Carina Tjörnstrand

Psychometric testing of a self-report measure of engagement in productive occupations.

Background Occupational therapists working with clients in productive occupations explicitly or implicitly assess their clients’ occupational engagement. Purpose To investigate the psychometric properties of the Profiles of Occupational Engagement in People with Severe Mental Illness: Productive Occupations (POES-P) in terms of internal consistency, initial construct validation, and floor and ceiling effects. Method Participants (n = 93) from six day centres completed the data collection. Correlations between the POES-P and instruments measuring similar and dissimilar attributes, such as satisfaction, psychosocial functioning, and unmet needs, were studied. Findings A moderate relationship was found between the POES-P and occupational satisfaction (r s = 0.43) and a weak one with psychosocial functioning (r s = 0.22). The association with researcher-assessed participant engagement was slightly higher (r s = 0.37), and the relationship with unmet needs was nonsignificant (r s = –0.15). Internal consistency of the POES-P (alpha = 0.85) was good, but the distribution of responses indicated a ceiling effect. Implications The POES-P seems promising for assessing engagement in work-like occupations but would benefit from further development. Description Les ergothérapeutes intervenant auprès des clients à l’aide d’occupations productives évaluent la participation occupationnelle de leurs clients de manière explicite ou implicite. But Examiner les propriétés psychométriques du Profiles of Occupational Engagement in People with Severe Mental Illness: Productive Occupations (POES-P) en fonction de la cohérence interne, la validité structurale initiale et les effets plancher et plafond. Méthodologie Des participants (n = 93) de six centres de jour ont participé à la cueillette de données. Les corrélations entre le POES-P et des instruments mesurant des attributs semblables et différents, comme la satisfaction, le fonctionnement psychosocial et les besoins non satisfaits ont été analysées. Résultats Une relation modérée a été observée entre le POES-P et la satisfaction occupationnelle (r s = 0,43) et une relation faible a été constatée entre le POES-P et le fonctionnement psychosocial (r s = 0,22). L’association entre le POES-P et la participation occupationnelle des participants évaluée par le chercheur était un peu plus élevée (r s = 0,37) et la relation avec les besoins non-satisfaits n’était pas significative (r s = –0,15). La cohérence interne du POES-P (alpha = 0,85) était bonne, mais la distribution des réponses indiquait un effet plafond. Conséquences Le POES-P semble prometteur pour évaluer la participation à des occupations s’apparentant au travail, mais il serait avantageux de développer davantage cet instrument de mesure.

The linkage between patterns of daily occupations and occupational balance: Applications within occupational science and occupational therapy practice

Abstract Patterns of daily occupations (PDO) and occupational balance (OB) are recurring phenomena in the literature. Both are related with health and well-being, which makes them central in occupational therapy practice and occupational science. The aim was to review how PDO and OB are described in the literature, to propose a view of how the two constructs may be linked, and elaborate on how such a view may benefit occupational science and occupational therapy. The literature was analysed by latent and manifest content analysis and comparative analysis. The findings were summarized in a model, framing PDO as the more objective and OB as the more subjective result from an interaction between personal preferences and environmental influences. The proposed model does not assume a cause–effect relationship between the targeted constructs, rather a mutual influence and a joint reaction to influencing factors. Indicators of PDO and OB were identified, as well as tools for assessing PDO and OB. The authors propose that discerning PDO and OB as separate but interacting phenomena may be useful in developing a theoretical discourse in occupational science and enhancing occupational therapy practice. Although the scope of this study was limited, the proposed view may hopefully inspire further scrutiny of constructs.

