Dennis Persson

Occupational value among individuals with long-term mental illness.

Purpose. The study compared the perceived value of occupation among a sample of individuals with long-term mental illness to a sample of people not diagnosed with mental illness. As well, it investigated whether diagnostic and demographic factors were related to perceived occupational value among the individuals with mental illness. Finally, the study examined the relationship between occupational value and ratings of health and well-being. Method. One hundred and three individuals with mental illness and 28 healthy individuals were recruited for the study. Results. Overall occupational value among the individuals diagnosed with mental illness differed only marginally from the healthy group, indicating that perceived occupational value was by and large not related to mental illness. Among the individuals with mental illness, having children living at home was related to occupational value. There were moderate to strong associations between occupational value and measures of health and well-being. Practice Implications. This study provides important insights into occupational value among individuals with persistent mental health problems and provides some preliminary evidence in support of the Value, Meaning and Occupation Model.

Value dimensions, Meaning and Complexity in Human Occupation: A tentative structure for analysis

In occupational therapy and occupational science, it is important to clarify the perspective from which the analysis of occupation is addressed. The purpose of this paper is to present a tentative structure for describing occupation, allowing for analysis in a lifelong panorama as well as for the immediate experience a person acquires from performing a single occupation. The concept of occupational value is introduced as a prerequisite for meaning, defining three different dimensions: concrete, symbolic, and self-reward value. A dynamic categorisation of single occupations is presented, considering each unique occupational performance viewed from a macro, meso, and a micro perspective, inspired by dynamic systems theory. It is proposed that all occupations are meaningful if they are integrated parts of a persons occupational continuity, and that it is the interaction between the mentioned three perspectives that determines their meaningfulness. With an explicit focus on value and meaning as perceived by the unique person, occupational therapists will become more skilled in designing meaningful occupational therapy interventions. This paper is a contribution to the development of occupational science as well as to occupational therapy, but the theoretical framework presented must be empirically tested in order to demonstrate its validity.In occupational therapy and occupational science, it is important to clarify the perspective from which the analysis of occupation is addressed. The purpose of this paper is to present a tentative structure for describing occupation, allowing for analysis in a lifelong panorama as well as for the immediate experience a person acquires from performing a single occupation. The concept of occupational value is introduced as a prerequisite for meaning, defining three different dimensions: concrete, symbolic, and self-reward value. A dynamic categorisation of single occupations is presented, considering each unique occupational performance viewed from a macro, meso, and a micro perspective, inspired by dynamic systems theory. It is proposed that all occupations are meaningful if they are integrated parts of a persons occupational continuity, and that it is the interaction between the mentioned three perspectives that determines their meaningfulness. With an explicit focus on value and meaning as perceived by the unique person, occupational therapists will become more skilled in designing meaningful occupational therapy interventions. This paper is a contribution to the development of occupational science as well as to occupational therapy, but the theoretical framework presented must be empirically tested in order to demonstrate its validity.

Towards an Experiential Model of Occupational Balance: An Alternative Perspective on Flow Theory Analysis

Abstract The Experience Sampling Methodology (ESM) being elaborated within flow theory provides a unique opportunity to collect data about occupational experiences. Both four‐ and eight‐channel models have been developed, to capture various dimensions of peoples lived experience. However neither of these models seems suitable for analysis and discussion of balance within everyday life and its relationship to other factors such as well‐being. The purpose of this study was to analyse balance of everyday occupations from a novel experiential viewpoint, using an alternative model in which the eight channels are condensed into three dimensions; High Matched Experiences, High Not Matched Experiences and Low Challenge Experiences. A secondary analysis of published data from four cross‐cultural ESM‐studies with a total of 159 participants from three countries was conducted. The results show a similar pattern in all samples, with Low Challenge Experiences comprising barely half of the pattern and the other two dimensions relatively evenly distributed. Analyses of three case examples indicate possible problems regarding balance conditions between the different dimensions. The analysis supports the condensed model as a framework to understand and analyse occupational balance and patterns from an experiential perspective. This dynamic model has the potential to explain the relationship between everyday dimensions of occupations as a health promoting balance as well as potentially dysfunctional patterns causing occupational deprivation or risk of overload and burnout.

Rasch analysis of an instrument for measuring occupational value : implications for theory and practice

This study investigated psychometric properties of an instrument for assessing perceived occupational value, the 26-item OVal-pd. Data from 225 Swedish subjects with and without known mental illness were analysed regarding fit to the Rasch measurement model (partial credit model), differential item functioning (DIF), and functioning of the OVal-pd four-category response scale. The reliability (index of person separation, analogous to Cronbachs alpha) was good (0.92) but there were signs of overall and item level (six items) misfit. There was DIF between people with and without mental illness for three items. Iterative deletion of misfitting items resulted in a new 18-item DIF-free scale with good overall and individual item fit and maintained reliability (0.91). There were no disordered response category thresholds. These observations also held true in separate analyses among people with and without mental illness. Thus, the first steps of ensuring that occupational value can be measured in a valid and reliable way have been taken. Still, occupational value is a dynamic construct and the aspects that fit the construct may vary between contexts. This has implications for, e.g., cross-cultural research and calls for identification of a core set of culture-free items to allow for valid cross-cultural comparisons.

Occupational value and relationships to meaning and health: Elaborations of the ValMO-model.

