Anneli Nyman

Influences of the social environment on engagement in occupations: The experience of persons with rheumatoid arthritis

The aim of this explorative study was to describe and enhance the understanding of how persons with rheumatoid arthritis (RA) experience the influence of the social environment on their engagement in occupations. Nine persons were interviewed and the data obtained were analysed using a comparative method. The findings revealed that other persons in the social environment influenced informants’ experiences of engaging in occupations in two ways, which formed the categories: “Constructive collaboration” and “Insufficient collaboration”. These categories had certain properties related to the actions the others undertook to assist the informants during their collaboration. These assisting actions influenced the informants’ possibilities to engage in occupations, and also their experience of engagement. The findings also showed that the “Conditions for collaboration” varied and influenced their collaboration, which thereby constituted a third category. The findings may contribute to a deeper understanding of how other persons can facilitate and restrict meaningful occupational experiences. This provides knowledge that can be used by occupational therapists when empowering their clients and those close to them to reflect on their actions and the consequences of these actions to enhance occupational engagement.

A Narrative of Agency Enacted within the Everyday Occupations of an Older Swedish Woman

This article explores how agency is enacted in everyday occupations with others and evolves over time. Agency is a complex concept that is closely linked to human occupation. By using a transactional perspective and a narrative approach, our ambition was to explore agency beyond individual acts or responsibilities. To achieve this, we used a story of an older woman in the context of being widowed and living with late-life depression. Data were generated over time using interviews and by taking part in the participants everyday occupations. Narrative analysis was used to create a contextualized in-depth story. The findings show how resources embedded in enacted stories can challenge ones view of oneself as a victim and create possibilities to be an agent, thereby illustrating how agency becomes enacted in the context of acting together in everyday occupations. In light of these findings, we reflect on how a transactional perspective can contribute to exploring the concept of agency as contextually situated and embedded in occupations. Further, we reflect on how the transactional dimensions of everyday occupations can be explored through a narrative approach.

Being part of an unfolding story: togetherness in everyday occupations when ageing

Abstract Aim: The aim of this study was to explore and enhance the understanding of how togetherness in everyday occupations is experienced and discussed among older adults. Method: Focus-group discussions generated the data and a total of 12 participants, including six women and six men, divided into three groups, participated in this study. Analysis was performed using a grounded theory approach. Results: The findings reflect how togetherness in everyday occupations can be comprehended as multifold transactional processes, emphasizing how an acted belonging was a situated experience connecting people and places through unfolding stories. The findings suggest that the process of meaning-making in ongoing life was closely associated with togetherness and was negotiated with others through shared culture and experiences. Togetherness meant being part of something in which the persons involved were contributing to each other in various ways. However, being part of togetherness was complicated, especially when the person’s life situation was challenged in some way. Conclusions: It was apparent from the analysis that togetherness could not be taken for granted. Rather, the findings reflect how togetherness was created and maintained through an ongoing process of nurturing established relationships as well as creating something new around occupations with others.

Togetherness in another way: Internet as a tool for togetherness in everyday occupations among older adults

Abstract Objective: This article explores and describes how the Internet was experienced as a tool for togetherness in everyday occupations among older adults. Methods: Discussions with 12 older adults, divided into three focus groups, generated data that were analysed using a grounded theory approach. Six women and six men between 67 and 79 years of age were purposively selected and recruited from a retirement organization in northern Sweden. Results: Findings reflect how online contexts generated new possibilities for togetherness in everyday occupations and created a sense of belonging with others and to society at large. However, togetherness through the Internet was also associated with ambiguity and uncertainty among older adults. The Internet provided opportunities for togetherness that were somehow different from togetherness derived from face-to-face contact, but it was also connected with a fear and a resistance. Conclusions: Findings from this research can extend our understanding of how online contexts have the possibility to promote togetherness in everyday occupations and what it means to be part of such a context among older adults. In light of these findings, the need is highlighted to consider the Internet as a tool for older adults to be socially engaged with the potential to reduce loneliness and isolation.

Participation and occupation in occupational therapy models of practice: A discussion of possibilities and challenges

Abstract Background: Occupation has been the focus in occupational therapy practice to greater or lesser degrees from a historical viewpoint. This evokes a need to discuss whether concepts that are added to our field will enhance or blur our focus on occupation. Aim: To explore how the concept of participation in the International Classification of Functioning, Disability and Health (ICF) is related to the concept of occupation by reviewing and comparing its use in three models of practice within occupational therapy. The aim was also to generate discussion on possibilities and challenges concerning the relationship of participation and occupation. Method: The models reviewed were The Model of Human Occupation (MOHO), the Canadian Model of Occupational Performance and Engagement (CMOP-E) and the Occupational Therapy Intervention Process Model (OTIPM). Results: The concept of participation was related to occupation in different ways in these models. Based on the review some challenges and considerations for occupational therapy were generated. Conclusion: Relating the concept of participation from the ICF to the concept of occupation in models of practice can be challenging. At the same time, relating the concepts can be a resource to develop occupational therapy and the understanding of occupational issues in society.

Occupations outside the home: Experiences of people with acquired brain injury:

Introduction Understanding those occupations outside the home that people with acquired brain injury find difficult, including the influencing factors, may help to develop appropriate support. The aim of this paper was to explore and describe how people with acquired brain injury experience engagement in occupations outside the home. Method This qualitative study included repeated semi-structured interviews with eight working-age persons with acquired brain injury, which were analysed by a constant comparison analysis. Findings The findings indicated that there were three influencing factors that had a critical effect on the participants’ changes in their engagement in occupations, the strategies they adopted, and the consequences for their lives. The categories reflected how the different changes in occupations outside the home were influenced by their struggles with sensory processing and fatigue, difficulties with completing preparations, and occupational risks. Conclusion The findings indicate that to improve engagement in occupations outside the home for people with acquired brain injury, professionals need to identify the different factors that are critical for each person’s engagement. The findings also indicate the importance of considering not only occupations outside the home but also preparations required at home and recovery afterward, and how engagement outside the home is influenced by the entire occupational repertoire.

Everyday activities outside the home are a struggle: Narratives from two persons with acquired brain injury

Abstract Background: Participation restriction is a common consequence after acquired brain injury (ABI). Aim: To explore and identify problematic situations in everyday activities outside the home for persons with acquired brain injury. Material and Method: Two persons of working age with ABI were included. Data were generated through repeated semi-structured interviews and participant observations. Narrative analysis was used to capture ongoing processes related to problematic situations during engagement in everyday activities outside the home. Results: The narratives reflect how places, everyday activities and social relations were closely connected and influenced engagement in everyday activities outside the home. The participants visited fewer places and performed more of their everyday activities alone in their homes after the injury compared to before. They were struggling to create meaning in their lives and trying to reformulate their identity. Problematic situations often occurred outside the home as a result of unexpected events. The narratives indicate a struggle to find new routines to handle challenging situations. Conclusions: The results provide an understanding of how problematic situations occurred and were managed in different ways. By observing everyday situations professionals can gain access to how persons with ABI act in and reflect upon problematic situations which can eventually improve the design of individually tailored interventions.