Staffan Josephsson

Creativity and order in communication: Implications from philosophy to narrative research concerning human occupation

Narrative theory and methods are increasingly featured in qualitative research relating to human occupation. The present article addresses the concept of narrative in relation to some relevant foundational philosophical and theoretical roots. Specifically a twofold function of narrative as a mechanism for producing order versus creativity is highlighted. It is argued that these functions might serve as resources in research relating to human occupation, specifically regarding issues pertaining to change and agency. Examples from qualitative empirical research relating to human occupation are used to demonstrate points under discussion.

The generalizability of training gains in dementia : effects of an imagery-based mnemonic on face−name retention duration

The generalizability of the results from a case study on the effects of an imagery mnemonic on face-name recall in dementia was examined (Hill, Evankovich, Sheikh, & Yesavage, 1987). Seven patients with Alzheimers disease (AD) and 1 patient with multi-infarct dementia (MID) were trained by using the method devised by Hill et al. Application of the mnemonic increased the time during which face-name associations could be held in memory for 1 AD patient, and this improvement was maintained in a 1-month follow-up assessment. However, no training gains were observed for the remaining 7 patients, thus questioning the generalizability of this method in enhancing memory in dementia.

Negotiating Occupational Identities while Living with Chronic Rheumatic Disease

The purpose of this study was to explore everyday occupation for five persons living with chronic rheumatic disease. Data were collected through qualitative interviews, followed by participant observations in the subjects’ homes. The data were analysed using a qualitative comparative approach, followed by an interpretation of the results based on narrative theory. Four themes were identified from the analyses: (a) the continuing challenges of everyday occupational life, (b) activities anchored to personal occupational history, (c) everyday occupations mediating personal meaning, and (d) activities involving suspense or unpredictability. The results showed that everyday occupation was a challenge for the participants, as their illness caused considerable variation in pain and functional abilities. This influenced the subjects’ ability to perform occupations of everyday life. Their individual occupational history was closely interwoven with their everyday life and served as the foundation for their way of managing the situation. The everyday occupations of the subjects also served as mediators of their personal values and interests, and they made changes following these issues, not as anticipated due to their changing functional condition. The narrative structure of occupation was found to provide the subjects with opportunities to manage issues concerning their identity and created high-level negotiating skills. Processes of negotiating occupational identities in the subjects’ everyday life are presented and discussed, and may add new knowledge to occupational therapy and occupational science, as well as generating further research questions.

Experiences of engagement in creative activity at a palliative care facility

OBJECTIVE To investigate the meanings that people with advanced cancer ascribe to engaging in creative activity in palliative occupational therapy. METHODS Sixteen interviews were conducted with eight participants over a period of 8-12 months. Participants were asked to narrate about their engagement in creative activities at a palliative intervention program. Transcribed interviews were analyzed with a phenomenological method. RESULTS Engagement in creative activities was found to ease life in proximity to death for persons with advanced cancer and limited survival time. For the participants, creativity meant that some of the consequences of incurable cancer could be confronted and alternative potentials could be explored and acknowledged. This occurred in an ongoing process of creating alternative ways to deal with life. SIGNIFICANCE OF RESULTS Creative activity is a means for participants to develop ways to adapt and cope with declining physical abilities and existential concerns through working with their hands and bodies. This complements the often negative focus in palliative phases of cancer with an understanding of how enriching aspects of life can be maintained. The results highlight how people in palliative care experience their engagement in creative activity in the form of crafts, and how such engagements may be a significant tool for finding alternative ways to handle challenges in ongoing life.

Occupational patterns of people with dementia in residential care: An ethnographic study

This paper describes an ethnographic study that sought to gain knowledge of the occupational patterns of persons with dementia in a care home and how the residents perceived the group activities in which they participated. The residents’ ages ranged from 82 to 92 years. They were seven women and one man. Both participant observation and interviews were used to collect data. Data analysis resulted in an ethnographic story organised around two key themes: (1) the occupational patterns of the residents, and (2) the residents’ perceptions of the activities offered. In this story residents appeared passive, playing the role of guests in the care home. Residents were dependent on staff to engage in daily occupations. Interviews revealed that residents perceived participation in activities as important to their mental and physical health and an advantage of living in the care home.

