Background: Sexual health is an important issue in daily life, but little is known about occupational therapy (OT) students’ views on these matters.

Aim: To explore occupational therapy students’ views on addressing sexual health in their future professional role.

Material and methods: A descriptive qualitative study involving 37 OT students in 5 focus groups was performed and analyzed using content analysis.

Results: Three categories: ‘Sexual health is part of occupational therapy and but not of the OT educational program’; ‘Need for knowledge to identify and intervene related to sexual health problems’; and finally, ‘Communication about sexual health—unknown, untried, but necessary’, formed the theme, ‘Willing to try, wanting to know more, and recognizing not only the difficulties and challenges but also the importance of sexual health in OT practice’.

Conclusions: OT-students consider sexual health as part of OT-practice, but experience lack of knowledge of sexual health related to disease/disability, cultural diversity, and age and sexual orientation. Educational programs need to cover these matters, including how to address sexual health in OT-practice, to enhance OT’s future competence related to promotion of sexual health for clients.

Significance: Knowledge on students’ views are vital to guide education on this important, rather neglected, area. 

Background. Knowledge about how people with severe mental illness find meaning in non-work occupations is important in order to develop programmes of meaningful daily occupations for this group.

Purpose. To examine the meaning daily occupations may bring to those who are severely mentally ill and unemployed.

Methods. Twelve unemployed people with severe mental illness were interviewed regarding their experience of meaning in daily occupations.

Findings. Meaning was experienced in a balance between occupations that helped the informants control their mental illness. Themes of meaning were: feeling competent and being socially engaged, having routines and being productive, being creative and seeking knowledge, and taking care of body and mind. Substitutes for paid work were found in occupations such as taking care of the household or being productive at a day centre.

Implications. People with severe mental illness should be allowed to play an active role in their rehabilitation process, using the occupational therapist for forming daily routines, creating a balance between work-like and restful occupations, finding occupations that meet one’s skills and training social behaviour. Besides, work-related occupations should be emphasized in the rehabilitation.

Background: Participation comprises attendance and involvement in everyday situations. Picture My Participation (PmP) is an instrument intended to measure participation in children with disabilities, particularly in low and middle income countries.

Aim: To investigate content validity and usefulness of PmP for measuring participation in children with intellectual disability (ID) in South Africa and Sweden.

Methods: A picture supported interview with 149 children, 6?18 years, with and without ID. Twenty everyday activities were provided. The three most important activities were selected by the child. Attendance was rated on all activities. Involvement was rated on the most important.

Results: All activities were selected as important by at least one child with ID in both countries. There were similarities in perceived importance between the children with and without ID from South Africa. The children from South Africa with ID were the only subgroup that used all scale points for rating attendance and involvement.

Conclusion: The 20 selected activities of PmP were especially relevant for children with ID in South Africa. The usefulness of the scales was higher for the children with ID in both countries. PmP is promising for assessing participation across different settings but psychometrical properties and clinical utility need further exploration.

Background: Limited time management skills cause problems in daily life for people with mild intellectual disability (ID) and “Let’s Get Organized” (LGO) is a promising manual-based occupational therapy group intervention aiming to support management skills.

Aims/Objectives: To evaluate the applicability of the Swedish version of LGO-S by i) exploring enhancements in time management skills, satisfaction with daily occupations, and aspects of executive functioning in people with time-management difficulties and mild ID, and ii) describing clinical experiences of using the LGO-S for people with mild ID.

Material and methods: Twenty-one adults with mild ID were included. Data were collected pre-/post-intervention and at 3- and 12-month follow-ups with: Swedish version of Assessment of Time Management Skills (ATMS-S), Satisfaction with Daily Occupation (SDO-13), and Weekly Calendar Planning Activity (WCPA-SE). There were few follow-up participants (n = 6-9).

Results: Significant change in time management skills that maintained at 12-months follow-ups. Significant increase in regulation of emotions at 12-month follow-up. Results at 12-months follow-up indicated sustainability in outcomes as measured by ATMS-S. A non-significant positive trend was observed in other outcomes between pre- and post-intervention.

Conclusions and significance: LGO-S seems applicable for improving skills in time management, organisation and planning also for people with mild ID.

The Code of Ethics for Occupational Therapists stipulates how occupational therapists should think about the profession’s central concepts in practice, where ‘Health’ is one such concept. Other guiding principles for practice are the Occupational Therapy Process Model and the ARTUR Case Record Structure. The aim of this study has been to identify and describe how occupational therapists at a hospital in Sweden documented interventions in patient case records. A stratified and random sample of one hundred case records was evaluated in relation to a checklist. The results showed that only 21 percent of the case records were complete. Often, the notes were found under the wrong keyword and 12 percent of the occupational therapy cases were indistinct and did not belong to any of the intervention categories in which occupational therapists normally intervene. Despite this, the majority of the case records reflected the ICF’s Activity/Participation component, which could be interpreted to mean that the occupational therapists held holistic health notions in line with the code of ethics. In order to improve the occupational therapists’ documentation in patient case records, further discussions of the central concepts and guiding principles for occupational therapy are required.

Background

Picture My Participation (PmP) is a promising instrument for measuring the participation in everyday situations of children with intellectual disability (ID), particularly in low- and middle-income countries.

Aim

To explore test-retest reliability of PmP by comparing two repeated measurements of children with ID in an urban context in South Africa.

Methods

A picture-supported interview with 31 children with ID, aged 7-17 years, was conducted twice, two weeks apart. The children rated their participation, operationalised as attendance and involvement, in 20 everyday activities. Analyses were completed for total scores, for the four subcomponents and at item level.

