Engagement In Meaningful Occupations Research Articles

Confused about Rehabilitation? Multi-Faceted Approaches for Brain Injured Patients in a Confusional State

Post-injury confusional state is a common phenomenon following acquired brain injury. A multi-faceted approach for decreasing confusion is recommended, but there is a paucity of research related to non-pharmacological management. The main objective was to present a conceptual model of multi-faceted approaches for confusion, and secondly to investigate the rehabilitation outcome following these approaches. The setting is a specialized ward for rehabilitation of patients with severe cognitive difficulties following acquired brain injury. The conceptual model encompasses neurobehavioral strategies, pharmacological treatment, engagement in meaningful occupations, next of kin involvement, organizational demands, the physical environment, along with differential diagnostics. Patient cases are provided to illustrate the impact of each approach. A total of 141 of 281 patients were in a confusional state at admission. At discharge, 62% had emerged from the confusional state. Patients in a confusional state due to traumatic brain injury and subarachnoid hemorrhage had clinically important differences of >22 points in the functional independence measure from admission to discharge, following rehabilitation efforts based on the conceptual model. No clinically important difference was seen in patients with non-SAH stroke and patients with other types of brain injuries. The proposed conceptual model should be further evaluated in complex intervention studies.

A scoping review into the service needs of people from culturally and linguistically diverse backgrounds living with disability to engage in meaningful occupations.

Although there is a large proportion of people from culturally and linguistically diverse backgrounds within Australia, their rate of access to disability services is disproportionately low. This review aims to understand the service needs of people from culturally and linguistically diverse backgrounds with disability to facilitate engagement in meaningful occupations. Arksey and O'Malley's scoping review framework was employed. Ten databases were searched for Australian studies. A deductive content analysis framework was applied in the synthesis. Fourteen papers were included. Themes that emerged include language and cultural needs and considerations, which highlights the need for information sharing to take account of intergenerational, intercultural and sociolinguistic differences. It also identified the need for improved training and skills of existing interpreters. Culturally competent and responsive services was another theme identified, which emphasised the need to enhance the workforces' understanding of cultural practices. There is also a strong call for a more culturally diverse workforce to reduce the use of some interpreters and to build a more culturally competent workforce. The last theme was responsive service delivery, which requires the governance to support the development of a nurturing trusting therapeutic relationship. Service providers should be trained on the inequities and intersectionality of this population. Further research is required to explore current disability policy in Australia with an intersectionality lens to ensure recommendations can be made to address barriers and ensure this population receives services in a manner that enhances their ability to engage in occupations meaningfully.

Engagement in meaningful occupations for people with dementia: A valuable source for maintaining the quality of life in institutional settings

Engagement in meaningful occupations for people with dementia: A valuable source for maintaining the quality of life in institutional settings

The Meaning of Roles and Routines for Families Experiencing Homelessness in the COVID-19 Pandemic

This study explored the experiences of mothers experiencing homelessness amidst the COVID-19 pandemic. Semi-structured interviews were completed with nine mothers and analyzed using thematic analysis. Themes uncovered during the interviews highlighted sources of motivation and perseverance, additional and ongoing impacts of COVID-19, sources of further mental anguish, and unmet needs challenging roles and routines. Notably, the identity of being a mother and the value placed on that role significantly influenced their daily routines and engagement in meaningful occupations. Occupational therapy practitioners can utilize these findings to deliver contextually sensitive care tailored to the unique circumstances and immediate requirements of this population.

Perspectives on Promotion of Quality of Life for Individuals Recovering from Substance Abuse: Priority for Occupational Therapy Programmes

The prevalence of substance abuse in South Africa is growing fast, impacting negatively on quality of life. Individuals abusing substances present with impaired occupational functioning, which warrants occupational therapy intervention. Meaningful engagement in occupations contribute to well-being and quality of life of an individual. It is important for the occupational therapist to be aware of the enhancers of quality of life for the intervention programme of persons living with substance use issues. The barriers of quality of life need to be addressed in the programme in order to guard against relapse. A holistic approach to the intervention of substance abuse is of paramount importance.

