Exploring Food Allergy Management and Food-Related Social Occupations in Elementary School-Aged Children

RATIONALE

Elementary school-aged children with food allergies face barriers to navigating safe food practices in concert with socializing while eating. Little research examines children's role in managing their health (i.e., a food allergy).

OBJECTIVES

This qualitative descriptive study explores the experiences of preadolescent children with food allergies relating to food allergy management and socialization in various foodscapes in the United States.

METHOD

Data gathering strategies included interviews, diaries, and photo elicitation. The analysis involved coding, discussion, and thematic development.

FINDINGS

Participants shared food allergy management with caregivers depending on the environment. They learned to educate others, respond to emergencies, and prepare daily relating to food allergies. They faced conflict with managing food allergies with peers but overall perceived food allergy management as a low burden.

CONCLUSION

When provided with positive social and environmental supports, school-aged children with food allergies can learn to safely manage social food environments without direct parental involvement.

Multispecies Occupations Involving Equines: An Action-Oriented Inquiry to Inform Occupational Therapy Practitioners

Research related to human-animal engagement often fails to address the complexity and nuance present in occupations and occupational therapy services that incorporate animals. The goal of this research was to develop a basic understanding of multispecies occupations (MSO) involving humans and equines, focusing on the action-oriented processes and transactions during socialization in outdoor, non-therapeutic contexts. We employed a multi-modal qualitative design with interviews and videography with n = 6 horse-human dyads, creating opportunities to understand and represent engagement beyond anthropocentric norms. Findings included a variety of dyad-specific features of occupation, including processes of embodied communication, the presence of behavioral synchrony, and perceptions of attunement arising from these processes. Examining MSO via a multi-modal inquiry offers new perspectives about the nature and experience of such occupations and supports a deeper understanding of potential mechanisms of change when animals are incorporated in occupational therapy interventions and practice.

Exploring Play Interactions of Children With Autism Spectrum Disorders and Their Pets

The purpose of this secondary qualitative analysis was to explore the play interactions of children with autism (n = 10) and their pets in the home environment. Researchers coded 115 minutes of video of children playing with their pets at home and transcripts from eight caregiver interviews. Thematic analysis revealed six codes which represented three themes, including children with ASD play with pets in a variety of ways, playing with pets supports child development, and playing with pets yields benefits for children with ASD. Findings suggest playing with pets may be beneficial for developing responsibility and social skills of children with ASD, particularly in how they interact with animals. Future research should examine perspectives of families who do not own or who have relinquished pets and perspectives of adults with ASD to better understand positive and negative aspects of pet play.

Experiences of Introduction to and Participation in Quad Rugby: A Grounded Theory Approach

Individuals with spinal cord injuries (SCI) report low physical activity participation levels. A lack of physical activity can lead to increased secondary health concerns, such as cardiovascular, psychological, genitourinary, and musculoskeletal complications. Adaptive sports, such as quad rugby, allow individuals with SCI to maintain appropriate physical activity levels. This grounded theory study aimed to explore the experiences of individuals learning about and participating in quad rugby after SCI in the United States. Twelve participants from seven states across the United States completed semistructured interviews. Four themes emerged: benefits of quad rugby participation, enabling quad rugby participation, barriers to quad rugby participation, and motivation for continued participation in quad rugby. This study highlights the importance of an early introduction to quad rugby after SCI and the biopsychosocial benefits of participation. Occupational therapy practitioners can address barriers identified in this study through innovative approaches and advocacy efforts.

Leisure Engagement Among People Living With Acquired Brain Injury: A Scoping Review

Return to previously valued occupations is a common goal of individuals following acquired brain injury (ABI). However, the focus of rehabilitation is often on self-care and productivity occupations. Return to leisure should be a priority of rehabilitation to support a person's physical, cognitive, social, and emotional well-being. Consequently, the aim of this article was to review the research evidence on engagement in leisure occupations among community-dwelling adults living with ABI. A six-step scoping review was conducted searching five databases. Articles were included if they focused on leisure engagement post-stroke or traumatic brain injury. Seventeen studies were included. Leisure engagement decreased post-ABI with engagement primarily in solitary, sedentary, cognitively inactive, home-based leisure. Leisure engagement was impacted by personal and contextual factors. The findings identify a need to focus on and address changes to leisure following ABI, with exploration of why these changes have occurred beyond personal factors.

Leisure and social occupational choice within nursing home facilities in Ireland: Residents perspectives

BACKGROUND

National standards for nursing homes in Ireland require that residents are offered a choice of recreational and stimulating activities to meet their needs and preferences.

