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.

Introduction:Looking back on the history of occupational therapy, creative activities played a major part in the rehabilitation process, but have been diminished during the last decades. This review looks at the importance and application of creative activities in occupational therapy in the 21st century.

Objectives:The aim of the review was to describe the value and importance of focusing on creative activities in occupational therapy intervention. Method: This scoping review was done as prequel to a book on creativity in occupational therapy, and based on literature search in the databases PubMed,Cinahl, PsychInfo, and the Danish library index. Our inclusion criteria were literature that covered the value and meaning of creative activity in general and/or application of creative activities as intervention tool. Peer-reviewed articles, articles and books in English, and Scandinavian languages were included.

Results/Discussion:This review showed that use of creative activities as a medium for healing/alleviating suffering have the power to rebuild or replace an identity during illness or major life crisis.The value of creative activities is individual and culture-based and as most have the need to expressthemselves through creativity, which makes creative activities important and useful. 

Conclusion: Results indicated that individuals have a need to be seen as unique and creative beings. This knowledge supports that creative activity as an agent of change within the rehabilitation process is important, when adaptinga new activity identity. The value and meaning of the creative activity for the individual or group should be examined before and during therapy. 

Contribution to occupational therapy practice:Focusing on implementing creative activities is important as they have potential to replace former crucial activities to a person’s activity identity. Creative activities are relevant in societies with stress, search for identity as a tool to understand individual reactions and feelings.

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.

Review objective/questions: The objective of the current review is to identify the types of occupations that are important in improving overall wellbeing amongst the elderly population.

It is assumed that conducting a systematic review with a qualitative approach will lead to a deeper understanding of how the independently‐living elderly enhance their wellbeing through participation in occupations. Such a review will contribute to the knowledge and practice within the health promotion framework with the healthy elderly population. Thus the review will be of use to occupational therapists and others working with elderly people in terms of both theory and practice, as the knowledge will be grounded in the reality of human experience. The specific question to be addressed in this review is:

Which occupations do the independently‐living elderly consider to enhance their overall wellbeing?

Background: An important health goal for elderly people in western countries is to maintain their ability to live independently and to function well.1 In the fields of social science and gerontology, concepts such as ‘active aging’ and ‘successful aging’ imply that ‘doing’ activities is closely related to wellbeing.3 Being active is an important factor in managing life and coping with the challenges related to advanced age.2

Activities are defined by all that people need, want or are obligated to do such as self‐care, household tasks, leisure and social interactions with family and friends.4 When a person engages in and gives the activity a purpose, value or reason, the activity will become meaningful and can be defined as an occupation.5,6 Crepeau et al. stated that occupations “include the day‐to‐day activities that enable people to sustain themselves, to contribute to the life of their family and to participate in the broader society”.7(p28) Thus, occupations are multifaceted phenomena as they provide meaning, identity and structure to a person's life.5 The one premise underpinning occupational therapy and occupational science is that the occupations in which people engage and their health are interrelated and this seems to be universal for the experience of wellbeing.8,9

The meaningfulness of the occupations in which a person engages throughout their lifespan changes over time.10The occupations a young man at university may find meaningful will probably differ from those of an elderly man who is retiring from work. For the elderly, there are different factors influencing their engagement in occupations. Examples of these include the aging process, as well as the individual's history of occupations. Significant changes in external conditions, for example retirement, also have an impact on the occupations considered by an individual to be meaningful and in which they will subsequently engage.11 This complex interaction between external conditions of the individual's lifespan and the internal perceptions of those conditions,12 influences the way in which the individual perceives general wellbeing.10

Several studies indicate that engagement in social occupations seems to improve the wellbeing of the elderly.9,13‐16 However, a Danish study showed that the majority of the elderly in their sample found physical and solitary occupations as being the most important for maintaining health and wellbeing.17 Productive activities such as remaining active in work or volunteering has also been indicated to have a positive effect on wellbeing.13,18 It is important for society in general, as well as social and health services in particular, to enable and assist the elderly in improving their health and enhance their general wellbeing. Conducting a systematic literature review on elderly persons’ occupations from the perspective of the elderly will lead to a deeper understanding on how the elderly can maintain their well‐being.

OBJECTIVE: The objective of this review was to synthesize knowledge regarding which types of occupations the elderly perceive as important to and supporting their overall wellbeing.

INTRODUCTION: Being active is an important part of managing the daily challenges of advanced old age. Occupational therapy and occupational science are based on the premise that a person's occupations are intertwined with their health and are thus needed for them to experience a meaningful life and improve their wellbeing.