Results

Test-retest agreement at an item level for both attendance and involvement showed slight/fair agreement for most activities (Kappa = 0.01-0.40), and moderate agreement for some activities (Kappa = 0.41?0.60). Moderate agreement was shown for the total scale and at component level (ICC = 0.5?0.75), except for (firstly) attendance of and involvement in 'Family Activities' (ICC = 0.26 for attendance, 0.33 for involvement), and (secondly) involvement in 'Personal Activities' (ICC = 0.33).

Conclusion

The result indicates that PmP can reliably be used at component level and as a screening tool for intervention planning to identify participation and participation restrictions in children with ID.

BackgroundPhronesis is a way of knowing, implying wisdom, experiences, and reflections that guide our judgements. Phronesis, important for learning, is a neglected form of knowledge when applied to research.AimTo examine how phronesis is conceptualised and practiced in three research projects.MethodData from eight interviews with researchers involved in three research projects was generated. The interview material was analysed. A theoretical matrix of contemporary understanding of phronesis was applied to the material.ResultExamples of phronesis from three research projects in occupational therapy are presented according to categories of contemporary phronesis; acknowledging embodiment, embracing humility, using perceptiveness, and practicing reflexivity.SignificanceThis unique approach of analysing research projects contributes to the understanding of phronesis and its implications for research, providing valuable insights into the researchers' praxis in their respective projectsConclusionThere is a need for a greater recognition of phronesis as a dimension of knowledge within all types of research, and within the discipline. By not recognising phronesis as a legitimate form of knowledge, the discipline perpetuates a superiority of knowledge from episteme that dominates our ways of learning about the world around us and where the type of knowledge gleaned from phronesis is consequently marginalised.

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease often associated with disability. Despite new treatments, pain and activity limitations are still present.

Objectives: To describe how persons with RA experience and manage pain in their daily life.

Methods: Seven semi-structured focus groups (FGs) were conducted and analyzed using content analysis.

Results: The analysis revealed four categories: 1) Pain expresses itself in different ways referred to pain as overwhelming, aching or as a feeling of stiffness. 2) Mitigating pain referred to the use of heat, cold, medications and activities as distractions from the pain. 3) Adapting to pain referred to strategies employed as coping mechanisms for the pain, e.g. planning and adjustment of daily activities, and use of assistive devices. 4) Pain in a social context referred to the participants’ social environment as being both supportive and uncomprehending, the latter causing patients to hide their pain.

Conclusions: Pain in RA is experienced in different ways. This emphasizes the multi-professional team to address this spectrum of experiences and to find pain management directed to the individual experience that also include the person’s social environment.

The aim of this pilotstudy is to present a more disticnct profile of the profession, deriving inspiration from Törnebohm's theory of paradigms. Six occupational therapists answered in writing 12 open essay questions about their ideas on paradigmatic matters. The focus in the questions is within the occupational therapist's field of action view and results are presented as aspects of practice. The occupational therapist is like a chameleon in the field of health care. She alters between different roles, using various parts of her professional competence to support the patient in reaching a meaningful everyday life from the patient's own perspective. The flexibility of the profession may contribute to many occupational therapists' feelings of having av vague professional profile, but is fundamental and a prerequisite of good occupational therapy. A greater awareness of our professional paradigm creates conditions by which it can be improved and adapted to variable demands. and a greater possibility to express the profession to society.

The aim of this study was to examine and characterize an aggregation of experienced occupational therapists´ exam papers with regard to the occupational therapists´ research interests, concerning especially ontological and strategical matters, during the time period 1984-1996. The title pages, summaries and results discussions of 84 papers were analyzed qualitatively and quantitatively with the starting point in two of the components from Törnebohm´s structure of paradigms: the world view- and the field of action view-component. The occupational therapists´ interest in research subjects related to the field of action view component of paradigms, and applied research on strategical matters, dominates throughout the material. The interest in research subjects related to the world view component of paradigms, and basic research on ontological matters, increases in the last five year period. The increasing interest in more ontological matters seems as a natural and necessary progress for a profession which is deeply involved in knowledge aquired by experience. Only by the development of a “double-edged” knowledge, the profession has the possibility of developing and adapting to future demands.

The aim of this study was to identify and characterise conceptions of health in a group of experienced occupational therapists. Data-collection involved the occupational therapists´ personal accounts of the meaning of health and data analysis was accomplished qualitatively. The material was found to comprise 52 distinguishable articulations of the meaning of health, which were categorized under three main themes: 22 articulations of Health as “feeling fine“; 20 articulations of Health as ability to act; and 10 articulations of Health as an objective state of body and/or mind. The results show a very strong tendency towards holistic health conceptions and also toward a phenomenological view on the body. If this tendency should be taken to reflect current basic views within the profession this would indicate a movement away from biomedical frames of reference on the theoretical level. This would seem to imply consequent movements on the practice level away from organ focused interventions to the benefit of interventions in the person/context dimension of occupational performance. Studies of processes of change seem to be needed and we suggest that a paradigm theory approach probably be most pertinent.

The objectives of this study were to inquire into notions of health among a group of 439 Swedish occupational therapists and to test a model derived from a qualitative study by Björklund and Svensson in a representative sample of occupational therapists in Sweden. The data were collected through a questionnaire and were analyzed using descriptive statistics, cluster analysis and confirmatory factor analysis. The means and ranking of the health notions showed that the Swedish occupational therapists most frequently hold holistic notions of health, and to a smaller extent biostatistical ones. Most Swedish occupational therapists indicate that being clearly conscious of one’s health notions is important both to themselves and to their profession. The test of the model provides a step towards developing an instrument for measuring notions of health that clearly distinguishes between holistic and biomedical ones and that could possibly be used for comparative studies.