AIMS/OBJECTIVES

To investigate residents' perceptions of leisure and social occupational choice in nursing homes in Ireland to determine if occupational choice is facilitated.

MATERIALS AND METHOD

Qualitative-descriptive design - nursing home residents completed two semi-structured interviews that explored their experiences of leisure and social occupational engagement.

RESULTS

Two overarching themes with six associated sub-themes emerged. From residents' perspectives, social and leisure occupational choice was dependent on: Environmental factors (nursing homes' Cultural, Social, Physical, and Temporal Environments) and Personal factors (residents' Health Status and Personal Attitudes).

CONCLUSION

The cultural environment had the most significant influence on residents' leisure and social occupational choice, highlighting the importance of person-centred care within nursing homes, to promote occupational choice. Resident's health status was also identified as a contributing factor.

SIGNIFICANCE

Occupational therapists could play a critical role in supporting the leisure and social occupational choices of nursing home residents by developing residents' skills, educating staff and adapting tasks and the environment to limit/reduce occupational deprivation.

Reflections of Black Married Working Mothers Managing Occupational Roles and Racism

Black married working mothers encounter forms of racism, on the job and in society. However, little attention is given to how these experiences affect their work and family lives. Qualitative thematic analysis was used to examine the narratives of 91 Black women, aged 20 to 55 years, to explore the effects of racism on their key occupational roles of wife, employee, and mother. Four major themes emerged for being a Black employee. Two themes were linked to Black mothering. Five themes were identified for being a Black wife. Also, two new culturally derived occupational roles emerged: advocate and pioneer. Findings suggest that Black married working mothers have unique transformative experiences in their occupational roles solely due to their minoritized status, which impacts their wellbeing. Occupation-based research should focus on racism's impact on the wellbeing of minoritized groups as they engage in desired and meaningful occupational roles.

Cognitive Self-Efficacy in Parkinson's Disease

Cognitive self-efficacy (CSE), one's belief in their ability to control their cognitive performance, is important for participation in daily activities and rehabilitation. This study aims to understand how Parkinson's disease (PD) affects CSE. The Cognitive Self-Efficacy Questionnaire (CSEQ) was administered to 47 non-demented PD and 52 healthy comparison (HC) participants. Groups were compared on their self-reported ability to recognize (Part 1) and manage (Part 2) cognitive symptoms and to perform cognitively complex functional activities (Part 4). Relationships between CSEQ scores and individual characteristics were assessed within PD. The PD group had lower CSEQ scores than the HC group for all Parts. Within PD, Part 2 scores were lower than Parts 1 and 4, and worse depressive symptoms and higher medication dosage correlated with lower CSE. People with PD may have low CSE, which can contribute to participation restrictions and reduced engagement in treatment. Occupational therapists should consider CSE with clients with PD.

An Exploratory Study of Young Stroke Survivors' Lived Experiences: A Multi-Methods Study Using Developmental Theory

Young adults make up 10% of strokes that occur in the United States each year. Little research has shown the developmental and occupational disruption as a result of stroke for this population. The objective of this study was to describe young stroke survivors' perceived disruptions using developmental theory. A multiple methods study was conducted with community-dwelling stroke survivors between the ages of 18 and 40 using Patient-Reported Outcomes Measurement Information System (PROMIS) measures and qualitative interviews. Five themes were reported from the qualitative data: stroke and health, work and school, romantic relationships, parenting, and other social relationships. PROMIS measure results were not significantly different from the normed population despite challenges revealed during qualitative interviews. Qualitative data showed variations in post-stroke deficits and occupational performance that could not be meaningfully captured by the PROMIS measures alone. Occupational therapy practitioners should use developmental theory to guide their understanding of occupational disruptions in young stroke survivors.

Fear of Falling Avoidance Behavior in Parkinson's Disease: Most Frequently Avoided Activities

BACKGROUND

Fear of falling avoidance behavior (FFAB) is common in Parkinson's disease (PD).

OBJECTIVES

The objectives of the study are to determine what activities are most avoided due to FFAB among people with PD and whether any associations exist with demographic factors or fall history.

METHOD

Cross-sectional analysis of 174 individuals with PD using the Modified FFAB Questionnaire.

RESULTS

Walking in dimly lit, unfamiliar places, and different surfaces, lifting and carrying objects, walking in crowded places, recreational/leisure activities, and going up/downstairs were most avoided. Fallers reported more FFAB (ps < .029). FFAB for certain activities was associated with increased or decreased odds of falling.