INCLUSION CRITERIA: This review, which included independently living elderly people aged 65 and over living in Europe, the USA, Canada and Australia, sought to uncover if the elderly see any specific types of occupations as enhancing their wellbeing. This review included qualitative studies with designs including, but not limited to, phenomenology, grounded theory, ethnography and action research.

METHODS: A three-step search strategy using Joanna Briggs Institute methodology was utilized. Both published and unpublished studies were searched. The following databases were searched for studies up to 2017: CINAHL, Nursing and Allied Health Source, Web of Science, PubMed and OpenGrey. Using the JBI Critical Appraisal Checklist for Qualitative Research, two independent reviewers assessed whether each study had the methodological quality required to be included in the review. Any disagreements were resolved through discussion with a third reviewer. The standardized JBI data extraction tool for interpretive and critical research was used to extract data from the included studies. JBI tools were used to pool the qualitative research findings. The findings were then aggregated through a process of rating according to quality, and categorized according to similarity in meaning, which generated a set of statements for each category. These categories were then subjected to a meta-synthesis to produce a single comprehensive set of synthesized findings useful as a basis for evidence-based practice.

RESULTS: All three of the included studies utilized qualitative interviews and followed a phenomenological approach. The studies included only participants aged 85 and over. Thirty-five findings were extracted and grouped into four categories, which were synthesized into two meta-syntheses: 1) The importance of "doing" alone - to feel good, I have to be the master of my own life; and 2) Old habits never die - a structured day is a good day. Based on the dependability and credibility of the three studies, the ranking was high (see Summary of Findings).

CONCLUSIONS: The present review shows that two factors enhance elderly people's wellbeing: first, variation and independence in undertaking activities; second, having a choice between the occupations and a structure of activities that make up daily life. The two factors are influenced by a balance between having activities alone and with others. This review is not intended to identify specific occupations that enhance elderly people's wellbeing, but rather to indicate which types of occupations enhance the wellbeing of the elderly, and provide value and meaning to their daily lives.Both the dependability and the credibility of the studies have been rated as moderate.

Background: The Canadian Occupational Performance Measure (COPM) is a recognized assessment tool within Danish occupational therapy (OT), and translated versions of the COPM have been implemented in Danish OT practice. However, a rigorous translation and cross-cultural validation process has not been applied to these versions.

Aims: To produce a new Danish translation of the COPM evaluating its semantic, conceptual, operational and item equivalence while addressing its face and content validity.

Methods: An iterative, multistage translation process was undertaken with (1) forward translation involving professional translators and bilingual OTs, (2) pilot testing and cognitive debriefing interviews with 15 OTs and 37 clients which were analyzed quantitatively and qualitatively, and (3) finalization with adaptations, back translation and approval.

Results: Content validity of COPM in terms of appropriateness, acceptability, intelligibility and comprehensiveness was found in 78–100% of the cases, and its ability to ensure a client-centred focus in the assessment process was confirmed. However, issues concerning the administration and content of the COPM were identified. Subsequently, two recommendations regarding the administration of the COPM were added to the Danish version.

Conclusion: Semantic, conceptual, operational and aspects of item equivalence of the COPM into Danish were achieved and supported by face and content validity.

Background

In Denmark patients are entitled to rehabilitation regardless of socio-economic status (SES). During this process therapists have to balance cost effectiveness with providing equal treatment. Aim To investigate whether occupational therapists and physiotherapists were influenced by the patient's SES.

Material and method

An experimental factorial vignette survey was used. Four different vignettes describing fictitious patient cases with different SES variables were randomly allocated to therapists working in somatic hospitals. Thereafter, the therapists judged specific clinical situations and general attitudes in relation to the patient's SES. Chi-square was used to test the statistical association between the variables.

Results

No statistically significant associations were found between the specific clinical situations and the patient's SES. A statistical significant association was found between general attitudes and the patient's SES. Subgroup analysis revealed a statistically significant association between the therapist's gender, age, and the therapeutic judgement in relation to SES.

Conclusion

In the specific clinical situations, Danish therapists seem to maintain their professional ethical principles, although they might face ethical dilemmas during their clinical decision-making. In order to prevent and resolve these dilemmas, they have to be made explicit. However, further research on how SES influences the health care professional's judgement is warranted.

