Marion Martin

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.

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.

Evaluation of Physiotherapy Clinical Educational Models: Comparing 1:1, 2:1 and 3:1 placements

Summary Nationally there is an increasing problem of clinical placement shortages for physiotherapy which is likely to become worse with the implementation of Government National Health Service plans. The purpose of this study was to compare experiences of clinical educators and students using three different clinical placement models. Method Eight clinical educators volunteered to experience 1:1, 2:1 and 3:1 placement models; 48 third-year physiotherapy students volunteered to attend these placements. Data were collected by face-to-face interviews with educators and students at the end of each placement. Department managers and visiting tutors were also interviewed when all the placements were completed. All interviews were recorded on audiotape, transcribed verbatim and assessed for accuracy. The data were analysed thematically using NVIVO software and assessed for reliability and validity. Results Themes emerged that had an effect on the success of a placement. These included the time the educator spent with individual students, size of department, number of patients and availability of accommodation. The experiences of the interviewees suggest that each of the models has advantages and disadvantages, but they all provide valuable learning opportunities. The results indicate that the success of any placement model depends heavily on how the placement is planned. Conclusion It is evident from the findings that all three models investigated have a place in physiotherapy clinical education. The 2:1 and 3:1 models provide different learning opportunities from the 1:1, but are no less important; they can now be promoted in the clinical setting with more evidence to support their use. If implemented these models will contribute to increasing placement numbers while still maintaining high quality learning environments for the students and rewarding experiences for the educators.

Peer Learning on Fieldwork Placements

Placements with a ratio of one fieldwork educator to two or more students have potential benefits for students and educators as well as for placement organisers, who have difficulty finding enough fieldwork experiences for students. A questionnaire was distributed to 14 students who had been on a 1:2 placement together, in order to find out what they perceived had been the advantages and disadvantages of this experience. Their responses were largely positive, giving enhanced learning and peer support as the main advantages. The most commonly cited disadvantage was added stress, which could occur if the two students were not compatible. It is recommended that this type of placement should be used more frequently, although it is Important that strategies should be employed by fieldwork educators to exploit the full potential of the learning experience.

Rethinking Occupational Deprivation and Boredom

Boredom is associated with a range of problematic feelings and behaviour, and may be on the increase. There is a popular assumption supported by occupational science which suggests that the experience arises from a lack of occupation, however, it is not clear why boredom should still exist when most people in affluent societies have more opportunity for engagement than ever before. This paper explores boredom in literature from the arts as well as from research which indicates that boredom may be a malady of those who have plenty as well as individuals who are deprived of resources. Boredom seems to be associated with poor attentional capacity combined with negative attitudes, resulting in an inability to become involved with any occupation. The usual way of dealing with boredom is to provide more stimulating activities. The author suggests that a more effective way would be to encourage the development of mindful activity. Mindfulness is a particular way of focusing attention, with openness and acceptance. It is recommended that boredom and its relationship to mindfulness may be an important area of research for occupational scientists, as a decrease in boredom could have wider benefits for society and the environment. Unanswered questions relating to boredom concern how it arises, and what can be done to overcome this problematic state of mind.

Sustaining professional identity in practice following role-emerging placements: opportunities and challenges for occupational therapists

Introduction Role-emerging placements are increasingly being used to help prepare occupational therapy graduates for practice in a changing health and social care climate. However, while the literature on such placements is increasing, few longitudinal studies have explored their impact on graduates’ professional practice and identity. Method Interpretative phenomenological analysis was used to gain an understanding of the ways in which five occupational therapy graduates felt their role-emerging placement influenced their professional identity and practice once qualified. In-depth interviews were carried out with the graduates once they had been working as occupational therapists for a minimum of 6 months. Results In the absence of other occupational therapists, students on placements created professional identities of their own making and generated visions of the type of therapist they wanted to become. Once qualified, however, there were mixed experiences concerning the extent to which this identity could be sustained in practice. Particular difficulty was encountered by those working in National Health Service settings, where graduates questioned whether their practice was congruent with the professional understandings and ways of being they had developed on placement. Conclusion Role-emerging placements acted as a catalyst for participants’ personal and professional development. Further research on the long-term influence of role-emerging placements is required.