The aim of this paper is to advance our understanding of participation and its relation to occupation, by analysing the daily occupational experiences of six men and women living with chronic pain. Open-ended interviews are used in conjunction with a constant comparative method of analysis. The findings are thematically presented as: "taking initiative and making choices", doing something physical", "doing something social", and "doing something for others". Furthermore, a short vignette is presented in which the authors attempt to juxtapose theoretical constructs with individual experiences in order to illustrate another level of contextual richness of the data. Methodological implications are discussed in relation to the findings, analytic presentation, and previous research.

Objective: The aim of this study was to evaluate the effect of an assistive technology (AT) intervention to improve the use of available computers as assistive technology in educational tasks for students with physical disabilities during an ongoing school year. Methods: Fifteen students (aged 12–18) with physical disabilities, included in mainstream classrooms in Sweden, and their teachers took part in the intervention. Pre-, post-, and follow-up data were collected with Goal Attainment Scaling (GAS), a computer usage diary, and with the Psychosocial Impact of Assistive Devices Scale (PIADS). Teachers' opinions of goal setting were collected at follow-up. Results: The intervention improved the goal-related computer usage in educational tasks and teachers reported they would use goal setting again when appropriate. At baseline, students reported a positive impact from computer usage with no differences over time regarding the PIADS subscales independence, adaptability, or self-esteem. Discussion: The AT intervention showed a positive effect on computer usage as AT in mainstream schools. Some additional support to teachers is recommended as not all students improved in all goal-related computer usage. A clinical implication is that students' computer usage can be improved and collaboratively established computer-based strategies can be carried out by teachers in mainstream schools.

BACKGROUND: Occupational balance is a central concept in occupational therapy and is commonly defined as an individual's perception of having the right amount and variety of occupations in daily life. This individualistic and subjective nature of occupational balance brings with it certain challenges when applied in practice. The aim of this discussion paper is to highlight the challenges associated with the lone application of individualistic occupational balance in practice situations, and propose some way forward.

METHODS: The Meleis' Theory to Practice to Theory strategy was used. Practice-based vignettes were used as a point of departure to discuss these challenges. This was followed by theorising the importance of including the others' perceptions of a person's pattern of daily occupations.

CONCLUSION: Besides a goal of increasing a person's occupational balance in clinical practice, striving towards creating a suitable pattern of daily occupations from a community perspective also seems to be a relevant goal.

Background: The Powered Mobility Device Autonomy Residential Screen (PoMoDARS) is a new tool to enable clinicians to screen resident capacity and performance skills for powered mobility device (PMD) use in residential aged care settings. The PoMoDARS is context specific, time efficient and promotes resident autonomy and safety.

Aims: To (i) undertake initial face and content validation of the PoMoDARS, and (ii) use the research findings to make any modifications.

Methods: A mixed-methods study design, underpinned by Classical Test Theory. Eight clinicians completed 20 PoMoDARS screens and provided both quantitative and qualitative feedback on item importance and ease of use within a formal interview.

Results: Initial face and content validity of the PoMoDARS were supported, with small modifications made to item descriptors and instructions.

Conclusions: The PoMoDARS has been developed for use in residential aged care settings to screen resident PMD use. While initial validation has been undertaken, further studies to determine the reliability of the tool and continue the validation process are required.

Significance: Older adults in residential aged care facilities benefit greatly from the autonomy gained through PMD use. The PoMoDARS promotes collaboration between occupational therapists, nurses, and the wider team to support residents and safe PMD use.

BACKGROUND: A literature review in 2001 found that children with disabilities were frequently transported in unsafe conditions and further research was required to investigate the gap between regulations, standards and actual transportation practices.

OBJECTIVES: To synthesize available evidence on the transportation of children with disabilities in road vehicles.

METHODS: Four databases were systematically searched: CINAHL; Medline; National Transport Library Catalogue (Sweden); and Transport Research International Documentation.

RESULTS: Nineteen studies ranging in methodological quality from poor to excellent were included in the review. The findings are presented under the following six major themes: child safety restraints, wheelchairs, vehicles, travel habits, parental and professional knowledge. The results are mapped onto two groups of children, those with behavioral problems and those with physical disabilities.

CONCLUSION: The literature reflected little change across the six major themes since the previous review. Children with disabilities continue to be inappropriately restrained in vehicles, constituting an ongoing road safety problem. There is a strong need to increase parent knowledge, upskill health professionals and provide families with financial assistance to enable them to ensure the safe transportation of children with disabilities to minimize the risk of injury and fatalities on the road, and enhance their participation in the community.

AIMS: The Satisfaction with Daily Occupations (SDO) scale assesses satisfaction within the domains of work, leisure, domestic tasks, and self-care. The aim was to investigate the psychometric properties of the Danish version of the SDO when used with asylum seekers.

METHODS: The participants were 93 Danes without known ill health and 43 asylum seekers. They completed the SDO and rated their perceived health, activity level, and general satisfaction with daily occupations. Translation into Danish and back-translation into Swedish was made by professional interpreters.

RESULTS: Internal consistency was α = 0.75 for the Danish sample and α = 0.79 for the asylum seekers. The SDO distinguished between asylum seekers and the Danish sample, suggesting criterion validity. Concurrent validity, analysed against general satisfaction with daily occupations, was indicated for both samples. Discriminant validity was indicated against self-rated health for both samples and against activity level for the Danish sample. There was, however, a correlation of 0.65 between the SDO satisfaction score and activity level for the asylum seekers.