The aim was to assess change in activities of daily living (ADL) ability amongst asylum seekers and if there were any difference between tortured and non-torture following a 10 months post-arrival period, and if self-reported health and exposure to torture were factors related to change in ADL-ability. The study was a combined baseline, follow-up correlational study amongst individuals from Afghanistan, Iran and Syria, living in Danish asylum centers. Forty-three persons aged 20-50, were invited and participated in the baseline study. Twenty-two were still in asylum center at the follow-up and 17 of them participated. ADL-ability was measured using Assessment of Motor and Process Skills and questionnaires about exposure to torture, self-reported mental health and pain. ADL motor and process measures, well-being and self-rated health declined from baseline to follow-up. Measures of pain and depression increased. Exposure to physical torture and change in ADL motor (r = 0.525) measures were associated, as well as change in current pain and change in ADL process (r = 0.525) measures. Due to preponderance of torture survivors analysis of group difference was not applicable. Health care workers should be aware of ADL concerns and exposure to torture in this population to best address their needs within rehabilitation settings.

Utifrån de begränsade möjligheterna till aktivitet i danska asylcenter är det relevant att undersöka asylsökandes tillfredsställelse med aktiviteter och aktivitetsnivå. En låg nivå av aktivitet och aktivitetstillfredsställelse kan medföra förlust av ADL-förmåga och dåligt hälsotillstånd. Dessutom har tortyr och självbedömd hälsa visat sig ha samband med ADL-förmåga hos asylsökande, och dessa faktorer kan förmodligen också kopplas till aktivitetsnivå och -tillfredsställelse.Målet var att beskriva asylsökandes aktivitetsnivå och -tillfredsställelse i danska asylcenter, samt undersöka om dessa variabler förändrades över tid. Ett annat syfte var att klargöra om faktorer som tortyr, självbedömd hälsa och ADL-förmåga kan relateras till aktivitetsnivå och -tillfredsställelse.43 asylsökande, varav 17 följdes upp vid 10 mån ingick i studien. Frågeschemat SDO, som mäter aktivitetsnivå och tillfredsställelse, samt MDI, WHO-5, PDQ, frågor om tortyr och socio-demografiska uppgifter, och AMPS användes.Studien påvisade låg tillfredsställelse med aktiviteterna. Inga statistiskt signifikanta förändringar förelåg från baseline till uppföljningen vad beträffar aktivitetsnivå och tillfredsställelse. Samband påvisades mellan AMPS-processförmåga, utbildning, värsta smärta och aktivitetsnivå, samt mellan AMPS-processförmåga och tillfredsställelse vid baseline. Vid uppföljningen fann man samband mellan WHO-5 och aktivitetsnivå och tillfredsställelse, och mellan MDI och aktivitetsnivå. Det påvisades ingen signifikant skillnad mellan torterade/icke torterade vid baseline eller uppföljningen.Asylsökande upplever låg tillfredsställelse med dagliga aktiviteter, både kort efter ankomst och efter 10 månader i asylcentret, men detta var inte relaterat till tortyr. Resultaten pekar på att de med hög aktivitetsnivå gradvis blir mindre utsatta för psykiska besvär. Det finns behov av mer forskning och utveckling av aktivitetsinriktad rehabilitering och förebyggande åtgärder för denna grupp.

BACKGROUND: There are challenging methodological issues in obtaining valid and reliable results on which to base occupational therapy interventions for ethnic minorities. The aim of this scoping review is to describe the methodological problems within occupational therapy research, when ethnic minorities are included.

METHOD: A thorough literature search yielded 21 articles obtained from the scientific databases PubMed, Cinahl, Web of Science and PsychInfo. Analysis followed Arksey and O'Malley's framework for scoping reviews, applying content analysis.

RESULTS: The results showed methodological issues concerning the entire research process from defining and recruiting samples, the conceptual understanding, lack of appropriate instruments, data collection using interpreters to analyzing data.

CONCLUSION: In order to avoid excluding the ethnic minorities from adequate occupational therapy research and interventions, development of methods for the entire research process is needed. It is a costly and time-consuming process, but the results will be valid and reliable, and therefore more applicable in clinical practice.

