Gaynor Sadlo

Retirement: An occupational transition with consequences for temporality, balance and meaning of occupations

Abstract The aim of this study was to explore retirement as an occupational transition. Twenty‐nine participants aged 66 years were interviewed and the data analysed using a comparative qualitative method. The analysis showed that a new temporal structure developed where the participants were gliding into a slower rhythm. Some occupations also changed meaning when they were performed in the new circumstances of retirement. A common pattern in the transition was to go from one imbalance, where work took too much time in life, to another type of imbalance where some kind of regular commitment within retirement would have been preferable. The discussion relates the findings concerning meaning and rhythm to concepts in dynamic systems theory. The importance of regular commitments in life for experience of occupational balance and the changing perspective of the future are also discussed.

The phenomenon of boredom

Boredom remains a poorly understood phenomenon despite its evident association with dysfunctional behavior and mental health problems. However, little research has been devoted to the topic, and the bulk of studies have almost exclusively been quantitative in design. For this reason, a qualitative, interpretive phenomenological study was carried out, during which ten participants were asked for their accounts of the experience of boredom. These people were sampled from the general population. The aims of the study were to find out more about the antecedents to boredom, the experience itself, any stages in its development, and methods used to deal with it. Findings indicated that boredom is an extremely unpleasant and distressing experience. Situations giving rise to the sensation varied between specific external factors, to a general propensity to boredom proneness, although, according to the participants of the study, these could change throughout their lifetime. Feelings comprising the experience of boredom were almost consistently those of restlessness combined with lethargy. No stages in the development of the experience were identified. Strategies used to overcome the problem varied greatly, but generally involved trying to find interesting things to do. These strategies tended to be unsuccessful. Traditional methods of dealing with boredom have focused on increasing stimulation and choice in the environment. The authors propose that a more effective strategy might be to focus more on internal causes of boredom, such as an inability to sustain attention, although further research is required to support this interpretation of the data.

I Have Mastered the Challenge of Living With a Chronic Disease: Life Stories of People With Rheumatoid Arthritis

Our aim with this study was to explore the narrative life story of individuals diagnosed with rheumatoid arthritis. An open qualitative approach, namely narrative biographic methodology, was applied to include the life context of the participants and to deliberately exclude predefinitions of concepts. Ten people with rheumatoid arthritis who retired early because of the disease participated and were interviewed three times according to a narrative biographic interview style. The biographical data and the interview texts were analyzed both individually and in comparison to each other. Some participants regarded rheumatoid arthritis as a challenge for mastery in their lives, whereas others adapted to the disease and “made the best out of a bad situation.” Especially in countries where the medical model predominates in health care, our findings can be used to broaden the current view that some health professionals have toward patients, and stress the importance of patients being self-responsible.

I Have a Disease But I Am Not Ill: A Narrative Study of Occupational Balance in People With Rheumatoid Arthritis

Occupational balance is a prominent concept in occupational therapy and in society at large, and could be a key concept in that it may enhance understanding of the link between occupation and health. Because there is a lack of empirical evidence, the aim of this study was to critically examine the existing assumptions regarding occupational balance. An open narrative approach was applied to include the life context of the participants and to deliberately exclude predefinitions of the concept. From 10 reconstructed life stories, which were analyzed individually, three new dimensions of occupational balance related to health and grounded in the data were developed: a balance between challenging versus relaxing occupations and activities, activities meaningful for the individual and activities meaningful in a sociocultural context, and activities intended to care for oneself and activities intended to care for others. These three dimensions of occupational balance may be key concepts for future research.

Evaluating Practice Education Models in Occupational Therapy: Comparing 1:1, 2:1 and 3:1 Placements

Practice education is an essential part of the education of health professionals, yet in spite of this there is an acknowledged shortage of placements. At the same time, educational research indicates that peer learning, and in particular problem-based learning, has advantages for students. Studies that have investigated models of placements where more than one student at a time share an educator have shown that this may bring benefits for both educators and students. This study was carried out with the aim of determining the impact of different models of practice placement (1:1, 2:1 and 3:1) on the quality of education for students and on the quality of the experience for educators, in both occupational therapy and physiotherapy courses at a university in the South of England. This article focuses on the occupational therapy component of the study. Six occupational therapy educators and 11 students took part, providing examples of all three models of placement. The findings indicated that while all three models provided both advantages and disadvantages for educators and students, the 2:1 model offered more opportunities for peer support and enhanced the quality of the educational experience through peer learning. In some settings, however, it is probably the case that only the 1:1 model is possible. The findings also suggest that the success of any placement model depends heavily on how well the placement has been planned.