75 The COVID-19 pandemic and social frailty: an evaluation of Occupational Therapy practice in a day hospital

Abstract Background Restrictions imposed to limit transmission of COVID-19 and to protect vulnerable persons led to loss of roles and routines, social isolation, sedentary lifestyles, increased anxiety, depression, and increased frailty among older people. In Occupational Therapy (OT) literature, ‘occupational deprivation’ describes this state of enforced disengagement in meaningful occupations which negatively impacts wellbeing. Clients attending a Day Hospital for Comprehensive Geriatric Assessment (CGA) reported residual elements of occupational deprivation and negative effects of COVID-19 restrictions with associated social frailty. OT practice was evaluated to determine the extent of services offered to remediate or improve social frailty and overall wellbeing. Methods During CGA, OTs assess clients’ occupational performance including cognition, mood, mobility, social environment and engagement in meaningful occupations. Routine (quantitative) data collected to evaluate the service was inputted and analysed using Microsoft Excel. OTs logged numbers of clients referred to services to remediate social frailty including day centres, social prescribing and an OT-led anxiety management group in the Day Hospital. Six months of data in 2023 was analysed. Results 288 clients received CGA by OT. The average age was 83. 33% were referred to Memory Technology Resource Rooms. 6% were referred to Day Centres or Active Retirement. 7% were referred to OT anxiety management group in the Day Hospital. 3% were referred to ALONE befriending. As part of routine OT practice, almost all clients were advised to continue with or to re-engage with previously enjoyed (meaningful) occupations such as attending mass, playing bridge, and visiting friends. Conclusion Occupational deprivation experienced by older adults during the COVID-19 pandemic contributes to increased social frailty. Older adults attending a Day Hospital received routine OT intervention focusing on enhancing their wellbeing and reversing social frailty associated with the COVID-19 restrictions. Assessment and management of social frailty is vital to understand the effects of the pandemic on older people and provide appropriate services.

Activity PRN: Exploring Meaningful Occupation 'As and When Required' on a Psychiatric Intensive Care Unit

Background: Occupational deprivation and barriers to meaningful and purposeful activity are key issues for patients admitted to psychiatric intensive care units (PICUs), resulting in occupational alienation. To increase the frequency of engagement in meaningful occupations, an intervention named 'Activity PRN' was developed. Method: A quasi-experimental study was completed, measuring the number of ad hoc activities and the frequency of activity engagement on a PICU ward over a period of six months. Therapeutic programme sessions were excluded as this study measured 'as and when required' activities. Data were collected from 18 patients admitted to the ward over a period of three months prior to the intervention start, and from 22 patients in the following three months during the intervention. Patients were supported to choose personally meaningful activities, which were then risk-assessed, and resources and activity locations were organised. Activity PRN cards were used to communicate their activity choices to ward staff, and facilitate activity engagement. Results: Data comparison showed greater provision of, and engagement in, meaningful activities as a result of the intervention. It was found that the terms 'Activity PRN' and 'PRN activities' were used commonly within the ward and hospital. Conclusion: Activity PRN was used as a successful intervention to reduce occupational deprivation and promote occupational justice on the ward. Further study is required to measure the clinical validity of Activity PRN within inpatient mental health units.

Aging Muslim immigrants transitioning from Muslim majority countries to Muslim minority countries: A scoping review addressing dynamics of occupation, place, and identity

ABSTRACT Immigration can challenge aging people’s health, social inclusion, and continued engagement in meaningful occupations, causing loss of and/or change in social status, relationships, and roles; all of which can be intimately tied to place and identity. Such losses may lead to depression, isolation, and can negatively affect quality of life. This scoping review aimed to better understand how aging Muslim immigrants re-establish and enact occupations and negotiate their identities across various places in the host country. Findings revealed the diverse ways aging Muslim immigrants made complex negotiations after migrating to an unfamiliar Muslim minority country to fulfill important roles, navigate ways to participate in meaningful occupations, and express their identities safely across places. The reviewed studies showed how this group was frequently confronted by challenges, including cultural and religious rejection, disruption in occupations, and structural barriers. However, many found ways to overcome these challenges through occupational engagement and social connectivity, which supported their integration process. Increased attention to the occupations of aging immigrants will allow researchers, service providers, and policy makers to make meaningful contributions to improve the lives of aging Muslim immigrants.

