Farzaneh Yazdani

Occupational balance: A study of the sociocultural perspective of Iranian occupational therapists

Background. The concept of occupational balance has always been important to occupational therapists and occupational scientists, but it is often interpreted differently by professionals, particularly in relation to practice. Purpose. This study focused on the understanding of occupational balance of a group of experienced occupational therapists who held positions at the time in Iran. Method. A preliminary qualitative study from within an interpretive paradigm was employed. A focus group was used for data collection, and the data were analyzed using thematic networks analysis in relation to occupational science concepts. Findings. Four organizing themes were uncovered: integrity in being, equilibrium in doing, contentedness in becoming, and harmony in belonging. The global theme of “fluidity” describes the dynamic nature of occupational balance. Implications. The concept of occupational balance needs to be further explored in different communities. Identifying similarities and differences in its meaning and application will inform culturally relevant client-centred education and practice.

Therapeutic mode preferences and associated factors among Norwegian undergraduate occupational therapy students: A cross-sectional exploratory study

Abstract Background: The Intentional Relationship Model is specifically focused on the relational aspect of therapy. The model describes six therapeutic modes; these represent different types of interaction for the therapist. However, preferences for therapeutic mode use are under researched. Aims: This study aims to describe preferences for therapeutic modes in undergraduate occupational therapy students, as well as to explore factors associated to each of the therapeutic modes. Methods: A sample of 96 occupational therapy students, based at two different Norwegian universities, participated in the study. They completed the Norwegian Self-Assessment of Modes Questionnaire along with sociodemographic information. Descriptive analysis, bivariate correlation and linear regression analysis were employed. Results: The problem-solving mode was most frequently endorsed. There were generally weak associations between the variables, but female sex and being a student in the education program in Trondheim were associated with higher preference for collaboration. Conclusion: There is diversity in students’ preferences for the modes, but the problem-solving mode was the most preferred. Students need to be aware of the mode they feel more comfortable with and make sure they use modes that fit with the specific client. Significance: The occupational therapy education programs need to incorporate raising awareness about therapeutic modes.

Occupational therapists’ perception of the concept of occupational balance

Abstract Introduction: Occupational balance is one of the concepts used by occupational therapists with no consensus on its definition. Literature demonstrates different perspectives when this concept is applied in practice and in its link to other concepts such as health and well-being. This study aims to explore how the concept of occupational balance is perceived and practised by occupational therapy practitioners. Method: A qualitative methodology was employed. Fourteen occupational therapists volunteered for the study. Nine occupational therapy practitioners were interviewed individually and five attended a focus group. Thematic analysis was applied to analyze the data. Results: Six themes were identified as follows: (1) occupational balance: what it is; (2) how occupational balance is formed; (3) occupational balance and well-being (4); subjective and objective representations of occupational balance (5); what disrupts/affects occupational balance; and (6) occupational balance/imbalance and occupational therapy practice. Conclusions: Both objective and subjective experiences of occupational balance need to be considered in order to make an informed decision in practice. The right occupational balance for each individual should be based on his/her values but with consideration of the principal of no harm to others.

The Norwegian occupational wholeness questionnaire (N-OWQ): Scale development and psychometric properties

Abstract Background: Occupational therapy has long emphasized the concepts doing, being, becoming and belonging, and a notion of balance between them. Measures of these concepts are in a developing stage. Aim: This study aimed to develop and examine the properties of the Norwegian version of the Occupational Wholeness Questionnaire (N-OWQ), which is proposed to measure being, becoming, and belonging, in addition to occupational wholeness as a higher-order concept. Methods: An anonymous sample of 248 persons over the age of 18 years completed the N-OWQ along with sociodemographic information. Principal Components Analysis (PCA) was performed on the scale items when examining factor structure. Item reduction was based on considerations of communalities, factor loadings, scale consistency if item deleted, and conceptual issues. Internal consistency was assessed with Cronbach’s α. Results: Following the PCA, the ‘Being’ and ‘Becoming’ scales merged into one five-item ‘Self’ scale (Cronbach’s α 0.77). The ‘Belonging’ scale items were split into two scales comprised by three items each: ‘Closeness’ (Cronbach’s α 0.70) and ‘Relatedness’ (Cronbach’s α 0.73). Conclusions: The revised N-OWQ merged the ‘Being’ and ‘Becoming’ items into one factor, whereas the ‘Belonging’ items were split into two distinct factors. Internal consistency for all scales were satisfactory.