CONCLUSION

Individuals with PD avoid walking in compromised situations and engaging in recreational/leisure activities due to FFAB. While excessive FFAB may increase the odds of falling, protective forms may be associated with decreased odds. Targeting FFAB among individuals with PD may increase safe participation in meaningful occupations in the home and community.

The impact of the BEL intervention on levels of motivation, engagement and recovery in people who attend community mental health services

BACKGROUND

Community-based day centres (DC) in Sweden provide support to people with severe mental health problems. The role of DC motivation for outcomes in terms of occupational engagement and personal recovery is yet unknown.

AIMS

To compare two groups who received DC services, one of which also received the 16-week Balancing Everyday Life (BEL) intervention. The focus was motivation for DC services at baseline and after 16 weeks of services, while also investigating the importance of DC motivation for the selected outcomes and service satisfaction.

MATERIAL AND METHODS

Sixty-five DC attendees were randomised to BEL (n = 27) or standard support (n = 38) and responded to questionnaires about motivation, the selected outcomes and satisfaction with DC services.

RESULTS

The groups did not differ on any measured aspects of motivation; nor were changes seen over time. The BEL group, but not those receiving standard support, improved from baseline to 16 weeks on occupational engagement and recovery. Motivation for attending the DC was related to service satisfaction.

CONCLUSION

The BEL program could be a viable enrichment tool in the DC context and boost occupational engagement and personal recovery among the attendees.

SIGNIFICANCE

The study provided knowledge of importance when developing community-based services while enhancing motivation.

Effects of Telehealth Parent Coaching in Supporting Family Participation, Cohesion, and Adaptability

Families provide foundational contexts in which most children develop and grow. For families of children with special health care needs (CSHCN), interdisciplinary supports can build family participation capacities, beyond individualistic child supports. This single-group pretest-posttest quasi-experimental study sought to determine the preliminary effects of the Healthy Families Flourish Program (HFFP), a telehealth occupation-based parent coaching intervention to promote participation, cohesion, adaptability, and communication for families of CSHCN. Eleven families, including 17 parents and 27 children, completed the 10-session intervention consisting of parent education and individualized coaching. Participants completed the Canadian Occupational Performance Measure, Goal Attainment Scaling, and the Family Adaptability and Cohesion Evaluation Scales pre-/post-intervention. Within-group comparisons showed improvements in family participation, cohesion, adaptability, and communication with Cohen's d effect sizes ranging from 0.55-3.32. Researchers found positive relationships between family participation and cohesion as well as participation and adaptability. Findings provide considerations for supporting families within socioecological contexts.

Effects of personal growth initiative on occupational engagement of college students in the uncertain social context: A cross-lagged model and a moderated mediation model

In recent years, the international social context has become increasingly volatile, uncertain, complex, ambiguous (VUCA), and college students need a high level of long-term occupational engagement to cope with the unpredictability of the current employment environment. In this context, this study used a longitudinal design to explore the relationship between personal growth initiative and occupational engagement among college students and, based on this, further explored the role of vocational identity and Big Five personality traits in it. This study used a questionnaire survey method and the study participants were 700 college students in Shandong, China. And the time interval between the two questionnaire measurements was 4 months, with 559 final valid participants (182 males and 377 females). The following results were found in this study: (1) The cross-lagged model found that personal growth initiative was a significant positive predictor of occupational engagement. (2) The moderated mediation model found that vocational identity mediated the relationship between personal growth initiative and occupational engagement, and that neuroticism among the Big Five personality traits played a moderating role, i.e., individuals with higher level of neuroticism personality trait had a relatively weaker positive predictive effect of vocational identity on occupational engagement. This study concludes that colleges and universities need to understand students' interests and personality traits and provide more targeted career education (e.g., intentional growth training and cognitive behavioral therapy) to promote their personal growth initiatives, reduce their neuroticism levels and in turn enhance their vocational identity in order to help college students achieve long-term sustainable occupational engagement in the uncertain social context.

Surprisingness and Occupational Engagement Influence Affective Forecasting in Career-Relevant Contexts

People tend to misestimate their future emotions. This phenomenon is thought to be associated with information accessibility. However, few studies have demonstrated the impact of context-specific information accessibility on affective forecasting. This research investigated the effects of information accessibility on affective forecasting in career context (i.e., occupational engagement was seen as information accessibility), during which surprise or not surprise context was played simultaneously. We found that affective forecasting appeared stably across emotional response types. Specifically, there was an underestimation in interest appraisals and an overestimation in satisfaction. These biases were influenced by occupational engagement, which only worked in career interest appraisals. High occupational engagement made people estimate their future emotions more accurately and overcome their forecasting bias. Surprisingness was then manipulated further to explain whether it could impact the effect of occupational engagement on affective forecasting. The emotional responses in both prediction and experience were affected by surprisingness, thus causing no affective forecasting biases. These results suggest the role of occupational engagement in affective forecasting and provide evidence supporting the information accessibility model about the mechanism in affective forecasting.