Assessing the Effectiveness of an Occupation-Based Intervention in Promoting OT Student Well-Being

Abstract Date Presented 04/21/2023 Mixed-methods study demonstrating the effectiveness of an occupation-based intervention in promoting OT student well-being. Significant interaction effects were found for well-being, self-compassion, engagement in meaningful occupations, and occupational balance. Primary Author and Speaker: Elena Wong Espiritu

Narratives on Time Use, Health, & Well-Being: The Life Stories of One Individual Living With Tetraplegia

Abstract Date Presented 04/20/2023 Narrative inquiry was used to understand the time-use choices of one person with tetraplegia. By exploring the link between time use and well-being, OTs can help restore engagement in meaningful occupations and promote health. Primary Author and Speaker: Amanda Balser Additional Authors and Speakers: Dana M. Howell Contributing Authors: Donna Colaianni

Evaluating Occupational Performance Needs Identified by Women Impacted by Cancer

Abstract Date Presented 04/21/2023 Cancer significantly affects function and engagement in meaningful occupations. This exploratory study showed that challenges were identified by women with cancer in diverse occupational areas, and their demographics did not affect these challenges. Primary Author and Speaker: Hannah Goldberg-O'Neil Additional Authors and Speakers: Colleen Maher, Rochelle Mendonca

Occupational Therapists' Beliefs and Experiences Managing Chronic Pain, Wellness, and Occupational Performance.

Chronic disease prevention, health, and wellness have become primary practice areas for occupational therapy. Occupational therapists (OTs) in pain rehabilitation are established as essential members of comprehensive and multidisciplinary pain management teams, focusing on increasing occupational performance through participation. This study's purpose was to investigate OTs' experiences managing chronic pain and to explore OTs' effectiveness in supporting clients' wellness and occupational performance through interventions. Eleven OTs (n = 11) participated with three themes emerging on chronic pain, interventions, and holistic teams. Findings suggest that OTs are successful at treating chronic pain, supporting wellness and occupational performance when their interventions are health-promoting, and clients are enabled to take an active role in their chronic pain management. This study demonstrates the critical impact OTs can have in multidisciplinary teams on clients' outcomes, such as increased occupational performance, wellness, and quality of life (QOL) through engagement in meaningful occupations.

Bridging gaps in the design and implementation of socially assistive technologies for dementia care: the role of occupational therapy

Dementia is a global health challenge, and people living with dementia (PLWD) are especially susceptible to reduced engagement in meaningful occupations, including social participation. In the past few decades, socially assistive technologies continue to be developed amidst a rapidly evolving technological landscape to support the social health of PLWD and their caregivers. Examples include social robots, virtual reality, smart home technology, and various digital technologies, such as mobile applications for tablets and smartphones. Despite an increasing body of research and interest in this field, several gaps relating to the design and implementation process of socially assistive technologies continue to undermine their relevance for PLWD in daily life. In this paper, some of these gaps are highlighted and the role of occupational therapy in the design and implementation of socially assistive technology is presented. In the design process, occupational therapists are uniquely skilled to advise and advocate for the tailoring and personalisation of technology to address the occupational needs of PLWD. In the implementation of socially assistive technologies, occupational therapists are skilled to educate, train, and conduct ongoing evaluations with PLWD and their caregivers, to incorporate socially assistive technologies into their routine and daily lives. We recommend that occupational therapists should continue to be acquainted with such technologies through continuous professional development and educational curricula. Moreover, we highlight the necessary collaboration between occupational therapists, technology developers, and researchers to enhance the process of designing and implementing socially assistive technology, so that their relevance for PLWD and their caregivers can be maximised. Implications for rehabilitation Developers and designers of socially assistive technology should consider the disease trajectory of different types of dementia, as well as the different needs, abilities, preferences, occupations and routines of people living with dementia (PLWD) and/or their caregivers. Collaborations between technology developers, researchers, and occupational therapists should take place iteratively throughout the process of designing and implementing socially assistive technology to maximise their relevance and applicability for people living with dementia and their caregivers. To continue enhancing the current role of occupational therapy in socially assistive technology provision, occupational therapists should keep up to date with socially assistive technology that are being developed to support the social health of PLWD.