Challenge-skills and mindfulness: an exploration of the conundrum of flow process

The process of flow, a psychological state that seems to occur during optimal human experience, is currently unclear. This exploratory study examines how flow begins and what happens during and after a flow experience. A phenomenological approach was taken to examine the flow experiences of an artist, a musician, and a horticulturist. Participants kept journals and participated in semi-structured interviews. The results suggest that two phenomena, “challenge-skills” and “mindfulness,” were identified as being “flow” experiences. Challenge-skills and mindfulness had some common features. Both involved living in the present moment, not worrying, and performing activities because they were intrinsically rewarding. They were distinctly different experiences in regard to the effort involved, the perception of time, and the consequences of the experience. Understanding the process of challenge-skills and mindfulness may have implications for our understanding of the relationship between occupation, consciousness, and health and for occupational therapy practice.

Perceived academic quality and approaches to studying in the health professions

Background: Students in higher education may adopt different approaches to studying, depending upon their perceptions of the academic quality of their courses and programmes, and both are likely to depend upon the nature of the curricula to which they are exposed. Aims: Perceptions of quality and approaches to studying were investigated in students taking pre-registration programmes in a school of health professions. Two of the programmes were 3-year undergraduate programmes with subject-based curricula, and two were 2-year entry-level masters programmes with problem-based curricula. Method: The Course Experience Questionnaire (CEQ) and the Revised Approaches to Studying Inventory (RASI) were administered to the students within a single survey. Their teachers were also surveyed with regard to their beliefs and intentions about teaching. Results: The teachers on the two kinds of programme exhibited similar beliefs and intentions about teaching. However, the students on the masters programmes produced higher ratings than did the students on the undergraduate programmes with regard to the appropriateness of their assessment, the acquisition of generic skills and the emphasis on student independence. The students on the masters programmes were also more likely to show a deep approach to studying and less likely to show a surface approach to studying than were the students on the undergraduate programmes. Conclusions: The CEQ and the RASI provide complementary evidence for use in research, in quality assurance and in quality enhancement. In comparison with subject-based curricula, problem-based curricula seem to enhance students’ perceptions of their programmes and the quality of their learning. Practice points Evaluations of academic programmes in the health professions need to take into account students’ perceptions of academic quality and the approaches to studying that they adopt. The CEQ and the RASI can be recommended for use as research instruments and together provide complementary evidence for use in quality assurance and quality enhancement. The introduction of problem-based curricula in the health professions can enhance students’ perceptions of the quality of their programmes and the quality of their learning.

Problem-Based Learning in the Development of an Occupational Therapy Curriculum, Part 1: The Process of Problem-Based Learning

‘Problem-based learning’ is a concept of learning in which students focus from the beginning of their course on a series of real professional issues, where the knowledge of the various academic disciplines that relate to these issues is integrated. The process evolved from dissatisfaction with the usual teaching methods in higher education, particularly in medicine. It seems eminently applicable to the education of occupational therapists, and its wider adoption is advocated. Part 1 of this article outlines the development of problem-based learning, describes its rationale, and discusses some of the evidence of its effectiveness. Part 2 will describe its implementation in the new BSc course at the London School of Occupational Therapy, West London Institute, College of Brunel University.

Further Explorations into the Conundrum of Flow Process

Abstract This study builds on previous research that has aimed to clarify uncertainties regarding what happens before, during and after a ‘flow’ experience, a psychological state that appears to arise during optimal human experience. A phenomenological approach was taken to examine the flow experiences of seven participants. The method included participants keeping journals and semi‐structured interviews. The flow process seemed to vary between challenge‐skills, enjoyment, positive distraction and mindfulness experiences. These experiences had similarities, as all participants described them as positive psychological states that were a consequence of being absorbed in an occupation, but differed in relation to prior affect and the degree of challenge an occupation presented. This research has highlighted the importance of meaning and the essential role occupation may have in protecting well‐being. Occupations may lead to optimal experience when they lead to altered and ordered states of consciousness.

Problem-based Learning in the Development of an Occupational Therapy Curriculum, Part 2: The BSc at the London School of Occupational Therapy

Part 1 of this article* defined the process of and rationale for problem-based learning (problem-focused education). Part 2 describes the new BSc(Hons) programme in occupational therapy at the West London Institute, which is designed around a series of true-life problems encountered by people who have been referred for occupational therapy. It was developed following experience of problem-focused education in the diploma course. Problems are presented to students in a special sequence, within units of study, graded to promote understanding and critical evaluation of the process of occupational therapy. There is an accent on fieldwork reasoning, and on the accumulation of usable knowledge required for each case. The capacity for self-direction for lifelong learning is promoted. The curriculum is intended to be motivating, exciting, relevant and challenging for students and staff. Evaluations of the diploma course have been positive, and the outcomes of this new degree are being monitored to ensure standards and to ascertain more clearly the educational value of fieldwork problems.