Short-term changes in occupational therapy students’ self-efficacy for therapeutic use of self:

Introduction Self-efficacy concerned with the therapeutic use of self is important for occupational therapists, and students need to develop the skills and the self-efficacy required to meet interpersonal challenges in practice. This study examined short-term changes in occupational therapy students’ self-efficacy for using therapeutic modes, for recognizing clients’ interpersonal characteristics, and for managing interpersonal events. Factors associated with such changes were also examined. Method A sample of 89 Norwegian occupational therapy students from two universities was used, and the students completed three questionnaires 2–3 weeks after a workshop and at 3 months’ follow-up. Changes on the outcome measures were analyzed with t-tests for dependent samples, and factors associated with the outcome changes were analyzed with linear regression analyses. Results During the follow-up period, the students improved their self-efficacy scores on all three outcome measures. Higher age was associated with more improvement on two of the outcome measures. Conclusion The occupational therapy students improved their self-efficacy for therapeutic use of self during the brief follow-up period. Thus, the time in education, either university-based or practice-based, seems to add to students’ self-efficacy for clinical skills in this area. Higher age appears to be a resource for gaining more self-efficacy from attending educational courses.

Self-efficacy for therapeutic mode use among occupational therapy students in Norway

Abstract Background: The intentional relationship model (IRM) proposes six distinct ways of relating to clients. A new instrument for measuring self-efficacy for using the therapeutic modes in occupational therapy practice was recently found to have good psychometric properties. To date, however, no research has investigated factors associated with self-efficacy for therapeutic mode use. Aim: This study aimed to explore sociodemographic and education-related factors associated with self-efficacy for therapeutic mode use in a sample of occupational therapy students in Norway. Methods: Occupational therapy students (n = 111) from two education programs completed the Norwegian version of the recently developed “Self-efficacy for therapeutic mode use” (N-SETMU), in addition to reporting sociodemographic and education-related information. Hierarchical linear regression analysis was used to examine factors independently associated with the students’ N-SETMU scores. Results: Higher N-SETMU scores were associated with better average academic performance among the students. Otherwise, none of the associations were statistically significant. Conclusions: As better academic results were linked with higher self-efficacy for therapeutic mode use, the study indicates that some students perform well academically and have high self-efficacy for practical skills, whereas others perform less well academically and have lower self-efficacy for practical skills. A potential transfer of self-efficacy beliefs from one area of performance (academic) to another (practical skills) seems possible, and this may be investigated in future studies.

Leisure time activities of Iranian patients with multiple sclerosis: a qualitative study

Background: Leisure time is one of the most important aspects of life, especially for people with chronic diseases. The concept and types of leisure have frequently been evaluated in different socio-cultural populations. The aim of this study was to identify the nature of leisure activities among a sample of Iranian patients with multiple sclerosis (MS) and classify the identified types of activities in the context of Iranian culture. Methods: In this qualitative study, semi-structured interview was applied to gather data from 34 MS patients that were selected through purposive sampling. The interviews were continued up to the point of saturation. Content analysis was used to explore experiences of the interviewees regarding their leisure activities. Results: Six categories of leisure activities were extracted for the studied patients with MS i.e.physical, social, individual, art/cultural, educational and spiritual/religious. Conclusion: The results represented the range and heterogeneity of leisure activities amongst the MS patients. Considering participation in spiritual/religious and social activities as leisure time undertaking might reflect cultural diversity in the perception and use of time for recreation. For mental health promotion purposes, paying special attention to the types of activities that people of different socio-cultural background choose for their refreshment could help health care providers in giving tailored advice for patients with MS and other chronic debilitating disease.