This article presents a study of three asylum-seeking men from Iran and Afghanistan. It aimed to explore how and if they experienced occupations as occupations in a Danish asylum centre and how their life experience shaped their choice and value of current occupations. In-depth narrative interviews explored the participants’ occupational history and its influence on their occupations in the asylum centre. A thematic analysis showed that the participants had been subjected to occupational disruption and deprivation by politically oppressive systems even before their flight. Their occupations in Denmark were to a certain extent influenced by their earlier occupations and the current occupational deprivation they all experienced was due to limited possibilities in the centre. Although they tried their best to fill their days and create structure, there was a loss of valued occupations and a profound sense of occupational deprivation. One of the participants had been subjected to torture and he experienced occupational deprivation to a greater extent. The findings suggest that further research should include exposure to torture as a key component when examining the occupational deprivation of asylum seekers.

AIM: The aim of this study was to describe asylum seekers' satisfaction with daily occupations and activity level while in a Danish asylum centre, and whether this changed over time. Another aim was to describe whether exposure to torture, self-rated health measures, and ADL ability were related to their satisfaction with daily occupations and activity level.

METHODS: A total of 43 asylum seekers at baseline and 17 at follow-up were included. The questionnaires Satisfaction with Daily Occupations, Major Depression Inventory, WHO-5 Wellbeing, Pain Detect, a questionnaire covering torture, and basic social information were used as well as Assessment of Motor and Process Skills.

RESULTS: The results showed a low level of satisfaction with daily occupations at both baseline and follow-up. There was no statistically significant change in satisfaction or activity level between baseline and the follow-up. Associations between AMPS process skills--education, worst pain and activity level--were present at baseline, as was a relationship between AMPS process skills and satisfaction. At follow-up, associations between WHO-5 and satisfaction and activity level and between MDI scores and activity level were found.

CONCLUSION: Asylum seekers experience a low level of satisfaction with daily occupations, both at arrival and after 10 months in an asylum centre. There is a need for further research and development of occupation-focused rehabilitation methods for the asylum seeker population.

OBJECTIVE: The aim of this study was to evaluate the extent of Activities of Daily Living (ADL) ability impairment in newly arrived Danish asylum seekers. It was hypothesized that exposure to trauma and torture would negatively influence ADL performance and that measures of ADL ability would be lower in individuals exposed to torture as compared to the non-tortured.

SUBJECTS: Forty-three newly arrived asylum seekers aged 20-50 years, from Iran, Afghanistan and Syria, were consecutively included in the study.

METHOD: ADL ability was assessed with the observation-based test Assessment of Motor and Process Skills (AMPS). Interviews were based on questionnaires about torture exposure, WHO-5 Wellbeing Index, Major Depression Inventory and Pain Detect Questionnaire. All participants were interviewed and tested using a linguistic interpreter.

RESULTS: Thirty three (77%) participants reported exposure to torture. The tortured did not differ significantly from the nontortured on measures of ADL ability (two-sample t-tests: Motor, p= 0.36; Process, p= 0.82). ADL performance impairment was observed in the overall study sample. Twelve had motor and 15 process ability measures below age norms and 2 below both AMPS motor and process cut-offs for effortless and efficient ADL performance. There were statistically significant - weak to moderate - correlations between self-reported psychological distress, VAS average pain, pain distribution and the AMPS measures.

CONCLUSION: The study results supported significant ADL ability impairment in tortured as well as non-tortured newly arrived asylum seekers. Implementation of performance-based evaluation of ADL ability as part of the initial medical screening of this particular population should be considered.

Background:Occupational balance is a well-known concept within occupational therapy. The OBQ (Wagman and Håkansson, 2014) is developed to measure occupational balance. The OBQ is a 13-item questionnaire with 4 response categories and has been translated into Danish. The aim of this study was to investigate the construct validity of the OBQ-DK using the Rasch model.

Method:Postal survey data to working aged participants (n=366; 69% women) were included. Their responses to the OBQ-DK were evaluated by Rasch analysis, partial credit model.

Results: Initially, Rasch analysis failed to support the unidimensional structure of the 13-item OBQ-DK (Chi-Square 104.5 (df 52; p <0.001). All items had ordered threshold. Differential Item Functioning was absent across contextual factors (sex, age, education). Adjustment of local item dependency between two items and removal of four misfitting items resulted in perfect fit to the Rasch model (Chi-Square 36.85 (df 32; p = 0.254). Reliability was high (PSI = 0.82). The four deleted misfitting items formed an additional unidimensional scale (Chi-Square 19.35 (df 16; p = 0.251). Reliability was acceptable (PSI = 0.78).

Conclusion: The study provides evidence for OBQ-DK’s construct validity. The Rasch analysis produced a 2-dimensional, 13-item questionnaire assessing the persons’ perception of occupational balance. Further research is required to establish the measures’ validity in various populations.Application to Practice:The results and small number of items makes it feasible to implement the OBQ-DK into clinical and/or research settings, where measuring occupational balance is needed. 

