Mandy Stanley

Older men’s participation in community‐based men’s sheds programmes

The purpose of this qualitative study was to investigate the lived experience of older men taking part in community-based shed programmes. Five men, aged 65 and over, who attended two different community sheds participated in semi-structured in-depth interviews in 2007. Data were analysed thematically with six main themes emerging as follows: ‘company of fellas’; ‘everybody’s got a story to tell’; ‘still got some kick’; ‘passing on your experiences’; ‘get on your goat’ and; ‘nobody’s boss’. Participation in community-based men’s sheds positively influences the health and well-being of older Australian men through provision of a ‘men’s space’ in which meaningful activities occur. Provision of community-based men’s shed programmes as among a range of activity options in the community may contribute positively to the physical, mental, social and occupational health of older men.

‘Nowadays you don’t even see your neighbours’: loneliness in the everyday lives of older Australians

Loneliness is a pressing social issue for older people globally. Despite this, there is a paucity of studies on how older people themselves perceive loneliness and how service providers can support them. This study sought to address the gap using in-depth and semi-structured interviews with 60 older people and eight focus groups with aged care service providers in Australia in 2007. A purposive sampling strategy was employed to incorporate maximum participant variation. People 65 years and over were recruited from four large service providers in two Australian states. Our findings show that loneliness is influenced by private, relational and temporal dimensions and whether older people feel that they have, or are seen by others as having, a sense of connectedness with the wider community. Participants expressed the importance of maintaining social contact and having a sense of connection and belonging to the community. Our study highlights both the significance of gathering the views of older people to generate an understanding about loneliness and the need to recognise loneliness as a diverse and complex experience, bound to the context in which it is understood and perceived and not synonymous with social isolation. Such an understanding can be used to both evaluate and improve upon programmes that address loneliness and to help maintain an integration of older people in the community.

Grounded Theory: Exploiting the Potential for Occupational Therapy

Occupational therapy possesses few mid-range substantive theories, particularly those that have been derived empirically or generated within the profession. Grounded theory offers a systematic and well recognised approach to study the richness and diversity of human experience, in order to generate relevant theory. This paper describes grounded theory, its theoretical orientation and its elements, and offers a critique of the approach. A selection of grounded theory studies related to occupational therapy and occupational science are reviewed to demonstrate the contribution that the approach has begun to make to, and the potential that the approach offers for, developing empirically derived occupational therapy theories.

An investigation into the relationship between engagement in valued occupations and life satisfaction for elderly South Australians

Abstract As the proportion of elderly people in the Australian population is rapidly increasing, especially the relative proportions of people over the age of 85, our society is faced with the challenge of planning and providing health and welfare services that meet the needs of the elderly. This exploratory study aimed to examine how a sample of elderly people spent their time, and the portion of that time that was spent in valued occupations. Relationships between engagement in valued occupations and life satisfaction were explored. Data were collected by subjects recording every occupation they engaged in over two days, recording the percentage of time spent in valued occupations and completing a life satisfaction scale. Fifty‐eight subjects living independently in the community were enrolled in the study by a random doorknocking procedure. All subjects spent some time in sleep, personal care and passive leisure. The hypothesis that as time spent in valued occupations increased, life satisfaction score...

Educators’ perspective of online course design and delivery

Background: With advances in technology, educators are increasingly involved in the delivery of online courses. This paper reports a qualitative descriptive study from the educators’ perspective of developing and delivering a fully online course to undergraduate health science students. Method: The authors engaged in reflective conversations about the course which were audio-taped, and the resultant transcripts analysed thematically. Results: Two main themes emerged: (1) Arousing students’ interest, which represented the central motivator in the formulation and implementation of the course, and (2) Working with larger numbers of students, which highlighted the most significant challenge encountered during course delivery. There are considerable workload issues for courses which attempt to use material that is relevant, applied to students’ interests, requires collaboration, and includes learning activities linked to sequential assessment. Time must be allowed for consistent, frequent and focused engagement with the students online in order to achieve a quality teaching and learning environment. Conclusions: The findings revealed that ongoing tension exists between aspiring to provide high quality, pedagogically sound, interesting and collaborative online learning opportunities and the workload and time demand realities of enacting these intentions.

'I understand all the major things': how older people with limited English proficiency decide their need for a professional interpreter during health care after stroke.

Objective To explore the process of decision-making of older people with limited English proficiency (LEP) about using a professional interpreter during their health care after stroke. Design A constructivist grounded theory approach was used. Up to two in-depth interviews were conducted with 13 older people with LEP from seven different language groups, and one older person who preferred to speak English, who had recently received health care after an acute stroke. Professional interpreters assisted with 19 of the 24 study interviews. Data were analysed and theoretical processes developed using a constant comparative method. Results Professional interpreters were not a strong presence in the health care experience after stroke for participants. The use of professional interpreters was a complex decision for participants, influenced by their perception of the language and health care expertise of themselves and others, their perceived position to make the decision and whom they trusted. Getting by in English allowed participants to follow rules-based talk of health professionals, but did not enable them to understand detailed information or explanation, or to engage in the management of their condition in a meaningful way. Conclusion Health professionals have an opportunity and a mandate to demonstrate leadership in the interpreter decision by providing knowledge, opportunity and encouragement for people with LEP, to use an interpreter to engage in, and understand, their health care after stroke. Health professionals may need to advise when interpretation is needed for health care situations, when communication difficulties may not be anticipated by the person with LEP.

