Time, Space, and the Kaleidoscopes of Occupation

Belonging, endurance, and resistance: Black placemaking theory in primary care

Black-Americans continue to experience pervasive health disparities. Factors contributing to increased disease risk include a general mistrust of biomedical institutions among Black Americans. The purpose of this focus group study was to identify, among Black patients who regularly seek care from a primary provider, salient themes regarding barriers to 1) receiving quality primary care; and 2) adhering to medical recommendations. We examined transcripts of eight focus groups held remotely with 29 Black patients (aged 30-60 years) who had established primary care providers. Using grounded theory and an inductive thematic analysis of the transcripts, we identified three themes (belonging, endurance, and resistance) consistent with Black placemaking theory. Our findings suggest that reducing health disparities for Black Americans will require clinical initiatives that emphasize: 1) attention to social influences on health behavior and to features of medical institutions that mark them as White spaces (belonging); 2) recognition of, as well as sensitivity to, community awareness of the systemic and interpersonal barriers to health and safety that many Black adults endure; and 3) reframing avoidant (resistant) behaviors as protective strategies among Black patients. Examining primary care in this way-through the lens of Black placemaking theory-reveals how culturally meaningful approaches to harnessing the specialized knowledge and resilience that clearly exists among many Black communities can improve health care delivery.

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.

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.

Generalist, specialist and generic positions experienced by occupational therapists in Norwegian municipalities

Purpose

Reforms in the health-care system may impact how health-care professionals perceive and enact their roles. This study aims to examine the way in which occupational therapists experience and describe their roles in municipalities after the implementation of a health reform (the Coordination Act) in Norway.

Design/methodology/approach

This qualitative study was designed within the perspectives of social constructivism. Data was collected through focus group interviews with 10 community-working occupational therapists. A thematic framework analysis was used to examine the participants’ experiences.

Findings

The following four themes emerged: external factors that framed and shaped the occupational therapists’ roles in municipalities; the strengths and dilemmas of the generalist; the problematic generic position and the strengths; and dilemmas of the specialist.

Originality/value

The study suggests that occupational therapy practitioners should identify new opportunities and adapt to health reform changes. They also need to renegotiate their roles as the health reforms require more specialized competences. Greater emphasis must be placed on the core knowledge and competences of occupational therapists to strengthen their professional identity in the municipalities.

Interaction between time organization and participation dimensions among higher education students

Introduction

In today's academic world, higher education students from all study areas are expected to simultaneously cope with a variety of assignments, which increases stress levels. This tension may affect productivity, health and quality of life. Hence, it is important for students to adopt effective time organization and management techniques. This study aims to characterize time organization and participation dimensions, and the relationships between those dimensions among undergraduate students.

Method

The research sample consisted of 60 undergraduate students who completed several questionnaires: demographic, time organization and participation scales assessing daily time organization; an occupational questionnaire; and additional questions for assessing further daily participation dimensions that are unique to students.

Results

Time-organization ability related to and maintained a predictive relationship with individual daily participation aspects. Particularly, academic and daily routine constituted a majority (44%) of the students' time. Regression analysis indicated that the way the students' daily activities were organized in terms of time use explained between 12% and 18% of the variance of daily participation dimensions as performance, enjoyment and motivation levels.

Conclusion

Time-organization abilities significantly affected students' participation dimensions. Further research is recommended to help develop an assessment and intervention programme suiting student needs and enhancing their productivity potential and wellbeing.

Technology and Occupation: Past, Present, and the Next 100 Years of Theory and Practice

During the first 100 years of occupational therapy, the profession developed a remarkable practice and theory base. All along, technology was an active and core component of practice, but often technology was mentioned only as an adjunct component of therapy and as if it was a specialty. This lecture proposes a new foundational theory that places technology at the heart of occupational therapy as a fundamental part of human occupation and the human experience. Moreover, this new Metaphysical Physical-Emotive Theory of Occupation pushes the occupational therapy profession and the occupational science discipline to overtly consider occupation on the level of a metaphysical-level reality. The presentation of this theory at the Centennial of the profession charges the field to test and further define the theory over the next 100 years and to leverage technology and its role in optimizing occupational performance into the future.

Principal Approaches to Understanding Occupation and Occupational Science Found in the Chilean Journal of Occupational Therapy (2001-2012)

Background

The progression of occupational science in Chile is documented in the main scientific publication of the field, the Chilean Journal of Occupational Therapy (RChTO).

Objective

Identify approaches to understanding and applying occupation and occupational science as elucidated in the RChTO.

Methodology

A systematic qualitative review of the journal (2001–2012) identified articles elucidating an approach to understanding and application operationally defined as references to specific authors, theories, models/paradigms, definitions, and other fields that support approaches to O/OS.

Results

The study identified two main approaches. The first considers occupation/occupational science from a practical perspective or as a means to explain human behavior; the second considers occupation/occupational science as an object of study. Each approach is further divided into categories.