Background: Asylum seekers often experience social exclusion, beyond work and productivity. For this group, social inclusion is needed in order to participate in their new society and regain control over daily life and occupations, as well as prevent health problems. Social inclusion has been discussed within occupational science, and a collaborative approach such as the Participatory Occupational Justice Framework recommended to be followed. However, there is still a lack of understanding of the asylum seekers? perspective on social inclusion, which this article begins to address through the lived experience of one participant.

Method: Framed as a phenomenological study, data were collected through interview and articles written by the asylum-seeking participant. The data were analysed using Giorgi?s method as modified by Malterud (2017).

Results: The participant's ideas revolved around the components of Bogeas and colleague's (2017) description of social inclusion and revealed the problems that he experienced daily in the asylum centre. His suggestions for change and social inclusion included the need for asylum seekers to take part in the daily work in the centre, establishing channels of information, and a residents' council to support collaboration with the local population. The participant stressed that social inclusion should be a two-way process, with both sides taking responsibility for working with the challenges.

Conclusion: Although there are objective conditions that might limit social inclusion, a collaborative and participatory approach offers the opportunity for social inclusion and participation in occupation. Employing such an approach would facilitate the health, well-being, and inclusion of asylum seekers; and promote occupational justice for an otherwise marginalised population.

Background

A survey showed European occupational scientists cover a broad range in occupational science (OS) research, however, no contemporary overviews of European OS research exists, and current research may provide valuable information for OS and occupational therapy.

Aim

The aim was to provide an overview of contemporary European OS research.

Materials and method

A scoping review was performed, including studies conducted in Europe and published in the British Journal of Occupational Therapy (BJOT), the Scandinavian Journal of Occupational Therapy (SJOT) or the Journal of Occupational Science (JOS) between 2015 and 2020. The journals were systematically searched, and quality assessment and thematic analysis were undertaken.

Results

Findings from 93 articles identified many studies from the Nordic countries. Most studies applied qualitative research methods. Theoretical concepts from OS were used in data generating and discussions. A wide range of demographics, and living conditions were explored. Recent articles took a reflexive stance on the positionality of the researcher/s.

Conclusions

This review highlights the diversity of OS research, suggesting a solid theoretical knowledge base within European OS research.

Significance

The results contribute to further development and maturation of the discipline of OS in Europe and internationally.

BackgroundOBQ11 was developed in a Swedish context. To evaluate occupational balance, accurate self-rating instruments in the native language are needed.AimThe aim was to investigate the measurement properties of the Danish version of OBQ11, using the Rasch analysis.MethodData for the analysis of the Danish version of OBQ11 (OBQ11-DK) was gathered online, and all full data records (n 366) were included in the analysis.ResultsThree items showed non-significant marginal under- or overfit, suggesting a degree of misfit between the data and the Rasch model. Unidimensionality was not reached, though, since the proportion of persons with different estimates were more than 5% and thus the OBQ11-DK cannot be said to assess a person's perception of occupational balance.ConclusionThe present version of the OBQ11-DK shows the need for further development and testing and is not tested for test/retest or in clinical samples. The results and small number of items may after modifications and further studies make it feasible to implement OBQ11-DK into settings where the measuring of occupational balance is needed.

Ethnic minorities have particular needs and difficulties in terms of support for meaningful occupations, lack of access to and use of occupation-based rehabilitation services. They are not established in the labour market and are seldom in paid employment. This study aimed to investigate how mentally ill ethnic minority clients experience, feel and think about participation in occupation-based rehabilitation, and potential barriers they might encounter. Nine participants experiencing mental illness and receiving occupation-based rehabilitation were interviewed. Grounded theory methods were used in order to collect and analyze data. One core category, "barriers for a continuous path towards enriched and meaningful occupation" described the participants' experiences of a variety of barriers related to personal, occupational and system factors that hindered participation in occupation-based rehabilitation and influenced their need for occupational development and growth. The core category was composed of; personal-related barriers, occupational-related barriers, and system-related barriers as well as six related sub-categories. These barriers interacted continually across time and space in ways that increased the participants' sense of occupational deprivation and alienation. The findings also suggested that the issues of paid employment for ethnic minorities with mental illness should feature on the agenda of local, regional and state politicians and professionals involved in occupational rehabilitation.