CONCLUSION: The SDO exhibited satisfactory internal consistency and criterion and concurrent validity. The findings regarding discriminant validity were somewhat inconclusive. The Danish SDO may be regarded as psychometrically sound but further psychometric testing is needed.

Background: People with psychiatric disabilities often find it difficult to maintain a satisfactory occupational balance.

Aims/objectives: This study aimed to investigate the validity and reliability of the Turkish version of the Occupational Balance Questionnaire (OBQ11-T) in mental health.

Material and methods: OBQ11-T was applied to 149 people for construct validity analysis and to 61 of them for reliability analysis. Validity was determined using factor analyses. The reliability of the OBQ between the first and second evaluations was assessed using the intraclass correlation coefficient (ICC) for each item and the total OBQ11-T score. Internal consistency was assessed using Cronbach’s alpha.

Results: The results of factor analysis revealed one factor that explains 35.94% of the total variance in the model. OBQ11-T item 1 had the lowest and OBQ11-T item 4 had the highest factor loadings. The model fits the data according to the indices of relative fit (RMSEA = 0.087, CMIN/DF = 2.129, CFI = 0.901). There was an excellent correlation between test and retest OBQ11-T total scores (ICC = 0.905). All items of the OBQ11-T showed good reliability. Cronbach’s alpha for the OBQ11-T total score was 0.839, indicating acceptable internal consistency.

Conclusions and significance: The current study showed that OBQ11-T is a valid and reliable tool for measuring the self-rated occupational balance of people with mental illness.

Occupational therapists need to be cognizant of evidence-based role balance advice and strategies that women with multigenerational caring responsibilities can implement independently or with minimal assistance, as role balance may not be the primary goal during many encounters with this population. Hence, this study aimed to identify the viewpoints on the most helpful role balance strategies for working sandwich generation women, both from their own perspectives and from the perspective of occupational therapists. This was achieved through a Q methodology study, where 54 statements were based on findings from interviews, sandwich generation literature and occupational therapy literature. In total, 31 working sandwich generation women and 42 occupational therapists completed the Q sort through either online or paper administration. The data were analysed using factor analysis with varimax rotation and were interpreted through collaboration with experts in the field. The findings revealed similarities between working sandwich generation women and occupational therapists, particularly in terms of advocating strategies related to sleep, rest and seeking practical assistance from support networks. Differences were also present, with working sandwich generation women viewpoints tending to emphasize strategies related to coping with a busy lifestyle attending to multiple responsibilities. In contrast, occupational therapy viewpoints prioritized strategies related to the occupational therapy process, such as goal setting, activity focused interventions, monitoring progress and facilitating sustainable outcomes.

Objective: This pilot study aimed to establish the appropriateness of the Model of Juggling Occupations in exploring the complex experience of role balance amongst working women with family responsibilities living in Perth, Australia.

Methods: In meeting this aim, an evaluation was conducted of a case study design, where data were collected through a questionnaire, time diary, and interview.

Results: Overall role balance varied over time and across participants. Positive indicators of role balance occurred frequently in the questionnaires and time diaries, despite the interviews revealing a predominance of negative evaluations of role balance. Between-role balance was achieved through compatible role overlap, buffering, and renewal. An exploration of within-role balance factors demonstrated that occupational participation, values, interests, personal causation, and habits were related to role balance.

Conclusions: This pilot study concluded that the Model of Juggling Occupations is an appropriate conceptual framework to explore the complex and dynamic experience of role balance amongst working women with family responsibilities. It was also confirmed that the case study design, including the questionnaire, time diary, and interview methods, is suitable for researching role balance from this perspective.

Women combining paid employment with dual caring responsibilities for children and aging parents, otherwise known as the sandwich generation, experience both benefits and costs related to role participation and quality of life. However, previous literature is inconclusive regarding the impact of this role combination on role balance. In the context of these mixed findings on role balance for working sandwich generation women, this study aimed to explore how within role characteristics and between role interactions are related to role balance for these women. This aim was achieved through the use of a questionnaire administered to 18 Australian working sandwich generation women. Data were analyzed using descriptive statistics and correlation coefficients, with findings suggesting the women studied tended to experience neither role balance or role imbalance. Within-role characteristics, particularly within the mother and family member roles, were related to role balance. In addition, between-role conflict and role interactions involving either the home maintainer or family member roles had the greatest impact on role balance.

Background: There is a lack of evidence-based knowledge in paediatric occupational therapy about the effectiveness of interventions using daily activities as a treatment modality in improving children’s participation.

Objective: This study aimed to evaluate the effectiveness of occupation-based and occupation-focused interventions in improving participation in everyday occupations for young children with a disability.

Material and methods: A systematic review based on Joanna Briggs Institute methodology and critical appraisal tools was conducted. Six databases were searched for quantitative intervention studies aimed at improving participation in everyday occupations of young children with a disability through the use of everyday occupation.

Results: The search yielded 3732 records, of which 13 studies met inclusion criteria. Ten studies met methodological quality criteria and were included in the synthesis, five randomised controlled trials and five quasi-experimental studies, involving a total of 424 children with a mean age of 6.5 years. The studies were classified into cognitive (n = 5), context-focussed (n = 2) and playgroup interventions (n = 3). Study quality ranged from low to moderate, only one study was rated high quality.

Conclusions and significance: Occupation-based and occupation-focused interventions may have a positive effect on participation in everyday occupations for young children with a disability, but study design, risk of bias and insufficient reporting limit confidence in the body of evidence.

Background: With the evolution of contemporary occupations mediated by digital technologies (DTs), there is a need for occupational therapists to develop and structure knowledge on how to support older adults’ engagement in occupations and social participation in a digitalised society.

