Occupational Engagement Research Articles

What makes older adults feel good?

Background and aimTo inform health promotion interventions, there is a need for large studies focusing specifically on what makes older adults feel good, from their own perspective. The aim was to explore older adults’ views of what makes them feel good in relation to their different characteristics.MethodsA qualitative and quantitative study design was used. Independently living people (n = 1212, mean age 78.85) answered the open-ended question, ‘What makes you feel good?’ during preventive home visits. Following inductive and summative content analysis, data was deductively sorted, based on The Canadian model of occupational performance and engagement, into the categories leisure, productivity, and self-care. Group comparisons were made between: men/women; having a partner/being single; and those with bad/good subjective health.ResultsIn total, 3117 notes were reported about what makes older adults feel good. Leisure activities were the most frequently reported (2501 times), for example social participation, physical activities, and cultural activities. Thereafter, productivity activities (565 times) such as gardening activities and activities in relation to one’s home were most frequently reported. Activities relating to self-care (51 times) were seldom reported. There were significant differences between men and women, having a partner and being single, and those in bad and good health, as regards the activities they reported as making them feel good.Discussion and conclusionsTo enable older adults to feel good, health promotion interventions can create opportunities for social participation and physical activities which suit older adults’ needs. Such interventions should be adapted to different groups.

The impact of the BEL intervention on levels of motivation, engagement and recovery in people who attend community mental health services

Background Community-based day centres (DC) in Sweden provide support to people with severe mental health problems. The role of DC motivation for outcomes in terms of occupational engagement and personal recovery is yet unknown. Aims To compare two groups who received DC services, one of which also received the 16-week Balancing Everyday Life (BEL) intervention. The focus was motivation for DC services at baseline and after 16 weeks of services, while also investigating the importance of DC motivation for the selected outcomes and service satisfaction. Material and Methods Sixty-five DC attendees were randomised to BEL (n = 27) or standard support (n = 38) and responded to questionnaires about motivation, the selected outcomes and satisfaction with DC services. Results The groups did not differ on any measured aspects of motivation; nor were changes seen over time. The BEL group, but not those receiving standard support, improved from baseline to 16 weeks on occupational engagement and recovery. Motivation for attending the DC was related to service satisfaction. Conclusion The BEL program could be a viable enrichment tool in the DC context and boost occupational engagement and personal recovery among the attendees. Significance The study provided knowledge of importance when developing community-based services while enhancing motivation.

Autism and Mental Health: The Role of Occupational Therapy

Research has indicated a high prevalence of mental health problems among autistic people, with elevated rates of depression, anxiety, and suicidality. The profession of occupational therapy has its roots in mental health and can offer a unique focus on occupation to support the mental health needs of autistic clients. In this Guest Editorial we introduce articles for this special issue of the American Journal of Occupational Therapy related to autism and mental health and use the Person-Environment-Occupation Model. The articles offer insights into how interactions among person, environment, and occupation factors affect the mental health of autistic populations and demonstrate ways that mental health can be supported through occupational engagement. Opportunities to support the mental health of autistic people include promoting engagement in meaningful activities, supporting individual strengths, and bolstering clients' sense of self and identification with their autistic identity. Future research is needed to uncover and test interventions to support autistic clients and should reflect cultural humility and participatory approaches. We chose to use identity-first language (rather than person-first language) to describe the autistic community in this Guest Editorial out of respect for common community member preferences and in accordance with recommendations for anti-ableist language use (Bottema-Beutel etal., 2021). Decisions about language for each article in this special issue were made by the respective authors.

A Sensory Integration Intervention in the School Setting to Support Performance and Participation: A Multiple-Baseline Study.