Development of the Japanese Version of the Engagement in Meaningful Activities Survey

OBJECTIVES

To create a Japanese version of the Engagement in Meaningful Activities Survey (EMAS) and assess internal consistency, test-retest reliability, convergent and structural validity.

METHOD

We conducted a cultural translation and validation study of the Japanese version of the EMAS (EMAS-J) in a sample of 96 community-dwelling older adults in the Tohoku Region of Japan.

RESULTS

Internal consistency of the EMAS-J (α = .91) was very good. Low to moderate correlations were found with indicators of health-related quality of life, depression, and life purpose and meaning. Exploratory factor analysis indicated a two-factor structure within the EMAS-J; cultural differences in item-factor composition compared with previously reported EMAS factor structures are discussed.

IMPLICATIONS

The EMAS-J is a reliable and valid assessment of engagement in meaningful activities for older adults in Japan. The assessment can be used to evaluate the effects of occupation-based interventions upon health and well-being.

Health Care Professional Perceptions About a Proposed NICU Intervention: The Importance of Community and Aligning With Everyday Occupations

The neonatal intensive care unit (NICU) is a dynamic system with multiple stakeholders and contextual factors impacting the implementation of novel practices. This qualitative study aimed to (a) define health care professionals' perceptions on the feasibility of implementing a sensory intervention to study its efficacy, and (b) elaborate on transactions occurring between NICU health care professionals and the proposed research. Eleven NICU professionals participated in one of three focus groups that were audio-recorded, transcribed, and analyzed thematically in NVivo first descriptively and then interpretively through a transactionalism lens. The health care professionals implied the intervention was feasible, but provided multiple suggestions to enhance implementation. The modification of familiar occupational practices, ingrained habits, and the potential impact on the collective occupational performance of NICU community members arose. Understanding occupations within the NICU as transactional allows for a broader view of occupational engagement and enhances knowledge of the nuances related to implementing clinical changes.

Technology-Aided Spatial Cues, Instructions, and Preferred Stimulation for Supporting People With Intellectual and Visual Disabilities in Their Occupational Engagement and Mobility: Usability Study

Background

Persons with severe or profound intellectual disability and visual impairment tend to be passive and sedentary, and technology-aided intervention may be required to improve their condition without excessive demands on staff time.

Objective

This study aims to extend the assessment of technology-aided interventions for supporting functional occupational engagement and mobility in 7 people with intellectual disability and visual impairment and to use a technology system that is simpler and less expensive than those previously used.

Methods

The technology system involved a Samsung Galaxy A10, 4 Philips Hue indoor motion sensors, and 4 mini speakers. Within each session, the participants were to collect 18 objects (ie, one at a time) from 3 different areas (stations) located within a large room, bring each of the objects to a central desk, and put away each of those objects there. For each object, the participants received verbal (spatial) cues for guiding them to the area where the object was to be collected, a verbal instruction (ie, request) to take an object, verbal (spatial) cues for guiding them to the central desk, a verbal instruction to put away the object collected, and praise and preferred stimulation.

Results

During baseline, the frequency of responses completed correctly (objects collected and put away independently) was 0 or near 0. During the intervention phase (ie, with the support of the technology setup), the frequency increased for all participants, reaching a mean of almost 18 (out of 18 response opportunities) for 6 participants and about 13 for the remaining participant. The mean session duration ranged from 12 to 30 minutes.

Conclusions

A program, such as the one used in this study, can be useful in promoting occupational engagement and mobility in persons with intellectual disability and visual impairment.

User Perspectives on the Service Delivery of Complex Power Wheelchairs

The purpose of this study was to explore users' perspectives on power wheelchair service delivery and understand their involvement in the equipment trial and selection process. Five power wheelchair users participated in. Responses and interview data analysis supported four main themes describing variability in the evaluation practices of the provider team, how consumers' participation goals were impacted by equipment usability, consumer involvement in equipment selection influenced satisfaction, and illustrated the complexities in the service delivery process. The conclusion suggests consumer involvement in the trial and selection process may contribute to power wheelchair outcome usability, satisfaction, and occupational engagement.

