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Occupational adaptation in diverse contexts with focus on persons in vulnerable life situations
Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).ORCID iD: 0000-0003-0192-9447
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Introduction. This present thesis focuses on occupational adaptation in the empirical context of vulnerable populations relative to ageing (Study II, III), disability (Study I, II) and poverty (Study IV) and in a theoretical context (V).

Aim. The overall aim was to explore and describe occupational adaptation in diverse contexts with a focus on persons in vulnerable life situations.

Methods. The thesis was conducted with a mixed design embracing quantitative and qualitative methods and a literature review. The data collection methods comprised questionnaires (Study I, II, III), individual interviews (Study II, IV), group interviews (Study III) and data base searches (Study V). Altogether 115 persons participated in the studies and 50 articles were included in the literature review. Qualitative content analysis was used to analyse the interviews (Study I, II, III, IV) and the literature review (Study V). Parametric and non-parametric statistics were applied when analysing the quantitative data (Study II, III).

Results: Women in St Petersburg, Russia, who have had a minor stroke reported more dependence in everyday occupations than the stroke symptoms indicated and they overemphasized their disability and dysfunction. When the environmental press did not meet their competence, it caused negative adaptive behaviour (Study I). In home rehabilitation for older persons with disabilities, interventions based on the occupational adaptation model was compared with interventions based on well-tried professional experience. The results indicated that the use of the occupational adaptation model increased experienced health and the participants acquired adaptive strategies to manage every day occupations. (Study II). An occupation based health-promoting programme for older community dwelling persons was compared with a control group. The intervention group showed statistically significant improvement in general health variables as vitality and mental health, but there were no statistically significant differences between the groups. A qualitative evaluation, in the intervention group, showed that participation in meaningful, challenging occupations in different environments stimulated the occupational adaptation process (Study III). Occupational adaptation among vulnerable EU citizens begging in Sweden was explored by interviews. The results showed that the participants experienced several occupational challenges when begging abroad. The results show a variety of adaptive responses, but whether they are experienced as positive or negative is a matter of perspective and can only be determined by the participants themselves (Study IV). Finally, the results from a literature review (Study V) showed that research on occupational adaptation was mainly based on Schkade and Schultz’s and Kielhofner’s theoretical approaches. Occupational adaptation was also used without further explanation or theoretical argument (Study V).

Conclusion: The surrounding context was shown to play an important role for the participants’ occupational adaptation. There were no general occupational challenges or adaptive responses to the various vulnerable life situations, but some common features in the participant groups’ adaptive responses were found. For example, if the environment put too great demand on the person and social support was lacking, there was a risk of negative adaptation. Moreover, persons with low functional capacity were vulnerable to environmental demands and dependent on a supportive environment for their adaptive response. However, persons living in supportive environments developed adaptive responses by themselves. Further, personal factors needed to be strengthened to meet the demands of the environment. Upholding occupational roles was a driving force in finding ways to adapt and perform occupations. Considering the theoretical context, the occupational adaptation theoretical approaches need to be further developed in relation to negative adaptation and to support use within community-based and health-promotive areas.

Place, publisher, year, edition, pages
Jönköping: Jönköping University, School of Health and Welfare , 2017. , 99 p.
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 083
Keyword [en]
Ageing, disability, empirical context, mixed design, poverty, theoretical context
National Category
Occupational Therapy
Identifiers
URN: urn:nbn:se:hj:diva-35516ISBN: 978-91-85835-82-9 OAI: oai:DiVA.org:hj-35516DiVA: diva2:1095694
Public defence
2017-06-16, Forum Humanum, School of Health and Welfare, Jönköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2017-05-24 Created: 2017-05-15 Last updated: 2017-06-15Bibliographically approved
List of papers
1. Activities of daily living among St Petersburg women after mild stroke
Open this publication in new window or tab >>Activities of daily living among St Petersburg women after mild stroke
2007 (English)In: Occupational Therapy International, ISSN 0966-7903, Vol. 14, no 3, 170-182 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to determine how women living in Saint-Petersburg, Russia and who have had a mild stroke, describe their performance in activities of daily living and possible causes of their occupational dysfunction.

Thirty-six women who have experienced a mild stroke and been referred to a rehabilitation center participated in the study. Data collection was conducted through interviews, including the ADL Staircase and a Modified Frenchay Activities Index for Stroke Patients. Additional data was collected through field notes and information from team members and relatives.

The results showed that women who have had a mild stroke and ADL limitations experience occupational dysfunction in ADL activities that is most often due to a combination of over-protection from relatives, the women’s feelings of anxiety and insecurity, and an over-emphasizing of their disability.