Conclusion

This study provides a novel perspective on regional use of occupational science concepts. These findings contribute to our understanding of this science in context and to recognition of the cultural relevance of these scientific concepts.

Scenes of fathering: The automobile as a place of occupation

OBJECTIVE

While occupations are increasingly analyzed within contexts, other than the home, the ordinary places that facilitate occupations have been overlooked. The aim of this article is to explore the automobile as a place of occupation using data from an ethnographic study of fathers of children with disabilities.

METHODS

Qualitative data obtained through observations and interviews with the fathers and their families were analyzed using a narrative approach. Properties that influence interactions include opportunities to communicate, the vehicle itself, and electronics.

RESULTS

Driving children in the automobile fulfills fathering responsibilities and is a time for connecting. For the fathers in this study, the automobile represents a place for negotiating complex demands of fathering.

CONCLUSIONS

This study demonstrates not only the importance of the automobile, but also the influence of the immediate space on the construction of occupations.

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

BACKGROUND

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

AIM

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

METHOD

A scoping review method was used.

RESULTS

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

CONCLUSION

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

Moving Beyond 'Aging In Place' to Understand Migration and Aging: Place Making and the Centrality Of Occupation

'Aging in place' has become a key conceptual framework for understanding and addressing place within the aging process. However, aging in place has been critiqued for not sufficiently providing tools to understand relations or transactions between aging and place, and for not matching the diversity of contemporary society in which people are moving between and across nations more than ever before. In this article, the authors draw from concepts of place and migration that are becoming increasingly visible in occupational science. The concept of 'aging in place' is critically examined as an example of an ideal where the understanding of place is insufficiently dynamic in a context of migration. The authors suggest that the concept of place making can instead be a useful tool to understand how occupation can be drawn upon to negotiate relationships that connect people to different places around the world, how the negotiated relations are embedded within the occupations that fill daily lives, and how this process is contextualized and enacted in relation to resources and capabilities.

What Happened to the Time? The Relationship of Occupational Therapy to Time

Introduction:

Time has a reciprocal relationship with occupation: each helps to define and give meaning to the other. This paper explores how this interconnection has been embraced within occupational therapy.

Method:

Literature from a variety of disciplines was critically reviewed, in order to discern how occupational therapy has engaged with the temporal dimensions of occupation since its inception and the relevance of time to current practice.

Findings and discussion:

Although theoretical discussions demonstrate the importance of aspects of time within occupation, there has been only limited translation of these into occupational therapy practice. Aspects of time use, tempo and temporality are discussed in relation to their application to clinical practice. As the pace of life increases and humanity's relationship with time changes, this presents the profession with both challenges and opportunities.

Conclusion:

Time is a vital aspect of occupation. Occupational therapists need to return to core values of time awareness, rhythm and balance, because the profession once again needs to find time.

Experiences of daily occupations at 99 years of age

The aim was to explore experiences of daily occupations among the oldest old. Ten 99-year-old persons were interviewed in their living environment about an ordinary day. The interviews were analysed according to the phenomenographic approach. The result showed that participants regarded themselves as competent and that they felt proud because they were involved in daily occupations. Being challenged was experienced as a way of performing difficult tasks, thus being confirmed as a capable person who performs and learns new things. The participants' occupational patterns preserve occupational ability and continuity in life in that they have a rhythm and allow the individuals to predict and handle interruptions. Participants experienced being incapable and being restricted as a result of personal, environmental, and social hindrances. The participants adapted to and reshaped their sense of self, which has been disrupted due to the discrepancy between self, the person's ability, and the real world "outside". Experience of daily occupation is unique, supports the sense of self, builds identities, and describes engagement and creative processes. Individual experience must be recognized as it can mean the difference between success and failure in maintaining meaningful daily occupation.

The Professionalisation of Occupational Therapy: A Continuing Challenge

Professions are socially constructed phenomena. Accordingly, an understanding of what is meant by a profession, with its associated social positioning and how that is interpreted, is governed by historical, temporal, cultural and ideological influences. For occupational therapy, such an understanding can be a real challenge. This is because of a dichotomy between its ontological, person-centred approach and the medically dominated constructs prevalent in the professionalisation of all caring professions and still inherent in health care arenas today (Etzioni 1969, Fairhurst 1981, Rivett 1997, Freidson 2001).

As a consequence of this traditionally accepted dominance and the roles ascribed to or enabled by this positioning, the professional identity of occupational therapy can be limited by the politics of power at the organisational level. This can shape how occupational therapy is understood, not only by significant others but also by the profession itself. Professional consistency and cohesion, both inside and outside the profession, could therefore be challenged, unless individual actors, organisational attitudes and social constructs change. There is a need both to confront and to accept the ever-changing nature of professionalism and the meaning of occupation in the postmodern world.