Factors Shaping Occupational Injustice among Resettled Syrian Refugees in the United States.

Background There have been a limited number of studies that have focused on factors which shape the experiences of resettlement and occupational injustice among refugee populations. Purpose To explore the factors that shape the living difficulties of Syrian refugees who were lawfully admitted into the United States and ways whereby they might interfere with shaping occupational injustice. Method Mixed methodologies were incorporated. The living difficulty scale for refugees (LDSR) was disseminated. Semistructured interviews were conducted, and fieldnotes were collected as sources of qualitative data. Results 254 participants (mean age 36.2 ± 9.6 yrs; 159 females and 95 males) completed the survey, and nine of them participated in the semistructured interviews. Age (p < 0.01), region (p < 0.001), and time in the United States (p < 0.05) had significant effects on the experiences of the participants, but not gender (p = 0.308). Occupational injustice is an outcome of an interaction between interpersonal and contextual factors. Practice Implications. Occupational therapists need to assume a vital role in maximizing opportunities of engagement in meaningful occupations for Syrian refugees to counteract occupational injustice and difficulties associated with resettlement.

The experience of meaning and value in occupations for forced migrants seeking asylum, and factors that facilitate occupational engagement: A meta-ethnography using a strength-based approach

Introduction Asylum-seekers face significant barriers to meaningful occupation, leading to negative health and wellbeing outcomes. This study provides a strength-based approach to enhance understandings about the meaning of occupation for those seeking asylum. Method A systematic search of the literature identified seven qualitative research studies. A meta-ethnographic approach was used to synthesise the findings. Results Examination of the selected studies generated three third-order interpretations as follows: keeping busy as a coping mechanism; maintaining continuity with past life by preserving identity, roles, values and culture; and building a new future with a drive to be a productive member of society. The study also identified factors that support meaningful occupational engagement during asylum. Conclusion This study shows that occupations are essential to existence for asylum-seekers. They help preserve identity and life-continuity; help people make sense of disorder in their life; and provide opportunity for reflection, leading to motivation toward goal-directed occupation. Finally, engaging in occupation helps people adjust and cope with trauma. The study highlights that a lack of meaningful occupations may limit the long-term benefits of occupational engagement while seeking asylum. Recommendations are made for further research to challenge restrictive policies and promote the rights and wellbeing of this population.

Occupational therapists’ experiences of implementing occupation-based practice in neurology, and its impact on professional identity

Introduction Facilitating engagement in meaningful occupations underpins occupational therapy intervention. Occupation-based practice, while linked to improved professional identity and job satisfaction for occupational therapists, is challenging to implement, particularly in hospital settings. This study aimed to explore occupational therapists’ perceptions of their role, and facilitators and challenges to implementing occupation-based practice in neurology. Method This qualitative descriptive study included semi-structured interviews with seven occupational therapists working in Australian acute/sub-acute neurology settings. Findings Three themes identified: Conceptualisation versus implementation of occupation-based practice; Use of occupation-based practice impacts role satisfaction; Promoting the profession. Participants described using occupations in their practice as important, however, reported that the challenges of the neurology environment hindered their ability to carry out occupation-based practice. Conclusion This study provides insights into occupational therapist’s perceptions regarding occupation-based practice in neurology settings, finding there is a need for occupational therapists to promote their role and use of occupations in neurology settings, and that occupation-based practice impacts job satisfaction. The study highlights occupational therapists working in neurology settings would benefit from a number of approaches including student interprofessional activities, potential buddy system for new graduates and experienced clinicians, and increased support by the profession to maintain their identity as occupation-based specialists.

