Carita Håkansson

Achieving balance in everyday life: Insights from women with stress-related disorders.

Abstract There is growing interest in developing a conceptual understanding of the experience of balance in everyday life, from an occupational perspective. The purpose of this study was to gain insights about balance in the everyday lives of women with stress‐related disorders. Data were gathered from 19 women who were past the first phase of recovery from a stress‐related disorder and participated in one of five focus groups. Analysis revealed that the participants experienced a continuum between imbalance and balance in everyday life. The themes that emerged were image of occupational self, strategies to manage and control everyday life, occupational repertoire, and occupational experience. Balance in everyday life was achieved through a dynamic interaction between these themes, which the women characterised as respecting their own values, needs, and resources; having strategies to manage and control everyday life; having a harmonious occupational repertoire; and engaging in personally meaningful occupation. Engagement in personally meaningful occupation appears to be a mechanism that enables people to achieve balance in everyday life by enabling them to develop a successful occupational self‐image, manageability, control, and a harmonious occupational repertoire. Well‐being seems to be the outcome of balance in everyday life, and lack of balance is experienced as overload.

Occupational balance as used in occupational therapy: A concept analysis

Abstract Occupational balance is a frequently used concept in occupational therapy, but it is complex and differences in content exist. Further knowledge would be valuable for scholars, practitioners, and measurement development. Concept analysis is a way to clarify concepts. The present concept analysis used Walker and Avants procedure for analysing the concept of occupational balance, with 43 articles included in the analysis. The results showed that occupational balance can be defined as the individuals perception of having the right amount of occupations and the right variation between occupations. Three perspectives of occupational balance were identified: in relation to occupational areas, in relation to occupations with different characteristics, and in relation to time use. The knowledge gained may guide the use of the concept, and some suggestions are made for its use and for further research.

Experience of meaning in everyday occupations among unemployed people with severe mental illness

Abstract The aim of this qualitative study was to examine the different facets of meaning that people who are severely mentally ill and unemployed may find in their everyday occupations. Twelve unemployed people with severe mental illness, six who attended day centres and six who did not, were interviewed regarding their experience of meaning in everyday occupations. The data were analysed with content analysis. The results showed that meaning was experienced when feeling competent and having a balance between different meaningful occupations that helped the informants control their mental illness. Themes of meaning were: being socially engaged, feeling competent and accepted by society, creating 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. The results suggest that people with severe mental illness should be encouraged to play an active role in their rehabilitation process, and receive support from the occupational therapist in addressing aspects such as forming a social network and daily routines, and finding a balance between work-like occupations and rest.

Engagement in patterns of daily occupations and perceived health among women of working age.

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.

Perceptions of life balance among a working population in Sweden.

A life in balance is commonly related to health and well-being. However, our knowledge regarding the perceptions of life balance among the general population is limited. Our aim was to explore the perception of life balance among working people without recent long-term sick leave. Individual interviews were conducted with 7 men and 12 women and analyzed according to grounded theory, aiming at achieving a description. The results showed that life balance includes four interrelated dimensions: activity balance, balance in body and mind, balance in relation to others, and time balance. Life balance was regarded by the participants as health related, promoted by a sense of security, and affected by context and individual strategies. Life balance was also seen as being individually defined and dynamic. The results indicate that the perceptions of life balance might be quite general because they show similarities with previous research on different populations.

Perceptions of employment, domestic work, and leisure as predictors of health among women and men

Background: The aims of this longitudinal study were to analyse whether perceptions of employment, domestic work and leisure were predictors of health among women and men, and whether the predictors revealed were the same for both genders. Method: A random sample comprising of 2,683 employees in public health care and social insurance offices (2286 women and 397 men) in western Sweden, answered a survey twice, within a two‐year interval. Results: The results showed that perceptions of low stress, good balance and high meaning in the occupations of everyday life predicted both good self‐rated health and balanced work attendance among women but not among men. For men, the most important predictor of both good self‐rated health and balanced work attendance was low work place stress. Conclusion: The men seemed to have a better balance between employment, domestic work, and leisure than the women. Furthermore, the results indicated that leisure might be a more pronounced health protector for women than for men.

Meaning in Life for People with Schizophrenia: Does it Include Occupation?