Abstract This study investigates the theoretical assumption of the Value and Meaning in Occupations model. The aim was to explore the relationship between occupational value, perceived meaning, and subjective health in a sample of individuals of working age, 50 men and 250 women. Frequency of experienced values in occupations was assessed through the Occupational Value instrument with pre-defined items. Perceived meaning was operationalized and assessed by the Sense of Coherence measure. Subjective health was estimated by two questions from the SF-36 questionnaire. The analyses implied descriptive analyses, correlations, and logistic regression analyses in which sociodemographic variables were included. The findings showed highly significant relationships between occupational value and perceived meaning and when belonging to the high group of occupational value the likelihood was tripled of belonging to the high group of perceived meaning. When married or cohabitating there was double the likelihood of belonging to the high group of perceived meaning. Although perceived meaning was found to be positively associated with subjective health, working full time was the most important factor in explaining subjective health, compared with working less than full time. The results confirm assumptions in the ValMO-model, and the importance of focusing on occupational value in clinical practice is highlighted.

The experience of everyday occupations and its relation to sense of coherence ‐ a methodological study

Abstract The connection between health and the activation of the body that occurs through occupational engagement in rehabilitation is unquestionable, but what impact on health and well‐being does the experience of occupational performance have in itself? This pilot study was conducted to develop a methodology that captured qualities of experience in the daily occupational repertoire of six heterogeneous cases. The following instruments were used: 1) Experience Sampling Method, 2) Occupational Storytelling, and 3) the Sense of Coherence Scale, encompassing both quantitative and qualitative dimensions of experiences. The first two instruments were found to supplement each other in capturing specific and global experiences of occupations respectively, while the third focused on the individuals sense of coherence in life, connected to a salutogenic understanding of health. The results of the study were the development of 1) individual Experience Quality Profiles (EQPs), based on an eight‐channel flow model,...

Time to Reevaluate the Machine Society: Post‐industrial Ethics from an Occupational Perspective

Abstract This paper discusses the ethics underlying the occupational repertoire of the post‐industrial citizen, giving attention to lifestyle phenomena such as increased tempo and quantity of occupations; manipulation of time, organisms and environments; decreases in sleep, rest and play etc. In trying to understand human behavior in the 21st century, an ethical perspective is delineated and some starting points for a discussion of ethics from an everyday occupational perspective are investigated. Using examples from contemporary Western society, human occupational behavior is described as imprinted by machine‐ethical values. It is argued that since behavior arising from such values has been little formulated or observed, it constitutes a substantial risk factor for ill health and stress. An alternative eco‐ethical perspective of occupation, inspired by Skolimowski the Polish professor of eco‐philosophy, is proposed. The concept of “ecopation” is introduced as an optional choice denoting occupations that are performed with concern for the ecological context at a pace that gives room for reflection and experience of meaning. The questions raised in this paper may be important for occupational scientists to more fully understand the implicit guidelines of contemporary and future occupation and for occupational therapists taking an active part in future healthcare.

The Journey of Recovery and Empowerment Embraced by Nature — Clients’ Perspectives on Nature-Based Rehabilitation in Relation to the Role of the Natural Environment

This paper presents findings from real life situations, a longitudinal single case study on the role of natural environments in nature-based rehabilitation (NBR) for individuals with stress-related mental disorders, at the Alnarp Rehabilitation Garden in Sweden. A sample of 43 former clients voluntarily participated in semi-structured interview, and the data were analyzed according to interpretative phenomenological analysis (IPA). Three main superordinate themes were identified as the three phases of NBR—Prelude, Recuperating and Empowerment—explaining and illuminating the role of the natural environments in each phase. An explanatory model of NBR in this context is presented including the three phases of NBR, IRP supportive occupations and a pyramid of supporting environments. A new component of supportive environments was identified and herby named, Social quietness, an important component facilitating personal and intimate engagement with the natural environments.

Occupational therapists' experience of working with immigrant clients in mental health care

Abstract Swedens cultural diversity generates considerable challenges for occupational therapists. The aim of this study was to explore experiences and perceptions of occupational therapists working with immigrant psychiatric clients from the Middle East region. The study included interviews with eight occupational therapists employed in mental health care and working in a variety of settings. The data collection and analysis were carried out in accordance with the grounded theory approach. One core category, “the challenges of the multicultural therapeutic journey—a journey on a winding road” was identified. The core category included three categories: dilemmas in clinical practice, feelings and thoughts, and building cultural bridges, in turn comprising sub-categories and components. The results showed that the many dilemmas influencing effective multicultural occupational therapy were cultural, societal, and professional in nature. The dilemmas influenced feelings and thoughts, in turn influencing both motivation for seeking cultural knowledge and choice of adequate strategies in which the multicultural therapeutic relationship could develop. The results imply that culturally congruent occupational therapy practice needs to be further developed and more research is needed on how cultural issues can be met in occupational therapy practice.

Stigma-handling strategies in everyday life among women aged 20 to 30 with transversal upper limb reduction deficiency

Abstract This grounded theory study shows an adaptation of stigma-handling strategies to situations in everyday life by women aged 20 to 30 with dysmelia, i.e. transversal upper limb reduction deficiency (TULRD). Strategies are comprehensive patterns of action aimed at controlling information about ones status as deviating from an ad hoc normality. Strategies consist of: (1) attitude (proofing/being); (2) tactic (concealing/revealing); (3) exposure (voluntary/imposed); and (4) boost (amplifying/altering). A proofing or being attitude constitutes a contextual adaptation understood in terms of a concealing or revealing tactic, aiming at delaying or promoting exposure to contextual attitudes and possible prejudices. If exposure is delayed, a person with dysmelia blends in. Exposure may be voluntary or imposed. After exposure, the relative importance of TULRD in the specific context may decrease, thus a boost of an amplification or altering of the attitude, i.e. boost is the interactional outcome enforcing t...