Mindfulness and Older People: A Small Study

Introduction: Very little research examines how older people respond to mindfulness-based therapy, nor has there been much literature on the subject published by occupational therapists. Method: This small research study was carried out with four older people who attended mindfulness classes run by an occupational therapist. Focus groups took place during the classes, and follow-up interviews were carried out a year later. Interpretative qualitative analysis was used to analyse data. Findings: The findings indicated that all four participants readily accepted this approach, believing it was especially suited to their age group. Although they all reported positive experiences during the classes, one year on they were either too ill to be interviewed or found that life events had prevented them from continuing to be mindful. Conclusion: The use of mindfulness-based therapy with older people is recommended, but more research is needed in this area.

Boredom as an Important Area of Inquiry for Occupational Therapists

This opinion piece argues that boredom should be considered as an important area of research by occupational therapists, although it has been somewhat neglected in the past. Literature on the subject identifies diverse causes of boredom, including occupational deprivation; however, it is not clear why the experience should be so prevalent in a culture where opportunities for engagement in activity are unprecedented. Boredom appears to be a subject of concern for people using mental health services as well as for the general population, but there is virtually no evidence of an effective way of overcoming the experience. Some areas for investigation are suggested.

Lack of meaningful activity on acute physical hospital wards: older peoples' experiences

Introduction Research suggests that older people on acute physical hospital wards are at increased risk of physical and mental health decline due to inactivity during their stay. Whilst studies have highlighted potential causes of such inactivity, there exists a paucity of occupational therapy research that explores engagement in meaningful occupation from patients’ perspectives in hospital settings. Method Interpretative phenomenological analysis was used to gain a deeper understanding of how 18 older people spent their time on hospital wards and the impact this had on their feelings of wellbeing. Interviews were carried out and analysed using interpretive phenomenological analysis guidelines. Findings Patients experienced a lack of meaningful activity on the wards which resulted in feelings of passivity, boredom and a sense of alienation from their normal roles, routines and sense of self. Despite a willingness to engage in activity, barriers were suggested as limited resources, hospital routines and personal limitations. Suggestions of potential meaningful activities were made. Conclusion Occupational therapy services need to review service provision and provide an occupation-focused service, ensuring that patients’ engagement in meaningful activities is seen as an integral part of their role in order to maintain patients’ mental and physical wellbeing. Recommendations for further research are highlighted.

Therapeutic presence: a mindful approach to effective therapy

Mindfulness is a profound way of cultivating present-moment attention and hence can be a way of facilitating therapeutic presence. The Buddhist and mindfulness perspectives recognize that at the core of who we are is deep potential for wisdom and wholeness. Unlike humanistic approaches that see the self as a process that is evolving or actualizing through life experiences, the Buddhist approach sees our core as already actualized. Through the dropping away of identity, needs, hunger for attention, longing, greed, and desire, our innate wisdom is illuminated. Mindfulness practices focus on quieting the mind and facing and resolving our core grasping to our needs and hungers. Like the ocean of mind, when the waves of hunger, grasping, and aversion settle, the presence and innate wisdom at the depth of being can emerge. In this chapter, we explicate mindfulness as one way that therapeutic presence can be facilitated. We look at the cultivation of presence with mindfulness through the four noble truths in Buddhism: Life is suffering; causes of suffering; cessation of suffering; and the path to the cessation of suffering. We explore the benefits of mindfulness in the cultivation of presence as well as present a clinical vignette as to how mindful awareness can help in session. We also look at some of the research, including the neurobiological studies of mindfulness, that indicates an enhancement of qualities of presence through The most precious gift we can offer others is our presence. When our mindfulness embraces those we love, they will bloom like flowers. —Thich Nhat Hanh (2007, p. 20) 12628-11_PT4-CH10-rev2.qxd 9/1/11 5:39 PM Page 179