psychiatrists was an important factor in the professionalisation of occupational therapy internationally.

Design/methodology/approach

Documentary sources and oral history interviews were analysed to conduct an instrumental case study of occupational therapy at St. Patrick’s Hospital from 1935 to 1969.

Findings

The research identified key individuals associated with the development of occupational therapy at St. Patrick’s Hospital, including psychiatrist Norman Moore, occupational therapy worker Olga Gale, occupational therapist Margaret Sinclair, and social therapist Irene Violet Grey. Occupational therapy was considered by the hospital authorities to be “an important part in the treatment of all types of psychiatric illness” (Board Meeting Minutes, 1956). It aimed to develop patient’s self-esteem and facilitate social participation. To achieve these objectives, patients engaged in activities such as dances, arts and crafts, and social activities.

Originality/value

This study has highlighted the contributions of key individuals, identified the links between occupational therapy and psychiatry, and provided an insight into the development of the profession in Ireland prior to the establishment of occupational therapy education in 1963. Occupational therapy practice at St. Patrick’s Hospital from 1935 to 1969 was congruent with the prevailing philosophy of occupational therapy internationally, which involved treatment through activities to enhance participation in society.