Objective: The objective of this study is to explore how tailoring to support older adults’ engagement in DT-mediated occupations could be schematised.

Material and methods: The study employed a multiple case study methodology. There were nine cases, with each case involving an older adult undergoing a collaborative process to support engagement in DT-mediated occupations. The collaborative process was initiated through questionnaires, observations, and dialogues. Meetings and tailoring strategies were documented in fieldnotes and memos on tailoring, respectively. Semi-structured interviews concluded data collection. Cross-case synthesis was used in data analysis.

Results: The result is a proposed scheme for tailoring to support older adults’ engagement in digital technology-mediated occupations, wherein strategies undertaken in the collaborative processes were synthesised and described.

Conclusion and significance: The proposed scheme for tailoring could contribute to occupational therapists’ knowledge on how to support older adults’ engagement in contemporary occupations. Testing the model in various practice settings is recommended in order to enhance occupational therapy practice.

The purpose of this study is to evaluate the internal scale validity, person response validity, and reliability of the newly developed Assessment of Computer-Related Skills (ACRS). Data from 32 healthy adult participants who performed two to three computer tasks were analysed to determine how well the participants fitted the many-faceted Rasch (MFR) model of the ACRS, as well as how well the ACRS skill items and tasks (a) fitted the MFR model of the ACRS, (b) matched the expectations for hierarchical ordering of their difficulties, and (c) differentiated persons into different levels of ability. Results indicated that with three skill items removed, the remaining 34 skill items, 8 computer tasks, and 30 participants demonstrated goodness-of-fit to the MFR model of the ACRS. The skills and tasks appeared to have logical hierarchical ordering and differentiated participants into at least three levels of ability. The findings affirmed the internal scale validity, person response validity and reliability of the ACRS for assessing persons' computer abilities. Future studies using a larger sample that includes individuals with disabilities and with difficulties with computer use are needed to further evaluate the validity and reliability of the ACRS.

Background

Heat waves impact the health of older adults, and occupations are important for health. An overview of research focussed on older adults' occupations in heat waves can be useful for occupational therapy practice.

Objective

To identify what the literature shows about older adults' experience and performance of, and participation in, occupations in heat waves.Material and methodThis scoping review included a literature search in five academic databases, four databases for grey literature, and a manual search. Literature in English regarding older adults 60+ and their occupations in heat waves were eligible.

Findings

Twelve studies were included. Findings showed that older adults adapt their occupations using bodily, environmental, and social interaction strategies and by changing their daily routines. Personal, environmental, social, and economic factors facilitate and maintain occupations in heat waves.

Conclusion

Older adults adapt their occupations in heat waves and different factors impact how they can be adapted. Future research is needed to explore how older adults experience their occupations in heat waves, and to deepen the knowledge about their heat-adaptive strategies.

Significance

The findings support the role of occupational therapists in the design and practice of interventions managing the impact of heat waves in daily life.

BACKGROUND: In the beginning of the COVID-19 pandemic, Swedish authorities enforced specific recommendations on social distancing for adults 70 years and older (70+). Day-to-day life changed for 15% of the Swedish population. The aim of the study was to explore how adults 70+ experienced and managed changes in everyday life due to the COVID-19 pandemic and how those changes affected wellbeing at the beginning of the virus outbreak.

METHODS: Eleven women and six men, (mean age 76 years), living in ordinary housing, participated in remote semi-structured interviews in April 2020. The interviews were analysed with qualitative content analysis.

FINDINGS: The theme Suddenly at risk - '…but it could have been worse' included four categories My world closed down; Negotiations, adaptations and prioritizations to manage staying at home; Barriers and facilitators to sustain occupational participation; and Considerations of my own and other's health and wellbeing emerged from the data analysis.

CONCLUSION: Everyday life changes had implications for health and well-being. The participants questioned previous conceptions of meaning in relation to habitual activities, likely leading to consistent occupational changes. However, these long-term effects remain to be explored, and considered to enable older adult's health during the pandemic and beyond.

Objective: The Australian Therapy Outcome Measures for Occupational Therapy (AusTOMs-OT) are used internationally to measure the outcomes of occupational therapy services across diagnoses, ages, and health care settings. This study reports on the inter-rater and test-retest reliability of the Self-care and Transfer scales as well as the intra-rater reliability of all scales of the Swedish (AusTOMs-OT-S) translation.

Methods: Fifteen occupational therapists rated 11 case study clients on two occasions, separated by two weeks. Test-retest reliability and inter-rater reliability were calculated for the Self-care scale and Transfer scales. Moreover, intra-rater reliability was calculated for each of the 15 therapists across all 12 scales.

Results: The inter-rater reliability intraclass correlation coefficients (ICCs) were all found to be high to very high, ranging from ICC 0.762 to 0.904; the intra-rater reliability coefficients were also very good with 11 of the 15 therapists achieving ICCs of 0.745 or over, and finally the test-retest ICCs were also found to be high, ranging from 0.705 to 0.920.

Conclusions: Although further research is required to confirm reliability, preliminary reliability of the AusTOMs-OT Swedish translation has been demonstrated and therapists can have confidence when using the scales.

BACKGROUND: Occupational balance is a central aspect in occupational therapy. Awareness of occupational balance/imbalance among occupational therapists could influence the orientation of their professional interventions.

OBJECTIVE: To describe and compare the occupational balance status of occupational therapists working in Spain.

MATERIAL AND METHODS: Cross-sectional descriptive study using an online questionnaire. Participants were occupational therapists working in Spain who answered a questionnaire including 22 questions on the sociodemographic and employment data and the Spanish version of the Occupational Balance Questionnaire (OBQ-E) ranging 0-65 where higher ratings equal better occupational balance.