Occupation's Role in Producing Inclusive Spaces: Immigrants' Experiences in Linguistic Minority Communities

While the "situatedness" of occupation in the context of migration has been explored using various approaches, there remains a need for a holistic and dynamic understanding of the concept of space and the spatiality of occupation. Adopting Lefebvre's theory of the production of space and taking a transactional approach to occupation, we examined the role of immigrants' occupational engagement in the production of Francophone minority community spaces in Metro Vancouver, Canada. We completed a critical ethnography and focus on findings from participant observations and in-depth and go-along interviews with French-speaking immigrants. Findings shed light on the influence of immigrants' occupational engagement on the production of minority spaces. To study the spatiality of occupation comprehensively, we need to move beyond an examination of the immediate environment to address other components of the production of space as well as the interrelation of spaces through occupation.

Integrating consequences of stroke into everyday life - Experiences from a long-term perspective

BACKGROUND

Occupational engagement encompasses both objective and subjective aspects of occupation. Long-term follow-up studies indicate that stroke can have a negative impact on the ability to perform IADL. Less is known about the subjective experiences of occupational engagement and how engagement may evolve after stroke.

OBJECTIVE

To explore stroke survivors' experiences of occupational engagement and how engagement changed over time and across contexts.

MATERIAL AND METHODS

Repeat, semi-structured interviews 15-18 years post-stroke, analysed using thematic analysis. Eight out of nine participants were classified as having had a mild stroke at onset.

RESULTS

The analysis resulted in five themes that together formed the main theme 'It takes time - integrating consequences of stroke into everyday life by engaging in occupation, using internal resources and adapting to context'. This illustrated how occupational outcome was the result of a continuous process in which occupational engagement was a way of gradually integrating consequences of stroke into everyday life.

CONCLUSION AND SIGNIFICANCE

Occupational engagement plays an important part in the process of moving on with life and can serve as both goal and means of achieving desired outcomes after stroke. Interventions that focus on enabling opportunities for occupational engagement in valued occupations and support the use of abilities and internal resources can reduce the impact of stroke in everyday life.

Octopus Watch Fosters Family Resilience by Enhancing Occupational Engagement for Children with Spina Bifida and/or Hydrocephalus: Pilot Study

BACKGROUND

Children with spina bifida and/or hydrocephalus (SB&/H) often experience difficulties with activities of daily living (ADLs) due to impaired executive functioning, increasing sedentary behaviours. The HeyJoy Octopus watch, a child-friendly icon-based smartwatch could be used as an enabler to promote purposeful ADLs (i.e., goal-orientated ADLs).

OBJECTIVE

to investigate the effectiveness of the Octopus watch in promoting purposeful ADLs for children living with SB&/H (<8 years).

METHODS

Mixed-methods engaging parents and children in four phases: (1) Administered demographic questionnaire, semi-structured interview, childhood executive functioning inventory (CHEXI) and the Canadian occupational performance measure (COPM); focus group one introducing the study, information pack using smartwatch and photovoice data collection methods. (2) Measured baseline movement for four days with smartwatch without using functions. (3) Measured activity for 16-days while using the smartwatch. (4) Re-administered assessments and conducted a second focus group based on photovoice narratives.

RESULTS

movement data recorded for four participants, three of four showed mean activity increase (36%). N-of-1 analyses found one participant showed clear improvement (p = 0.021, r² = 0.28). Mean inhibition decreased by 16.4%, and mean change in COPM performance and satisfaction scores were 2.1 and 2.4, respectively. The photovoice narrative focus group supports findings evidenced with improved daily routines.

CONCLUSIONS

The Octopus watch is an innovative early intervention that can promote purposeful ADLs, fostering family resilience by enhancing occupational engagement. Further research is required.

Understanding occupational engagement for individuals with bariatric needs: The perspectives of Australian Occupational Therapists

INTRODUCTION

Over the last 20 years, the number of individuals affected by obesity in Australia has increased by 56%. The impact of excessive weight gain results in a wide range of physical, psychological and social difficulties, with resultant changes to occupational performance and engagement. For some people within this population, a further consequence of this increasing weight gain contributes to additional difficulties, with the individual being considered to be "bariatric". For these people, resultant changes include decreased capacity to engage in self-care activities, leisure occupations and productive roles, creating significant difficulties in undertaking important life roles. This phenomenological study aimed to understand the occupational engagement of individuals with bariatric needs, and to identify potential opportunities to support the engagement and participation of these individuals from the perspectives of Australian occupational therapists.

METHODS

Qualitative data were collected from 11 semi-structured interviews with occupational therapists from a variety of practice settings.