Joining, belonging, and re-valuing : a process of meaning-making through group participation in a mental health lifestyle intervention

Abstract Background: Balancing Everyday Life (BEL), a new group-based intervention for mental health service users, was implemented in Sweden. Mental health service users often experience group interventions as meaningful, but knowledge of the process of meaning-making in a group is lacking. Aim: To explore participants’ perceptions of the group in the Balancing Everyday Life (BEL) lifestyle intervention; specifically, personal experiences of what brings meaning when participating in a group. Methods: This qualitative Grounded Theory study included 26 interviews with 19 BEL participants. Results: A process of meaning-making in a group was constructed: Joining with others: from feeling alone to connected, A sense of belonging: mutual support and understanding, and Re-valuing Self: respect and self-worth. No longer feeling alone contributed to meaning. Peers and group leaders were considered important parts of the group, and participants appreciated feeling understood, respected, and helping others. Conclusion: The proposed process of meaning-making, as well as ‘Joining’ as a unique step, seems to be new contributions which could help practitioners when organizing groups. Overcoming fear of joining could break a cycle of isolation and lead to connecting and belonging. The value of participants finding purpose through helping others should be further explored.

Quality of life among people with psychiatric disabilities attending community-based day centres or Clubhouses

BACKGROUND People with psychiatric disability have been found to have a poorer quality of life (QOL) compared to the general population, and QOL is an important outcome from psychosocial rehabilitation. AIMS This study aimed at comparing users of two approaches to psychosocial rehabilitation in Sweden, community-based mental health day centres (DCs) and clubhouses, regarding QOL. A further aim was to investigate predictors of QOL. METHODS People regularly attending DCs (n = 128) or clubhouses (n = 57) completed questionnaires at baseline and a 9-month follow-up about socio-demographics, QOL, self-esteem, social network, satisfaction with daily occupations, satisfaction with services and the units organisation. RESULTS Quality of life remained stable over time in both groups. QOL at follow-up was associated with baseline self-esteem, social network, satisfaction with daily occupations and QOL at baseline. The strongest indicator of a higher QOL at follow-up was attending a clubhouse programme followed by having scored high on QOL at baseline. CONCLUSION Both approaches were suited for supporting their users in maintaining QOL. Visiting clubhouses seems, however, advantageous for QOL in a longer-term perspective. Although this study contributed some new knowledge, research should further address which circumstances are associated with maintaining stability in QOL.

Programme characteristics and everyday occupations in day centres and clubhouses in Sweden.

Abstract Background: Meaningful everyday occupations are important for mental health and recovery and are provided by both community-based day centres (DCs) and clubhouses. It is unknown, however, if any of the two has more recovery-promoting features. Objective: This nine-month longitudinal study compared DC and clubhouses, concerning the users’ perceptions of unit and programme characteristics, and aspects of everyday occupations in terms of engagement and satisfaction. Stability over time in these respects, as well as motivation for participation and relationships with occupational engagement and satisfaction, were explored. Methods: Participants from 10 DCs (n = 128) and 5 clubhouses (n = 57) completed self-report instruments. Results: DC attendees rated lower levels on two organizational factors; choice and ability to influence decisions, and the unit’s social network. Motivation showed to be an important factor for perceived occupational engagement, which did not differ between the two groups. DC attendees were more satisfied with their everyday occupations at baseline, but that factor increased more in the clubhouse group and there was no group difference at follow-up. The unit and programme characteristics and occupational engagement showed stability over time. Discussion: Clubhouses seemed more advantageous and DC services may consider developing users’ opportunities for choice and decision-making, and peer support.

Quality of Life Among People with Psychiatric Disabilities : Does Day Centre Attendance Make a Difference?

The purpose was to investigate (i) how people with psychiatric disabilities who attend day centres experience their quality of life (QoL) compared to non-attendees, (ii) differences in QoL between those who attend meeting place-oriented centres and those who attend work-oriented centres, (iii) possible correlates of QoL among day centre attendees. Ninety-three day centre attendees and 82 non-attendees completed questionnaires addressing QoL and selected correlates. No group difference was found regarding QoL. Factors related with a good QoL were high levels of self-mastery and motivation. Thus, promoting day centre attendees’ self-mastery and motivation might enhance their QoL.