There is a paucity of research that explores the effectiveness of sensory integration interventions in the school setting. To test the effectiveness of a sensory integration intervention paired with teacher consultation, aligned with the principles of Ayres Sensory Integration® and the Sensory Therapies and Research Frame of Reference, to improve functional regulation and active participation in school for students with sensory integration and processing differences. Concurrent, multiple-baseline, single-subject design. Public elementary school in the United States. Students (N = 3; ages 5-8 yr) whose sensory integration and processing differences were affecting their school occupational performance and were not remediated by integrated support. For 15 wk, each student had one-to-one sensory integration intervention 2×/wk for 30 min and a consultation between the occupational therapist and teacher weekly for 10 min. The dependent variables, functional regulation and active participation, were measured weekly. The Short Child Occupational Profile and Behavior Assessment System for Children, Third Edition, were given before and after intervention. Goal Attainment Scaling and semistructured interviews with the teachers and participants were completed after intervention. All 3 students showed meaningful improvement in functional regulation and active participation in the classroom during the intervention period as demonstrated by a 2-SD band method or celeration line analysis. All additional measures noted positive change. Findings suggest that sensory integration intervention with consultation in the education setting can improve school performance and participation for children with sensory integration and processing challenges. What This Article Adds: This study offers an evidence-based model of service delivery for the school setting that is effective in improving the functional regulation and active participation of students whose sensory integration and processing challenges interfere with occupational engagement and are not mitigated by embedded supports.

Conquering Educational Mountains: Maintaining a Radiology Clinical Education Track

Establishing a clinical education track as part of a radiology residency is essential in shaping future radiology educators. Many obstacles will be encountered while starting, maintaining, and improving these educational pathways. Hurdles may include recruiting suitable residents for the track, recruiting and supporting faculty advisors, sustaining long-term resident engagement, counteracting educational exclusivity, and providing adequate time and financial support. Although every program and institution may face individualized "mountains" to overcome, they are not insurmountable. The goal of this review is to address different conflicts we have encountered while maintaining the clinical education tract at our institution and to provide tips for overcoming them.

대학생의 성찰학습이 진로관여행동에 미치는 영향: 학습몰입의 매개효과

이 연구는 대학생의 성찰학습, 학습몰입, 진로관여행동 간의 구조적 관계를 검증하고자 하였다. 먼저, 대학생의 성찰학습이 진로관여행동에 미치는 영향을 확인하고 성찰학습과 진로관여행동 사이에서 학습몰입의 매개효과를 검증하였다. 이러한 연구목적 달성을 위해 충북소재 4년제 대학의 항공계열 학생 대상으로 설문조사를 진행하였으며 203부의 설문응답을 최종 표본으로 사용하고, SPSS 25.0, AMOS 25.0 소프트웨어를 사용하여 분석을 실시하였다. 분석결과, 성찰학습은 학습몰입과 진로관여행동 모두와 유의한 정적관계를 갖는 것으로 밝혀졌다. 또한, 성찰학습은 진로관여행동에 직접적인 정적 영향을 미치고 학습몰입은 성찰학습과 진로관여행동의 사이에서 매개효과를 갖는다는 것을 확인하였다. 이는 대학생들의 성찰학습이 이루어질수록 진로관여행동이 증진된다는 것을 의미하며 인지적 특성인 성찰학습에 심리적 특성으로 볼 수 있는 학습몰입이 더 해질때 진로관여행동은 더욱 큰 효과를 만들어낼수 있는 것을 의미한다. 따라서 대학은 학생이 자기성찰의 학습태도를 습득하고 학업에 몰입할 수 있는 교육환경을 제공할 필요가 있다.

Normative Basis for Climate-Related Civic Engagement by Residents of Lake Superior’s North Shore region

This study examines the determinants of resident engagement in climate change using a survey of a sample of residents in Lake Superior’s North Shore region in Minnesota. We examine the influence of climate concern, responsibility, subjective norms and personal norms on civic engagement. Study findings indicate that climate concern, ascription of local responsibility, and subjective norms influence residents’ personal norms, or sense of personal obligation, which in turn positively predicts civic engagement. Study findings highlight the importance of norms as a motivator of climate-related engagement. Results point to the potential for engaging community members in climate-related activities by tapping feelings of personal obligation for climate change adaptation or mitigation.

Men's Lived Experiences of Breast Cancer and Changes in Occupation.

Male breast cancer is rare and frequently diagnosed at later stages of disease with low survival rates. There is a lack of knowledge of how breast cancer impacts men's occupations. This study is aimed at understanding the lived experiences of men with breast cancer and their changes in occupation. Methodology. Twenty-four men with breast cancer participated in semistructured phone interviews. Data was open-coded and analyzed for themes. Findings. The six major themes are as follows: (1) death as a reality, (2) unique personal insights, (3) social environment, (4) interactions with the healthcare system, (5) decreased engagement in occupations, and (6) finding meaning in new occupations. The healthcare team can improve the patient experience by discussing and responding to the client's experience throughout the diagnosis, intervention, and survival continuum. The scope of occupational therapy is well suited to address the needs of men with breast cancer to maintain optimal levels of functioning.