RESULTS

Thematic analysis identified four central themes (a) Occupational engagement was significantly impacted by a lack of suitable resources and availability of daily living equipment; (b) Health and well-being were impacted by a disruption in meaningful occupational engagement; (c) Occupational roles were limited due to poor occupational identity and perceptions of not belonging within the community; (d) Occupational therapists do have a varied role when working with individuals with bariatric needs.

CONCLUSION

Occupational therapists engaged in this study indicated that people with bariatric needs were significantly impacted by many complex issues as a result of their health condition, often contributing to poor health and decreased well-being. Occupational therapists are well-placed to engage with individuals with bariatric needs across many care contexts and must take up potential opportunities to provide services targeted towards the increased engagement and participation of these individuals, with resultant improvements to health and well-being.

Major Incongruence and Occupational Engagement: A Moderated Mediation Model of Career Distress and Outcome Expectation

This study investigated the possible mediation of career distress in the relationship between major incongruence and occupational engagement and whether this mediation depends on the degree of outcome expectation. Moderated mediation analysis was tested on a sample of 346 Korean undergraduate students. The results indicated that career distress mediated the relationship between major incongruence and occupational engagement. Moreover, the negative indirect effect of major incongruence on occupational engagement through career distress weakened as the level of outcome expectation increased. The significant mediation effect of career distress is meaningful given the evidence on the role of emotion in career adaptation. In addition, the significant moderation effect of cognitive evaluation and belief in the mediating relationship on career problem, career emotion, and career behavior is meaningful in that it provides insights in cognitive intervention that could be effective in career counseling.

Engagement and social interaction in dementia care settings. A call for occupational and social justice

As full citizens, people with dementia are entitled to engage in social and occupational activities in residential care settings. Limitation or deprivation of choice and experience of valued occupations has been described elsewhere as occupational injustice. This research frames the unmet needs of people with dementia for occupation and social interaction, as issues of human rights and citizenship. It identifies a gap in current measurement tools of engagement in residential settings and in response, presents the Assessment Tool for Occupational and Social Engagement (ATOSE) as an objective measure of engagement. It examines results from a study of five residential care settings in Ireland using the ATOSE which included 73 residents with dementia and/or enduring mental health diagnoses. Residents spent on average, 38% of their time engaged and 62% of their time not engaged while in their communal sitting rooms. The ATOSE observations supported the rights of residents as citizens to have low levels of engagement addressed. A critical gerontology lens is employed to discuss concepts of citizenship, occupational justice, and social justice in the context of this research project.

Older women's engagement in community occupations: Considerations of lifespan and place

Background: To reach the promise of age-friendly communities, more complete understandings of how participation in community occupations occurs, in place and over time, is needed.Aim: To explore older Canadian women's engagement in community occupations as it occurs over the lifespan and in context.Materials and methods: Data from three selected participants were drawn from an exploration of older adults' social connectedness in neighbourhoods, which involved an ethnographic approach involving narrative interviews, go-along interviews, and activity tracking and follow-up interviews. A transactional lens oriented analysis, considering occupation in place, over time. Analysis involved identifying key storylines and themes and drew on conceptualizations of transition and continuity.Results: The participants' stories revolved around two themes: continuity within leisure over time and social engagement as a work in progress. The participants demonstrated differing patterns of achieving continuity within leisure and worked to maintain social engagement in the face of continually evolving social networks.Conclusions and significance: Findings enhance understandings of transition, continuity and the transactions between person and place that shape leisure and social engagement over time. Occupational therapists can consider community occupations from a transactional lens within services and policy to better support older women's participation and inclusion in neighbourhoods.

A Technology-Aided Program to Support Basic Occupational Engagement and Mobility in Persons with Multiple Disabilities

Background

Persons with severe/profound intellectual and multiple disabilities tend to be passive and sedentary. Promoting their occupational engagement and mobility (i.e., indoor walking) can help to modify their condition and improve their environmental input, health, and social image.

Aim

This study assessed whether a technology-aided program was suitable to (a) support independent occupation and mobility in eight participants with intellectual and sensory disabilities and (b) eventually increase the participants’ heart rates to levels considered beneficial for them.

Method

The program, which involved a computer system regulating the presentation of auditory or visual cues and the delivery of preferred stimulation, was introduced according to a non-concurrent multiple baseline design across participants. The auditory or visual cues guided the participants to collect objects from different desks and to transport them to a final destination (i.e., depositing them into a carton). Preferred stimulation was available to the participants for collecting and for depositing the objects.