RESULTS: A total of 648 currently working occupational therapists participated. Mostly women, with median age of 32 years, without partner, children, or dependents. The median OBQ-E was 37 (IQR = 27; 45). Statistically significant differences were found between the medians of participants varying in the categories 'hired as an occupational therapist', weekly work hours, and population working with children and adults.

CONCLUSIONS AND SIGNIFICANCE: Spanish occupational therapists presented a moderate occupational balance that varied between subgroups. Professional recognition, working hours, and the population they attend are aspects that influence their occupational balance. Knowledge of occupational therapists' occupational balance could contribute to the development of policies aimed at promoting it.

Background: There is a need for an instrument to measure participation and independence in children with disabilities. FUNDES-Child-SE has its origin in the participation questionnaire Child and Adolescent Scale of Participation.

Aims: Test the psychometric properties of internal consistency and test-retest reliability.

Material and methods: This cross-sectional study included caregivers of 163 children with disability aged 6–18 years, 59 of whom were also included in the test-retest study. Descriptive statistics were used to evaluate the proportions of valid ratings. Internal consistency and test-retest reliability were tested through Cronbach’s alpha and the intra-class correlation coefficient.

Results: The amount of not relevant/not applicable ratings was substantial but varied between items and subdomains. Internal consistency was acceptable (0.8–0.95), and the test-retest was marginal to excellent (0.73–0.95).

Conclusions: The reliability together with the content validity support the use of the FUNDES-Child-SE to measure participation and independence in children with disabilities. However, results should be interpreted with caution due to the small sample size and possible selection bias. Modifications to reduce the not relevant/not applicable responses should be investigated together with the instrument’s responsiveness.

Significance: FUNDES-Child-SE can be used to facilitate a discussion of participation and independence and to plan interventions in a habilitation setting.

BACKGROUND: Stress-related disorders cause suffering and difficulties in managing occupations and relationships in everyday life. A previous study of women with stress-related disorders, who photographed well-being and talked about the photographs in interviews, showed that moments of well-being still exist but further knowledge is needed about their perceptions of participating in such a study.

AIM: To describe how people with stress-related disorders experience taking photographs related to well-being in everyday life and reflecting on and talking about these photographs.

MATERIAL AND METHODS: Twelve women, 27-54 years with stress-related disorders were recruited from primary healthcare centres. They participated in interviews based on the photographs and qualitative content analysis was used.

RESULTS: One theme 'catching a glimpse of and momentarily capturing well-being' and four categories were identified: 'Photographing moments of well-being visualizes well-being', 'Using photographs could either facilitate or complicate the narrative', 'Changing perspective in everyday life' and 'Creating recollections of well-being'.

CONCLUSIONS AND SIGNIFICANCE: Introducing a focus on well-being in everyday life despite living with a stress-related disorder might contribute a valuable complement to stress rehabilitation for occupational therapists and other health professionals. Using photographs as a basis for reflections about everyday life and health/well-being also seems positive for this group.

Background

Depression and anxiety often reduce people's ability to cope with everyday occupations. There is a lack of knowledge about such problems in people of working age with depression and anxiety.

Aim

To describe which problems people with depression or anxiety disorders experience when performing everyday occupations and which occupations are affected.

Materials and methods

Data based on the Canadian Occupational Performance Measure was used in this cross-sectional study. A total of 118 participants aged 18-65 years, with depression or anxiety, were recruited from primary healthcare and general mental healthcare services. The data were analysed with descriptive statistics and directed content analysis.

Results

The participants rated a low level of occupational performance, and their satisfaction with performance even lower. They described a great number of problems with their everyday occupations. The most frequent problem areas concerned household management, socialization and personal care. Detailed descriptions of which type of problem they experienced during everyday occupations are included.

Conclusions

This study provides knowledge of which problems people with depression and anxiety disorders experience in everyday occupations within self-care, productivity, as well as leisure. Furthermore, they rate performance and satisfaction with performance of the five occupations they find the most important to change in everyday life.

Background: The potential to influence the design of one’s local environment is especially important to older people since age-related problems, in combination with a less supportive environment, can prevent the performance of meaningful activities. It is unclear how best to tailor a participatory approach to support the task of collaborating with older persons about their local environment. Life filming was used in such a project. Objective: To describe Life filming as a means of participatory approach in relation to older community-dwelling persons and the design of their local environment. Material and method: A descriptive single case study. Data were generated through field notes and memos, and analyzed utilizing thematic analysis. Participants have validated the findings. Findings: Five themes describe central aspects of Life filming in the given context: Anchoring the concept of participation, Practical application of Life filming, The film as a product, Making a real difference, and An identity as a capable older person. Conclusion: Life filming supported participation, both as a process and an outcome. It had benefits on multiple levels: for the individual person, for older persons as a group, and for the municipality. Life filming could constitute a useful digital tool for practice when a participatory approach is desired. 

Background: Welfare Technology (WT) can promote participation in activity. Thus, initiatives to support the implementation of WT products and services in municipality care settings needs to be developed and evaluated to benefit end-users. Objective: To evaluate an interactive showroom of WT. Material and method: Municipal employees (n = 217) filled in a questionnaire before and after they visited an interactive showroom of WT. Findings: The number of participants confirming WT’s potential to contribute to municipal operation areas increased in seven out of eight areas after their visits (p < 0.05). A statistically significant increase was also found regarding general knowledge of and confidence in WT and its potential value. Conclusion: A visit to the interactive showroom increased the perceived general knowledge and appreciated value of WT. The perception of the possibility of implementing WT in various municipal operation areas also increased, which may contribute to the implementation of WT in municipal care settings.