Studying Narrative-in-Action in Women With Chronic Rheumatic Conditions:

In this article we aim to sculpt a possible methodology for studying how a good everyday life comes about when living with chronic rheumatic conditions (CRC). Our “how” focus acknowledges a woman with CRC as one member of a diverse population, whereby we question the biomedically based view that she differs from the population. The more frequently asked “what” question colors study designs and results in categories and characteristics regarding what she is able to do and what adaptations she has made in everyday life as a consequence of her disease. Adopting a narrative approach, we ask how a good everyday life comes about, and illustrate this with ethnographic material of the everyday activities of women living with CRC. We conceptualize narrative as embedded in the process of enacting activities. Furthermore, we highlight hermeneutical interpretative processes of how meaning works in the stream of everyday action.

Leaving homelessness and addiction: Narratives of an occupational transition

The aim of this exploratory study was to gain an understanding of occupational aspects of homelessness and of the transition from homelessness. Data were collected through narrative interviews of two formerly homeless women recovering from drug addiction. Data were analyzed using a constant comparative method followed by a narrative analysis. The findings first identified homelessness as a life of high intensity lived within a limited time perspective. Further, for these women homelessness was related to drug addiction, which was experienced at first as a solution to life situations that seemed impossible to handle. Second, the analysis showed how social relationships can strengthen or change the lived plots of the participants. Third, the transition out of homelessness was accomplished through the development and enactment of new lived plots. Finally the analysis showed that life as formerly homeless women was experienced as less intense and as a life that can only partly be controlled. This new life includes a broader time perspective. In the discussion, the relationship between time use and the meaning-making process and possible practical implications of this study are presented.

Occupation and Well-being: A Study of Some Slovenian People's Experiences of Engagement in Occupation in Relation to Well-being

This study investigated some Slovenian peoples experiences of well-being whilst engaged in daily occupations. No research has previously been carried out in this area in Slovenia. Research is needed to improve our knowledge about peoples experiences while carrying out occupations to be able to better understand the needs of potential clients. In this qualitative study, focus groups involving 24 Slovenians from different parts of the country participated in the data collection. Four central themes were identified in the analysis: (1) occupation as the organizer of a preferred rhythm that creates a feeling of balance in life, (2) occupation as the creator of an experience of mastery and control, (3) occupation as a facilitator of social relationships, and (4) occupation as a way to connect and contribute to family and society.

To regain participation in occupations through human encounters - narratives from women with spinal cord injury

Purpose. To gain an understanding of how women with spinal cord injury (SCI) experienced human encounters in occupations and how these influenced their participation. Method. The data were collected through two or three in-depth interviews with 13 women (age 25 – 61 years) with SCI. Data analysis was carried out by using a paradigmatic analysis of narrative data, followed by an interpretation based on a narrative theory. Results. The results showed a complexity where the womens experiences and acting in human encounters changed over time. In these human encounters the women struggled with conflicts, supported other persons that were insecure and revaluated their apprehension about persons in their social network. These multidimensional human encounters thereby enabled them to regain participation in occupations. Conclusions. This shows that human encounters are important for persons with disabilities so they can restructure their occupational identity and their needs for participation in occupations. The study also showed that the use of narratives as a tool within rehabilitation could lead to an increased understanding of the subjective changes that occur over time for a person with a disability.

Collaborative memory intervention in dementia: Caregiver participation matters

The aim of the study was to examine the effectiveness of a collaborative memory intervention for persons with dementia and their spousal caregivers, where the couple acquired and practised memory supportive strategies (spaced-retrieval and hierarchical cuing) to learn a face–name association and to set a table for coffee/tea. The collaborative intervention was compared to an individual intervention where the person with dementia received the same training but without the participating caregiver and to a control group of couples receiving no training. The results showed that following collaborative intervention recall performance in two collaborative tasks became more equally shared between the spouses, reflected in a decrease in recall for the caregiver and in an increase in recall for the spouse with dementia between pre- and post-test; whereas for the other two groups the caregivers dominated collaborative recall both at pre- and post-test. The results also showed that the persons with dementia in the collaborative group improved their individually assessed episodic memory performance as compared to the persons with dementia in the other two groups. Finally, training had no effects on episodic memory, perceived burden or depressive symptoms for the caregivers. These results suggest that the active participation of the caregiver matters in cognitive dementia rehabilitation.