Racially Informed Care: A Treatment Approach and Exploration of the Implications of Race Related Barriers in the United States

Social factors surrounding race and ethnicity often create barriers to meaningful occupation and keep people of color from achieving a greater quality of life (Pooremamali et al., 2016). These barriers often result in occupational deprivation and feelings of alienation in society. Research has shown that these barriers created by systematic racism exist for individuals across different environments and persist over their lifetime (Pooremamali et al., 2016). Because of these barriers and the prolonged stress responses caused by racism, people of color, especially black and brown, have significantly higher rates of chronic illness than White Americans. People of color, specifically African Americans, experience increased levels of stress from discrimination, criminal victimization, and financial stress, compared to others, while also being disproportionately burdened by chronic disease (Geronimus et al., 2006). These facts make it clear that people of color face difficulties that significantly decrease quality of life. This article aims to describe the unique barriers facing people of color and investigate the many areas of a person’s life affected by racism, which directly or indirectly influence occupational performance. In addition, it will explore occupational therapy interventions that use Racially Informed Care (RIC), a practice model that supports people of color in coping with racism to promote the fullness of life through successful engagement in meaningful occupations to which all human beings are entitled.

Enhancing engagement in meaningful occupation in a dementia town: A qualitative evaluation of MOED - The meaningful occupational engagement intervention for people with dementia.

Engagement in meaningful everyday life occupations is linked to well-being. However, people with dementia are often deprived of engagement. As a response, a Danish Dementia Town was established with the intention of transforming care services to improve opportunities for meaningful engagement. The evidence-based The meaningful occupational engagement intervention for people with dementia (MOED) intervention was developed and implemented in dementia town to enhance meaningful occupational engagement. The purpose of this paper is to evaluate the content, impact and implementation process of MOED. To evaluate MOED, we applied a program theory-based qualitative approach, building on participant observations and informal conversations with people with dementia (n = 7) and staff (n = 9). Data were analysed from a hermeneutic approach to gain an in-depth understanding of how MOED influenced meaningful occupational engagement and to evaluate the implementation process. The main theme 'Engagement in meaningful occupations - a conditional and fragile process' emerged along with three subthemes: 'Creating an everyday space of meaning: Conditions of the intervention', 'Occupational engagement as an opportunity to blossom: Impact of the intervention' and 'Professional identity, culture and reflections: Contextual barriers to changes to working practice'. Together, the subthemes illustrate how engagement in meaningful occupations arose. However, opportunities to engage in meaningful occupations were fragile, as they depended on various factors within the context. Engagement in meaningful occupations emerged when MOED was applied in accordance with the program theory, as it seemed to create spaces where people with dementia could engage in meaningful occupations and they could blossom over time. However, MOED was only partially implemented in accordance with the developed program theory, as several contextual barriers influenced the sustainability of the intervention. MOED showed potential to support improvement in dementia care activity programmes to enhance opportunities to engage in meaningful occupations in everyday life for people living with dementia.

Intervenções da terapia ocupacional para adultos com dificuldades de aprendizagem: avaliando os encaminhamentos recebidos antes e durante o pico da pandemia pelo COVID-19

Abstract Introduction The COVID-19 pandemic has significantly impacted on service provision for adults who have a learning disability, resulting in reduced occupational activities, routine, and social contact. Objective To analyse referrals received for Occupational Therapy intervention for adults who have a learning disability pre-COVID-19 (2019) and during COVID-19 (2020). Method This is a descriptive study conducted as a service evaluation with an NHS Trust Clinical Effectiveness Team in a city in the North of England. The data source was obtained from referral documentation. Quantitative and qualitative data were extracted from a data Performa and analysed using descriptive statistics (mean, median, mode, and standard deviation) performed by the Software Microsoft Excel. Results The total number of cases used in this evaluation was 274. There was an increase in referrals during the COVID-19 pandemic, the greatest increase was for Occupational Therapy intervention focusing on engagement in meaningful occupation. Over both years the predominant referrals were for equipment reviews. Conclusion Data collected captures a broad range of information regarding Occupational Therapy service provision pre and during the COVID-19 pandemic and puts this in the context of future considerations regarding the Occupational Therapy services for adults who have a learning disability.

Role of Occupational Therapy in Pain Management

The American Occupational Therapy Association (AOTA) asserts that occupational therapists and occupational therapy assistants, collectively referred to as occupational therapy practitioners (AOTA, 2020b), are distinctly prepared to work independently and to contribute to interprofessional teams in the treatment of pain. Occupational therapy practitioners work to ensure active engagement in meaningful occupations for "persons, groups, or populations (i.e., the client)" (AOTA, 2020b, p. 1) at risk for and affected by pain.