The aim of this study was to describe what people with schizophrenia may discern as bringing meaning to their lives, based on the premise that it cannot be taken for granted that occupation would be part of that. A qualitative approach with semi-structured interviews was utilized to understand how the informants experienced meaning in life. Based on purposeful sampling in four Swedish supported housing units, 10 informants were recruited. They included five men and five women, aged 36 to 50 years, none of whom had a regular daily occupation. Qualitative content analysis revealed five categories about sources of meaning in their lives: social contacts, engagement in occupations, experiencing health, precious memories, and positive feelings. The categories also appeared to influence each other; engagement in occupations and perceiving health mutually reinforced each other, as did perceiving health and positive feelings. The findings contribute to the knowledge of what may bring meaning to the lives of people diagnosed with schizophrenia and, importantly, strengthen the occupational science assumption that occupation brings meaning to peoples lives and promotes health. The findings also suggest that further research is needed to develop greater understanding about the connections between occupation and meaning in occupational science.

How life balance is perceived by Swedish women recovering from a stress‐related disorder: A validation of the life balance model

This phenomenological research is the second part of two analysis phases. The purpose of the first analysis phase was to gain insights about the experiences, perceptions, and attitudes about lifestyle balance of 19 women who were recovering from stress‐related disorders. The findings indicated that the women perceived both balance and imbalance relative to their image of occupational self, strategies to manage and control everyday life, occupational repertoire, and occupational experience. The purpose of the second analysis phase was to re‐analyze the data for its congruence with the Matuska and Christiansen life balance model using a matrix system, and to test the validity of the model. Results from the second phase are reported. When discussing the continuum between balance and imbalance in their lives, the women described occupations that met needs related to each of the five lifestyle balance model dimensions. They felt balanced or imbalanced depending on whether they were able to maintain their physical health, nurture important relationships, create a positive identity, pursue rewarding and stimulating occupations, and manage their time and energy to achieve daily goals and renewal. These findings provide additional validity for the life balance model, which may be used in occupational science.

Managing work life with systemic sclerosis

OBJECTIVE To explore how individuals with SSc manage their work life. METHODS We conducted four focus group interviews, which included 17 patients currently working at least 20 h per week. The interviews were recorded and transcribed verbatim. The transcribed texts were analysed according to thematic content analysis. Relevant statements that generated preliminary categories were identified, after which themes and underlying subthemes were generated. RESULTS The participants perceived their work role as being important, giving them a structure in everyday life and a sense of being useful members of society. Work and private life were interacting, and different adjustments had been developed to create a satisfactory balance of activities in daily life. Three themes emerged: adjustment of work situation, adapting to own resources and disclosing limitations. Reduced working hours, flexibility in the workplace concerning time schedule, room and tasks were all valuable adjustments, and were dependent on the employer, fellow workers as well as the individuals attitude towards informing employer and colleagues about his/her limitations. The participants had simplified and rationalized a lot of household chores and pointed to the importance of prioritizing meaningful activities, as well as the necessity of having time for rest and recovery. CONCLUSIONS Reduced working hours, work flexibility and prioritizing meaningful activities and recovery were important factors in order to manage work life. Intervention, including problem-solving techniques and re-designing of activities in daily life, could be useful to coach individuals towards finding a balance in their work life.

Associations between women’s subjective perceptions of daily occupations and life satisfaction, and the role of perceived control

BACKGROUND/AIM More knowledge is needed about the role of perceived control in the associations between different perceptions of daily occupations and positive health outcomes. The aim was to explore the associations between different subjective perceptions of daily occupations, in terms of occupational balance, occupational meaning, occupational value and satisfaction with occupations, and life satisfaction, and the role of perceived control in those associations. METHODS A questionnaire including questions about perceptions of daily occupations, perceived control and life satisfaction were answered by a random sample of 488 middle-aged Swedish women. Multiple logistic regression analysis was used to test the associations between perceptions of daily occupations and life satisfaction, and the role of perceived control. RESULTS After adjustments for perceived control women who perceived a high level of satisfaction with work and leisure, occupational balance, occupational meaning and occupational value perceived greater life satisfaction than the other women. Perceived control was not significant in the model. CONCLUSIONS It seems that occupational balance and occupational meaning were pivotal for the womens life satisfaction, but satisfaction with work and leisure, as well as perceived occupational value, was also of importance. The assumption that perceived control would have a role in the association between perceptions of occupations and life satisfaction was not confirmed. SIGNIFICANCE OF THE STUDY The results indicate that occupational therapists need to focus on occupational balance, occupational meaning, occupational value and satisfaction with work and leisure to promote positive health outcomes, in terms of life satisfaction, when working with middle-aged female clients.