Occupational Adaptation as a Social Process in Everyday Life

Whilst the term occupational adaptation is understood conceptually as both a state and a process closely linked to ones identity, few studies have considered how this concept reveals itself in everyday settings. Thus, there is merit in employing grounded theory methodology – with a focus on uncovering social process – to further understand the concept of occupational adaptation. This paper draws on findings from two grounded theory studies. Study one explored the settlement processes of 25 women who had emigrated from India to New Zealand between the years 1987–2005. In study two, 15 participants over the age of 75 and living in an Australian city were interviewed regarding their understanding of well-being. Shaping Self (study 1) and Trading Off (study 2) were revealed as forms of occupational adaptation through which participants increased their occupational choices. The findings further reinforce current understandings of occupational adaptation as tied to identity and well-being, and advance the notion that occupational adaptation can be used as a strategy to proactively respond to altered situations and broaden ones occupational choices. Occupational scientists interested in extending understandings of occupational adaptation are encouraged to consider choosing a grounded theory methodology to frame their study.

Becoming the parent of a preterm infant: A meta-ethnographic synthesis

Introduction The adoption of family-centred care within neonatal intensive care has been increasing in profile. However, there has been limited exploration of the concept of parenting as an occupation as a means of supporting parent engagement. Method A meta-ethnographic synthesis was conducted to explore the body of literature regarding experiences in the neonatal intensive care unit that enable parents to participate in parenting occupations. Five databases were systematically searched with 35 identified studies appraised using the Critical Appraisal Skills Programme tool and included in the synthesis. Findings Eight themes emerged from the synthesis: relinquishing the anticipated role of parent; feeling vulnerable and powerless; juggling roles and responsibilities; (re)claiming an alternative parental role; navigating environmental boundaries; developing partnerships with staff; coming to know the baby; and adapting to parenting. Conclusion The experiences that enable parents to participate in parenting occupations are multi-faceted, and explicate the process of occupational adaptation that occurs in relation to parenting a preterm infant. These findings provide occupational therapists with greater insight into the experiences of parents of preterm infants in the neonatal setting.

The acquisition of parenting occupations in neonatal intensive care: A preliminary perspective.

Background. The birth of a preterm infant represents a major crisis for parents that may impact their performance of parenting occupations. Purpose. The purpose of the study was to explore the experiences that enable parents to participate in occupations associated with the role of parenting in a neonatal intensive care unit (NICU). Method. A paradigmatic analysis of narratives was completed based on interviews conducted with six parents of preterm infants. Findings. Six themes were identified: anticipating occupations versus reality, needing emotional resilience, working to reclaim the parental role, navigating the NICU occupation–environment transactions, building and maintaining relationships with staff, and revisioning the future. Implications. The use of an occupation-based approach moves parents’ involvement in the NICU beyond basic caregiving occupations. It highlights the importance of providing opportunities for nurturing and caring for their infants in ways that are meaningful to their identity as a parent.

The experience of acupuncture care from the perspective of people with chronic low back pain: a grounded theory study

Objectives To explore the experience of acupuncture care from the perspective of people with chronic low back pain. Methods A grounded theory, qualitative study using indepth interviews was undertaken with 11 people who had received acupuncture care for chronic low back pain. Interviews were audio-recorded and transcribed verbatim. Initial, focused and theoretical coding were used to identify a core category and several other categories. Results The core category, Reclaiming Control, was related to the sense of well-being experienced by most of the participants as a result of undergoing acupuncture care. The other categories were Gaining Sanctuary, Gaining Trust and Working Together. These categories reflected the processes of participants entering an aesthetically appealing, calm and relaxing space; developing confidence in the acupuncturists’ ability to care for them; and negotiating strategies and sharing decision-making with acupuncturists about their care. Conclusions Clinicians using acupuncture as a management strategy for low back pain may elicit an immediate sense of calmness in patients with subsequent well-being benefits. A sense of calmness may also be enhanced through providing a relaxing physical environment. The transactional and interpersonal processes of establishing trust and rapport, and shared decision-making are important for clients. Shared decision-making can be improved by clinicians carefully considering the explanation of issues and plans to a particular patient, especially by developing an understanding of each patients worldview and using language that the suits each individuals healthcare orientation. Our findings should be interpreted cautiously as the results may be generalisable only to private practice in affluent countries, and whether the findings are representative beyond this setting remains unclear.