Results

During the program, all participants had an increase in their independent responses of collecting objects and transporting them to the final destination. Their heart rates also increased to levels reflecting moderate-intensity physical exercise, potentially beneficial for their health.

Conclusion

A program, such as that used in this study, can promote occupational engagement and mobility in persons with multiple disabilities.

Well-being and perceptions of everyday activities among those who attend community-based day centres for people with mental illness in Sweden - Does an immigrant background make a difference?

BACKGROUND

Community-based day centres (CBDCs) for people with mental illness are a common service for both people with an immigrant background and native Swedes.

AIM

The aim was to compare CBDC attendees with an immigrant background with attendees who were native Swedes in terms of well-being and perceptions of everyday activities and investigate whether ethnic background could predict these factors.

METHODS

Attendees at nine CBDCs were invited to participate. In all, 56 with an immigrant background and 69 native Swedes completed self-report questionnaires that addressed various aspects of well-being and everyday activities.

RESULTS

Attendees with an immigrant background had a worse situation regarding perceived self-esteem, empowerment and satisfaction with everyday activities. In multivariate logistic regression analyses, ethnic background only became a significant predictor in regard to empowerment. Quality of life and activity level were of importance for satisfaction with everyday activities. Empowerment and self-esteem mutually influenced each other.

CONCLUSION

Having a mental illness and an immigrant background may infer a particular risk for low empowerment. The mental health services and society at large should consider measures for adjusting the support to this group, including an analysis of how environments and contexts may act as barriers to activity enrichment and culturally congruent support.

Qualitative Experience of Sleep in Individuals With Spinal Cord Injury

Poor sleep contributes to adverse health outcomes making it important to understand sleep in medically vulnerable populations, including those with spinal cord injury (SCI). However, little attention has been paid to circumstances specific to SCI that may negatively affect sleep, or to consequences of poor sleep in this population. The objective of this study was to examine the experience of sleep among individuals with SCI. Secondary analysis using thematic coding of qualitative data from an ethnographic study of community-dwelling adults with SCI was conducted. Sleep-related data were found in transcripts for 90% of the sample. Participants described diminished sleep duration and irregular sleep patterns. Several factors contributing to poor sleep were identified, including SCI-related circumstances and sleep environment. Participants also discussed how poor sleep affected occupational engagement. This study highlights the extent of sleep disturbance experienced after SCI and the subsequent impact on occupational performance, and provides direction for clinical practice.

Critical Reflections on Participatory Action Research in a Prison Setting: Toward Occupational Justice

There is little information about prison-related occupational deprivation, and about doing research in prison. To document an occupational therapist and two prisoners' critical reflections on an informal occupational therapy education program using participatory action research (PAR), we reflect on our combined experiences of evaluating an occupational therapy program. The reflections include articulation of power differentials and examples of occupational deprivation and injustice at every stage of the program evaluation process. We found that the PAR process allowed all collaborators to engage of co-occupation and gain a keener understanding of occupational justice. With co-occupation came personal growth and an appreciation for each other's humanity despite our diverse backgrounds. Recognizing that research in prison can be challenging, the results suggest it can also be rewarding. We offer insights and practical suggestions for doing research in prison.

Translating Occupational Justice Education Into Action: Reflections From an Exploratory Single Case Study

There is a growing body of scholarly literature about occupational justice, human rights, and power redistribution ready to be integrated into occupational science and occupational therapy education. As students around the world become familiar with the concepts and intents underlying occupational justice, it will be important to investigate their translation of occupational justice understandings into actions outside the classroom. This exploratory single case study describes curricular, university, and regional factors related to one former student's engagement in social protests following her occupational justice education. Based on her reflections, we emphasize the need to provide classroom opportunities where students can apply and critically reflect on (a) knowledge about occupational justice and (b) unintended consequences and potential professional tensions that may arise in relation to pursuing occupational justice. Future research will benefit from broader comparative studies that analyze personal, contextual, and programmatic differences among instances of occupational justice education and students' engagement in occupational reconstructions.

Managing occupations in everyday life for people with advanced cancer living at home

BACKGROUND

People with advanced cancer are able to live for extended periods of time. Advanced cancer can cause functional limitations influencing the ability to manage occupations. Although studies have shown that people with advanced cancer experience occupational difficulties, there is only limited research that specifically explores how these occupational difficulties are managed.

OBJECTIVE

To describe and explore how people with advanced cancer manage occupations when living at home.

MATERIAL AND METHODS

A sub-sample of 73 participants from a larger occupational therapy project took part in the study. The participants were consecutively recruited from a Danish university hospital. Qualitative interviews were performed at the homes of the participants. Content analysis was applied to the data.