The aim of this study was to explore and describe how occupational therapists (OTs) and patients perceived ABILHAND, a new assessment tool for measuring manual ability, in order to evaluate it in terms of content validity and clinical utility in stroke rehabilitation in Sweden. Three main steps were followed to achieve the study goal. First, ABILHAND was translated, and second OTs used ABILHAND with patients admitted for occupational therapy intervention. Finally, in the third step, which aimed to evaluate the content validity and clinical utility of ABILHAND, focus-group interviews were used as a qualitative method of research. The results indicate that ABILHAND might benefit from adjustments to improve content validity. The results also show that standardization for clinical administration is necessary, the production of a manual is essential and the development of a user-friendly computer program for processing data is desirable. An additional finding in this study is an insight into the clinical reasoning of the OTs, which resulted in two conclusions. First, OTs need to discuss and learn more about central concepts in occupational therapy, and second they need to learn more about standardized assessment and how tests are developed and used.

Background: Occupational balance (OB) is an important concept in occupational therapy and is considered as an essential component of health and well-being.

Aim: The aim of this study was to investigate the validity and reliability of the Turkish version of the Occupational Balance Questionnaire-11 (OBQ11-T).

Materials and methods: The OBQ11-T was administered to 116 individuals for construct validity analysis and to 58 individuals for reliability analysis. Validity was determined using explanatory and confirmatory factor analysis. In confirmatory factor analysis, RMSEA (root mean square error of approximation) value, comparative fit index (CFI), and Chi-square to degrees of freedom ratio (CMIN/DF) were analysed. The test-retest method and Cronbach's alpha coefficient were used to assess the reliability and internal consistency of the OBQ11-T, respectively.

Results: The model fit the data according to the indices of relative fit (RMSEA = 0.076, CMIN/DF = 1.661, and CFI = 0.875). The correlation coefficient between test and retest OBQ11-T total scores was 0.922. Total scores showed a significant statistical relationship (p<0.01), indicating good reliability. Cronbach's alpha for OBQ11-T total score was 0.785, indicating acceptable internal consistency.

Conclusions and significance: The current study demonstrates that the OBQ11-T is a valid and reliable tool for measuring the self-rated OB of healthy individuals.

Background The concept of occupational identity has become an important focus within occupational science and occupational therapy, drawing both recognition and inquiry. Even if the concept is highly relevant for understanding the occupational nature of human beings, ambiguity regarding the identification and application of occupational identity exists. Aim This analysis aimed to clarify the concept of occupational identity by examining its current use and application within occupational therapy. Materials and methods Walker and Avant's method for concept analysis was utilized to clarify the concept of occupational identity. Results Analysis resulted in three distinct categories of use: occupational identity construction, occupational identity discrepancy and occupational identity disruption, described contextually in terms of the self being, the self being and doing, and the self being and doing with others. Conclusions Findings validated the significant connection between occupation and identity through doing, being and future becoming. Also uncovered were considerable connections to belonging. Significance Occupational identity encompassed complex connections comprising both individual and collective components. Personally meaningful expression and connection were of particular significance to occupational identity as discrepancies or disruption of meaningful connections had negative implications for occupational engagement.

Background

Health promotion services need to be developed to respond to the needs of an ageing population. Lifestyle Redesign(R) (LR(R)) is an occupational therapy intervention that has been addressed as cost-effective in the USA.

Aims/objectives

This scoping review aimed to identify how the LR(R) has been implemented and what the results have been with older adults living independently in countries other than the USA.

Material and methods

Sixteen studies were included. Quantitative results were interpreted through the numeric data and qualitative results through inductive thematic analysis.

Results

The delivery of the LR(R) shared both similarities and differences with the original LR(R), and the variations concerned interventions length, facilitators, and the outcome measures used. In the quantitative results, there was often a positive trend in intervention groups' health-related quality of life, mental health, and occupational performance; in qualitative results, there was improvement in self-esteem and possibilities in building new communities.

Conclusions and significance

The original LR(R) was often transferrable into cultural settings other than the USA and many positive outcomes in the health and well-being of older adults were addressed. However, to understand the feasibility and effectiveness of the LR(R), scientific research and publications need to be enhanced.

BACKGROUND: Sick leave due to long-term stress is increasing in Finland and other Western countries. Occupational therapists might contribute to the prevention of and/or recovery from stress-related exhaustion.

AIMS/OBJECTIVES: To describe what is known about occupational therapy for stress-related exhaustion.

MATERIAL AND METHODS: A five-step scoping review included papers published in six databases from 2000 to 2022. Extracted data was summarized to show the occupational therapy contribution within the literature.

RESULTS: There were 29 papers meeting the inclusion criteria, of which a limited number described preventive interventions. Most articles described recovery-oriented occupational therapy with group interventions. The occupational therapists contributed with prevention measures, mostly targeting recovery in multi-professional interventions in terms of stress reduction or return-to-work.

CONCLUSIONS: Occupational therapy involving stress management both prevents stress and supports recovery from stress-related exhaustion. Occupational therapists internationally use craft, nature activities or gardening as stress management measures.

SIGNIFICANCE: Occupational therapy appears to be a potential treatment option for stress-related exhaustion internationally in conditions that could also work in Finland, for example in occupational healthcare.