The Rehabilitation Paradox: Street-Working Children in Afghanistan

International humanitarian intervention in Afghanistan reflects a policy discourse of “rehabilitation,” which is very evident in relation to nongovernmental organization (NGO) projects for street-working children. Through analysing national and international policy, professional perceptions of the children, and field visits to see how policy relates to practice in NGO projects in Kabul, this article argues that the discourse is a “rehabilitation paradox.” The international goal is to return “minority” children, who are numerically the majority, to a “mainstream,” which is either mythical or a transient international elite. John Gray argues that Western utopianism explains the misguided nature of recent international military interventions, and this article extends that argument to rehabilitation. Without a concept of rehabilitation, “intervention” can be an act of wanton destruction. Policymakers need to be aware of how education can become complicit in the political arguments that are used to legitimise questionable interventions. It is proposed that, conceptually and practically, habilitation would be a more appropriate goal.

Psychometric Properties of an Instrument Derived from the Intentional Relationship Model: The Self-Efficacy for Recognizing Clients’ Interpersonal Characteristics (N-SERIC)

Background: The Intentional Relationship Model conceptualizes the therapeutic use of self in occupational therapy. To increase motivation for and success in establishing therapeutic relationships, therapists need selfefficacy for using the self in therapeutic practice. However, attempts to combine this model with self-efficacy theory are rare, and instruments by which to measure self-efficacy for therapeutic use of self are in a developing stage. This study aimed to examine the factor structure and internal consistency of the Norwegian Self-Efficacy for Recognizing Interpersonal Characteristics (N-SERIC). Methods: Occupational therapy students (n = 100) from two education programs completed the instrument and sociodemographic information. The factor structure was examined with Principal Components Analysis (PCA), and internal consistency was assessed with Cronbach’s α and inter-item correlations. Results: The PCA revealed that all N-SERIC items belonged to the same latent factor, with factor loadings ranging between 0.75 and 0.89. The internal consistency of the scale items was high (Cronbach’s α = 0.96). Conclusions: The N-SERIC scale is unidimensional and the items have very high internal consistency. Thus, the scale sum score can be useful for occupational therapy research and audits focusing on interpersonal aspects of practice. Comments The authors disclose no conflicts of interest.

Effectiveness of cognitive orientation to (daily) occupational performance (CO-OP) on children with cerebral palsy: A mixed design

BACKGROUND Cerebral palsy (CP) is the most common cause of physical disabilities during childhood. Therapeutic interventions mainly focus on impairment reduction to address motor-based difficulties. In contrast, Cognitive Orientation to daily Occupational Performance (CO-OP) is a cognitive approach, providing intervention at the level of activity and participation. AIMS This study aims to determine whether the CO-OP approach improves motor skills and achievement in motor-based occupational performance goals in children with CP. METHODS AND PROCEDURES In this mixed design research (i.e., a multiple baseline single case experimental design and a one-group pretest-posttest design), five children with CP participated in 12 CO-OP intervention sessions. Repeated measures of motor skills for the multiple baseline single case experimental design were taken using the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP); pre- and post-measures of parent/child perception of performance and satisfaction were identified using the Canadian Occupational Performance Measure (COPM); level of achievement was identified using Goal Attainment Scaling (GAS). OUTCOMES AND RESULTS According to the BOTMP results, all children were able to engage in the CO-OP intervention to improve motor performance. Significant differences after treatment were found in both performance and performance satisfaction ratings using the COPM as rated by parents and children. The GAS results showed progress in achievement levels for all children; all goals were achieved or exceeded. CONCLUSIONS AND IMPLICATIONS CO-OP intervention can be helpful in improving motor skills and achieving self-identified, motor-based goals in children with CP.