The results are limited based on the small sample and restricted geographic area.

There is a need to further investigate how individuals who have had a mild stroke can be physically and socially rehabilitated and reintegrated into the community in countries with developing economies such as Russia.

Keyword
Occupational dysfunction, stroke rehabilitation in Russia
National Category
Occupational Therapy Nursing
Identifiers
urn:nbn:se:hj:diva-6198 (URN)
Available from: 2007-11-08 Created: 2007-11-08 Last updated: 2017-05-15Bibliographically approved
2. Occupational Adaptation or Well-tried, Professional Experience in Rehabilitation of the Disabled Elderly at Home
Open this publication in new window or tab >>Occupational Adaptation or Well-tried, Professional Experience in Rehabilitation of the Disabled Elderly at Home
2006 (English)In: Activities, Adaptation & Aging, ISSN 0192-4788, E-ISSN 1544-4368, Vol. 30, no 1, 1-21 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this pilot study was to examine whether the use of the Occupational Adaptation Model increases independence and experienced health for disabled elderly in home rehabilitation in primary care. The study had an integrated design, in which the data were collected through a quasi-experimental plan in combination with semi-structured interviews with disabled elderly. The data were analyzed both quantitatively and qualitatively. The results indicated that the use of the model increases experienced health and gives the occupational therapist a tool for helping the disabled elderly to understand and engage themselves in their life situations.

Place, publisher, year, edition, pages
Taylor & Francis, 2006
Keyword
Experienced health, FIM, home-rehabilitation, IAM, independence, SF-36, semi-structured interviews, quasi-experimental design.
National Category
Occupational Therapy Other Social Sciences not elsewhere specified
Identifiers
urn:nbn:se:hj:diva-6188 (URN)10.1300/J016v30n01_01 (DOI)
Available from: 2007-10-21 Created: 2007-10-21 Last updated: 2017-05-15Bibliographically approved
3. The impact of occupational therapy and lifestyle interventions on older persons’ health, well-being, and occupational adaptation: A mixed-design study
Open this publication in new window or tab >>The impact of occupational therapy and lifestyle interventions on older persons’ health, well-being, and occupational adaptation: A mixed-design study
2015 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 23, no 3, 207-219 p.Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of this study was to investigate whether a four-month occupational based health-promoting programme for older persons living in community dwellings could maintain/improve their general health and well-being. Further, the aim was to explore whether the programme facilitated the older persons’ occupational adaptation.

Methods: The study had a quasi-experimental design, with a non-equivalent control group combined with semi-structured interviews. The intervention group comprised 22 participants, and the control group 18. Outcomes were measured using the Short Form 36, Life Satisfaction Index-Z and Meaningful Activity Participation Assessment. Content analysis, based on concepts from the Model of Occupational Adaptation, was used to analyse the interviews.

Results: The intervention group showed statistically significant improvements in general health variables such as vitality and mental health, and positive trends for psychological well-being. There were no statistically significant differences between the intervention group and the control group, but the groups were not fully matched. The qualitative analysis based on Occupational Adaptation pointed out social aspects as a compliment to the overall results.

Conclusions: Participating in meaningful, challenging activities in different environments stimulates the occupational adaptation process; this is something occupational therapists could use to empower older persons to find their optimal occupational lives

Place, publisher, year, edition, pages
Taylor & Francis, 2015
Keyword
Adaptive response, community dwellings, health promotion, mastery, primary care
National Category
Occupational Therapy
Identifiers
urn:nbn:se:hj:diva-28506 (URN)10.3109/11038128.2015.1093544 (DOI)000374634100004 ()26442837 (PubMedID)2-s2.0-84945232657 (Scopus ID)
Available from: 2015-12-07 Created: 2015-12-07 Last updated: 2017-05-15Bibliographically approved
4. Occupational adaptation in vulnerable EU citizens when begging in Sweden
Open this publication in new window or tab >>Occupational adaptation in vulnerable EU citizens when begging in Sweden
Show others...
(English)Manuscript (preprint) (Other academic)
National Category
Occupational Therapy
Identifiers
urn:nbn:se:hj:diva-35514 (URN)
Available from: 2017-05-15 Created: 2017-05-15 Last updated: 2017-05-15Bibliographically approved
5. The use of occupational adaptation in research articles: a scoping review
Open this publication in new window or tab >>The use of occupational adaptation in research articles: a scoping review
(English)Manuscript (preprint) (Other academic)
National Category
Occupational Therapy
Identifiers
urn:nbn:se:hj:diva-35515 (URN)
Available from: 2017-05-15 Created: 2017-05-15 Last updated: 2017-05-15Bibliographically approved

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