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The impact of occupational therapy and lifestyle interventions on older persons’ health, well-being, and occupational adaptation: A mixed-design study
Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.ORCID iD: 0000-0003-3594-4805
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. Vol. 23, no 3, 207-219 p.
Keyword [en]
Adaptive response, community dwellings, health promotion, mastery, primary care
National Category
Occupational Therapy
Identifiers
URN: urn:nbn:se:hj:diva-28506DOI: 10.3109/11038128.2015.1093544ISI: 000374634100004PubMedID: 26442837Scopus ID: 2-s2.0-84945232657OAI: oai:DiVA.org:hj-28506DiVA: diva2:877786
Available from: 2015-12-07 Created: 2015-12-07 Last updated: 2017-12-01Bibliographically approved
In thesis
1. Occupational adaptation in diverse contexts with focus on persons in vulnerable life situations
Open this publication in new window or tab >>Occupational adaptation in diverse contexts with focus on persons in vulnerable life situations
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
Ageing, disability, empirical context, mixed design, poverty, theoretical context
National Category
Occupational Therapy
Identifiers
urn:nbn:se:hj:diva-35516 (URN)978-91-85835-82-9 (ISBN)
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

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Johansson, AnnBjörklund, Anita

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