Lena Haglund

Doing everyday life—experiences of the oldest old

The purpose of this article is to explore how a group of elderly people, living and managing on their own, describe and experience their everyday doings. Interviews and observations were conducted with 18 community-living people aged 85 and above. The experiences of ‘Doing everyday life’ are described in five overarching themes: ‘Experiencing being old’, ‘Doings in everyday life’, ‘Patterns of the day’, ‘Altered doings’, and ‘The importance of time’. What is done during an ordinary day does not differ much from earlier in life, but how the doings are performed has changed. Being occupied and staying healthy and sound in mind was stressed as important in old age and even if reduced energy and functional constraints limited the doings, a strong volition to manage independently was expressed. The participants perceived society as regarding the elderly as useless and worthless. Knowledge emanating from the very old themselves is vital to diversify the image of elderly people and to offer interventions and support adapted to their needs and desires.

Validity of the Swedish Version of the Worker Role Interview

The Worker Role Interview (WRI) was developed as an assessment of psychosocial factors which influence work success and return to work following an injury. The instrument has been translated and adapted for Swedish culture. This article presents the findings from a study of the validity of the Swedish Worker Role Interview (SWRI) with a psychiatric population. Results indicate that the Swedish instrument is a valid measure of psychosocial capacity for work. Comparison of findings from the SWRI with research on the WRI indicates that the instrument is valid across both cultures and languages and can be used effectively with both physically and psychiatrically disabled clients.

Practice models in Swedish psychiatric occupational therapy

In clinical settings, occupational therapists need models both from their own field, occupational therapy, and from other fields in order to offer the clients adequate treatment. It is unknown whic ...

A critical analysis of the Model of Human Occupation.

The aim of this paper is to begin a dialogue regarding the use of the Model of Human Occupation (MOHO) (Kielhofner, 1995). Three questions formed the basis for discussion: 1. Is the MOHO consistent with the values and beliefs of occupational therapy?; 2. Does the MOHO support the intervention process in occupational therapy? and; 3. Is the MOHO consistent and applicable to the current regulations and societal values in Sweden? The authors propose that the MOHO must be further developed in order to support assessment and intervention in occupational therapy. Specifically, they find the MOHO lacking with regard the influence of the environment on human behaviour, appreciation of the dialectic process between the human and the environment, and of the importance of the subsystem volition in the intervention process.

Perceptions of the work environment among people with experience of long term sick leave

PURPOSE The aims were to describe and analyze how people with experience of long term sick leave perceive that factors in their work environment support or interfere with work performance, satisfaction, and well-being. METHOD The 53 participants were interviewed with the Work Environment Impact Scale (WEIS). The WEIS ratings and belonging notes were analyzed by descriptive statistics and qualitative analysis respectively. Differences in WEIS ratings between; women and men; participants with somatic and mental diseases; and participants working and on full-time sick leave were tested. RESULTS The most supportive factors concerned social interactions at work, and the value and meaning of work. The factors perceived as most interfering concerned work demands and rewards. The social relations at work were perceived as more supportive by the working group than by those on full-time sick leave. The participants with somatic diseases perceived physical work factors as more interfering than did participants with mental diseases, who in turn perceived the value and meaning of work as more interfering. CONCLUSION Knowledge about the interaction between the worker and the work environment could reveal useful information about the complex phenomenon of reducing sick leave. The WEIS seems useful in providing information about how alterations and accommodations in the work environment could support individual workers.

Psychometric properties of the Worker Role Self-assessment instrument used to evaluate unemployed people in Sweden

The aim was to determine the psychometric properties of the new Worker Role Self-assessment (WRS) instrument. The content validity, utility, test–retest reliability, sensitivity to change, and predictive validity of the WRS were investigated in two subject samples, which were selected at work and pain rehabilitation clinics, respectively. One of these groups consisted of 23 clients and four occupational therapists, and the other comprised 83 clients. All clients in both samples were unemployed. The results showed that both the clients and the occupational therapists perceived the content validity and the utility of the WRS as good. The test–retest reliability showed mostly good to moderate agreement, and the internal consistency was satisfactory. One of the items showed predictive validity for work capacity, and the same item was sensitive to change. However, a ceiling effect reduced the utility and the sensitivity to change. Our findings indicate that the WRS is promising as a tool that clinicians can use to evaluate the capacity for return to work and for planning interventions, although some revisions are needed to counteract the ceiling effect.

Activity and participation in psychiatric institutional care

National action plans emphasize the importance of strengthening the role of patients in health and medical care. Patients should feel that they can participate and that they are seen as a resource. In occupational therapy, the client-centred approach has developed, whereby it is key to enable patients to participate in their treatment. The International Classification of Functioning Disability and Health (ICF) has inspired this study, in which concepts such as activity and participation are central. The purpose of the study was to describe how patients in psychiatric institutional care conceive their opportunities to be active, and how they participate in their own treatment. Questionnaires were sent to patients who had received care during a six-month period. Ten patients were then selected for interview. The study shows that younger patients and patients who were treated involuntarily were generally more dissatisfied than other patients. The patients’ perceptions of their environment were influenced by the values in the ward. Topics such as atmosphere in the ward, reception, continuity, and support were presented. Important factors related to activity and participation were: agreement concerning the treatment plan, discussions about expectations, creating conditions for engagement in activities, and providing the patients with opportunities to take responsibility for themselves.

Occupational functioning in relation to psychiatric diagnoses: Schizophrenia and mood disorders

The purposeof the study was to investigate whether a patients adaptive occupational functioning is related to diagnoses of schizophrenia or mood disorders. The Occupational Case Analysis Interview and Rating Scale (OCAIRS) was used to examine the patients adaptation in everyday occupation. Three groups of patients were studied: patients with schizophrenia (n=18), major depression (n=20), and bipolar disorders (n=22). The adaptive occupational functioning of patients with schizophrenia and those with bipolar disorders was significantly reduced, to the same levels as that of patients with major depression. Thus, a patients adaptive occupational functioning seems to be related to the studied psychiatric diagnoses. This observation may be used as a first step when screen patients for occupational therapy.

Psychosocial streghts and challenges related to work among persons with intellectual disabilities

This study aims to describe the psychosocial strengths and challenges related to work among persons with intellectual disabilities. The instrument used for this purpose was the Swedish version of the Worker Role Interview. Thirty people with moderate to mild intellectual disability participated in the study. The findings indicate that the participants have many psychosocial strengths that positively affect their worker role. For most of the participants, work is a highly valued life domain and something to which they feel a commitment. It is also shown that the participants have well-developed work habits and a supportive social environment. The main problem area for some participants was in the area of personal causation. Overall, MOHO and the WRI provided useful concepts and a practical method of assessment for understanding strengths and challenges in persons with intellectual disabilities related to work.

Assessment of Occupational Functioning for Screening of Patients to Occupational Therapy in General Psychiatric Care

A Swedish version of the Occupational Case Analysis Interview and Rating Scale (OCAIRS-S) has been tested earlier for interrater reliability. The present study, using the second version of OCAIRS-S and including a sample of 145 patients, showed interrater correlations between .88 and .96 (Intraclass Correlation Coefficient). The results indicate that OCAIRS-S predicts which patients should be included in and excluded from occupational therapy and identifies patients who should be observed more before making such decisions. The study indicates a need for further investigations regarding which components in OCAIRS-S influence the occupational therapist in judging the patients need for occupational therapy.