RESULTS

Managing occupations were manifested in two main categories; (1) Conditions influencing occupations in everyday life and (2) Self-developed strategies to manage occupations.

SIGNIFICANCE

The findings suggest that people with advanced cancer should be supported to a greater extent in finding ways to manage familiar as well as new and more personally meaningful occupations to enhance quality of life.

Engagement in Play Activities as a Means for Youth in Detention to Acquire Life Skills

This study describes how occupational therapists in a community-based programme, Occupational Therapy Training Program (OTTP), use play activities to facilitate the acquisition of life skills by youth in detention. This pilot study explored the extent of engagement of male and female inmates aged 14 to 18 years old in structured play activities on topics such as interpersonal relationships, self-awareness, cultural celebrations and the transition to community. Retrospective analysis of data collected from surveys using the Engagement in OTTP Activities Questionnaire (EOAQ), completed by youth participants at the end of each group session, was used to measure the extent of occupational engagement. Worksheets and artworks produced by OTTP participants during those group sessions were also analysed. The participants reported very high engagement in OTTP. Engagement scores for male participants were higher than those for female participants, and male and female participants had higher engagement scores for different activities. Over 90% of the worksheets and artworks were found to be complete and relevant to the topic of the session. Play activities could be an appropriate way for occupational therapists to encourage youth in detention to acquire life skills. Demographic information and the actual number of participants are unknown because of how the existing data were collected. Future studies examining the potential gender-related preferences for specific topics deserve further investigation as well as research comparing the youth's engagement in OTTP interventions using play activities to other group interventions. Copyright © 2016 John Wiley & Sons, Ltd.

Factors related to the return to work potential in persons with severe mental illness

OBJECTIVE

This cross-sectional study aimed at investigating the relationship between the return to work potential, according to the Worker Role Interview (WRI) assessment, and clinical characteristics and level of empowerment and occupational engagement among persons with severe mental illness who express their own interest in working.

METHODS

120 participants entered the study. The WRI, the Brief Psychiatric and Rating Scale, a sociodemographic questionnaire, the Empowerment Scale, and the Profiles of Occupational Engagement in Severe mental illness were used for data collection. Correlation and regression analyses were used for statistics.

RESULTS

The return to work potential was significantly associated with having fewer symptoms, rehabilitation support or productive activities, and higher levels of engagement and empowerment. A younger age had an inverse relation to the lifestyle component in WRI. Depressive symptoms and occupational engagement explained 42% of the variance.

CONCLUSIONS

The findings support the use of an empowerment approach, taking into account the clients' symptoms, age, and time use. In addition, involvement in vocational support and productive activities may be advantageous early on in the recovery process.

Occupational engagement among community dwelling older people: A time-geographic perspective†

How older people spend their time in different occupations could contribute to our understanding of everyday life in healthy ageing. This study adopted a time-geographic method and occupational perspective to explore the occupational engagement of community dwelling older people. The term occupational engagement encompasses what people do, where and with whom they spend their time and the perceived level of competence and meaningfulness of their time use. Nineteen volunteers born between 1932 and 1933, living alone in an urban area in northern Sweden and receiving no home care services, completed open time-geographic diaries for 5 days in May 2010. The diary data were analyzed using Daily Life software program. The study revealed the complexity and the diversity of the older people's occupational engagement and that most of their time was spent alone in their home. The older people reported they were very good at doing almost half of the occupations in which they engaged and that their occupations were primarily either very meaningful or meaningful. While some methodological limitations were identified, time-geographic studies of community dwelling older people living independently are considered to have potential to contribute to community and social planning for older people as they can provide interesting insights to older persons' time use and occupational needs.

The influence of context: a naturalistic study of Ugandan children's doings in outdoor spaces

The purpose of this study was to explore children's everyday outdoor occupations in context. A naturalistic observational approach was employed to record the observed outdoor occupations of children in Mbarara, Uganda. Thematic analysis, through pattern formation and constant comparative analysis, was used to uncover categories and themes in the data. Patterns emerged from the data revealing two overarching categories containing three themes: 1) types of occupations: play, work and nothing in particular and 2) characteristics of occupational engagement: being in peer groups, having fun and using materials in the environment. The themes reveal that children's occupations are both similar and different across minority and majority world cultures and that children's occupations are contextually situated and flexible in nature. A limitation of the study was that the observational approach made identification of children's ages subjective. Subsequent studies should explore children's experiences of occupational engagement using interviews and focus groups.