The aim of the present cross-sectional study was to examine how subjective experiences of engagement in patterns of daily occupations (gainful employment, domestic work, enjoyable and recreational occupations) were associated with perceived health among women of working age. The sample (n_488) was drawn from a longitudinal cohort study of women of working age in Gothenburg, Sweden. Participants were women 38 (n_202) and 50 (n_286) years of age. They completed a questionnaire including questions about occupational experiences in relation to their patterns of daily occupations, perceived health, and socioeconomic factors. The results of the present study showed that a combination of different experience dimensions of patterns of daily occupations was associated with perceived health among women of working age, even when adjusted for socioeconomic factors and age. The results provided occupational pattern-related health indicators, i.e. manageability, personally meaningful occupations, and occupational balance. To combine these health indicators can be a way for occupational therapists to enable women to develop strategies to promote health and to prevent stress and sick leave.

This study aimed to describe and analyse self-rated health in relation to sense of coherence and socioeconomic and health-related factors and to explore the associations between self-rated health and these factors in order to identify health resources and health limitations in a group of healthy middle-aged women. Healthy middle-aged women from a defined geographical area in Southern Sweden ( n =577) answered a postal survey with the sense of coherence scale and questions about socioeconomic and health-related conditions. The results showed that very good/rather good self-rated health was associated with high sense of coherence and good economic situation, and these factors can be seen as a health resource. Poor self-rated health was most strongly associated with perceived symptoms of tension, weak sense of coherence, treatment for depression, treatment for chronic disease, and difficult economic situation, and these factors can be seen as health limitations. In conclusion, only 29% of the women rated their health as very good and 41% of the women had symptoms of tension but they were not sick-listed. It is of major public health interest to improve the understanding of self-rated health and to develop health promotion for women and methods to prevent symptoms of tension and sick-listing.

Background: Occupational balance is fundamental to occupational therapy and occupational science. Therefore, the Occupational Balance Questionnaire (OBQ) was developed and has previously been found psychometrically valid according to classical test theory.

Aim: To investigate the internal construct validity of the OBQ using Rasch measurement theory.

Material and methods: Data from two general population samples were used to investigate the psychometric properties of the OBQ according to Rasch measurement theory.

Results: The analyses identified problems with the current response scale and multidimensionality of two items. As a result, a revised version, the OBQ11, was suggested and exhibited response categories that worked properly, good reliability (0.92), model fit and measurement invariance across age and gender groups. The hierarchical item ordering was in agreement with previous research.

Conclusion: The new OBQ11 satisfies the measurement criteria defined by the Rasch model. However, further studies of additional samples are needed to validate its generic properties.

Significance: The purpose of the OBQ11 is to measure occupational balance of individuals or groups, and to identify aspects of occupational balance in need of improvement. Our observations suggest that the OBQ11 is a valid and promising complement to other instruments.

Objective: The aim of this study was to evaluate complex intervention using time aids for children with intellectual and developmental disabilities who exhibit limitations in daily time management.

Methods: Participating children (n = 47) (F17/M30) were aged 6–11 with ADHD, autism spectrum disorders, mild or moderate intellectual disability, spina bifida, and cerebral palsy. This study used a Randomized Block and Waiting List control group design, with 25 children allocated to control and 22 to intervention group. In total 10 children (21.3%), five from each group, dropped out, leaving 37 children in the data analysis.

Results: Children in both groups gained significantly in time-processing ability between the first and second data collection, but the children in the intervention group improved time-processing ability significantly more than controls. The control group also displayed significant changes after receiving intervention between the second and third data collection. The intervention had a large effect (ES Cohen's d = 0.81) on time-processing ability and a medium effect (ES Cohen's d = 0.68) on managing one's time.

Conclusions: This study provides preliminary evidence that time-processing ability and managing one's time can be improved by intervention using time aids in children with intellectual and developmental disabilities, supporting the need to consider time aids in intervention in these children.

Objective: Lengthy sick leave makes demands on work ability enhancing interventions in primary health care. Problem-based method (PBM) and cognitive behavioural therapy (CBT) are interventions aimed at people with common mental disorders. This study aimed to describe how individuals experienced interventions and the impact the interventions had on the individuals' ability to work and perform other everyday activities. Method: Fourteen women and two men, eight each from two interventions, were interviewed. The interviews were analysed using qualitative content analysis. Results: The analysis revealed one overarching theme: "Reaching safe ground or continuing to seek help". Four categories were identified: "From being passive to making one's own efforts in the rehabilitation process", "Being stuck on a treadmill or daring to change", "Evolving from routine to more aware behaviour", and "Fitting in or not fitting in with workplace situations". Conclusions: According to the participants, experiences from both PBM and CBT had a positive impact on their ability to work and perform other everyday activities in a more sustainable way. Reflecting on behaviour and achieving limiting strategies were perceived as helpful in both interventions, although varying abilities to incorporate strategies were described. In general, the results support the use of active coping-developing interventions rather than passive treatments.

Background: Mental health problems (MHP) are a major public health challenge. Conventional healthcare has shown limitation on reducing MHP and there is a call for offering methods beyond healthcare as well as improve access to healthcare.

Aims: To explore experiences among people having MHP of (i) taking part in existential conversations in groups beyond conventional healthcare and (ii) seeking and receiving conventional healthcare.

Materials and methods: Four focus group interviews were conducted after finishing existential conversations in groups. Data was analyzed following thematic analysis.

Results: The theme Access to a community for exploration and acceptance describes communication through impressions and expressions together with others. A reflective perspective on everyday life, describes re-evaluation through reflection. Within the theme Experiences of healthcare related encounters, referring to the second aim, participants recollected feelings of disconnectedness, difficulties verbalizing MHP and dealing with rigid, standardized measures.

Conclusion: Existential conversations in group may contribute to a more reflected doing in accordance with one’s own values as well as improved mental health literacy. Design and measures within healthcare need to explicitly address MHP and consider individual’s own preferences.

Significance: This study contributes to understanding of coping with MHP in everyday life from an existential perspective.

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