Supporting resident engagement via web-based assessment system: experience of activity professionals from long-term care settings

ABSTRACT Loneliness, depression, and social isolation are observed among residents in long-term care settings. Activity professionals can help prevent this by encouraging residents and providing them with opportunities to be more active during daily life. Questionnaires measuring the extent to which activity professionals design and implement activities among residents are lacking. In addition, there are no measurement instruments to gain insight into activity professionals work performance. A web-based assessment system, ‘Elder Engagement Performance Improvement (EEPI),’ has the potential to help activity professionals support resident engagement. This study explored long-term care activity professionals’ experiences in using the EEPI assessment.Semi-structured interviews with 23 long-term care activity professionals (e.g. certified activities directors, therapeutic recreation specialists, life enrichment directors, and life engagement directors) were conducted and analyzed using qualitative content analysis.Activity professionals` experiences showed the EEPI was a means of improving the performance of activity professionals by increasing residents’ engagement both in quality and quantity. Four main themes emerged from this explorative investigation: (a) Lack of assessment tools, (b) Acceptance of the web-based assessment system, (c) Barriers to using the EEPI (time, staffing issues, and lack of management support), and (d) Areas for job improvement (person-centered activities and engagement).The EEPI may serve as a valuable tool in long-term care settings for activity professionals. The web-based assessment system, EEPI, facilitated activity professionals’ daily work and involved the residents’ interests in their activities, which may enhance resident engagement and reduce the risk of social isolation in long-term care facilities.

Resident Physician Interactions and Engagement With Written Assessments of Performance.

Despite the requirements of the Accreditation Council for Graduate Medical Education (ACGME) to provide feedback, assessments are often not meeting the needs of resident learners. The objective of this study was to explore residents' approach to reviewing, interpreting, and incorporating the feedback provided in written faculty assessments. We conductedsemistructured interviews with 14 family medicine residents. We used line-by-line iterative coding of the transcripts through the constant comparative method to identify themes and reach a consensus. The study revealed the following themes: (1) residents value the narrative portion of assessments over numerical ratings, (2) performance reflection and reaction are part of the feedback process, (3) residents had difficulty incorporating formal assessments as many did not provide actionable feedback. Residents reported that narrative feedback gives more insight to performance and leads to actionable changes in behaviors. Programs should consider education for both faculty and residents on the usefulness, importance, and purpose of the ACGME Milestones in order to accurately determine resident competency and provide a summative assessment. Until the purpose of the ACGME Milestones is realized and utilized, it should be noted that the comment portion of evaluations will likely be the focus of the resident's interaction with their assessments.

Measuring Resident Participation in the Renewal of Older Residential Communities in China under Policy Change

There is a growing global trend to encourage citizen participation in solving urban problems, and there is worldwide consensus that the public voice needs to be considered. This study uses an extended Theory of Planned Behavior (TPB) to focus on the factors influencing resident engagement following changes in renewal strategies in older residential communities in China. Empirical analysis was carried out based on structural equation modeling (SEM) of a completed questionnaire with 865 respondents. The results showed that Neighborhood Relations (NR) had a positive impact on Participation Attitude (PA); both PA and Awareness Participation (AP) had a positive effect on Self-evaluation (SE), and SE and AP had a positive impact on Participation Guarantee (PG). A survey was also conducted on residents’ concerns and perceptions of the redevelopment of the old neighborhood, analyzing the current issues of residents’ more significant concerns. It showed that public emergencies can affect residents’ inherent perceptions. This study enriches the China-specific focus of the issue and is a reference for similar studies in the future.

The Role of Graduate Medical Education in the Fight Against Health Misinformation.

The Role of Graduate Medical Education in the Fight Against Health Misinformation.

The Effect of College Student’s Occupational Engagement on Happenstance Coping skill and Mediating Effects of Relatedness

The Effect of College Student’s Occupational Engagement on Happenstance Coping skill and Mediating Effects of Relatedness

Activistic citizenship in nursing homes: co-ownership in the mundane.

The traditional narrative of dementia, focused on cognition as constructive of personhood, has been challenged by person-centred care as well as a rights-based citizenship lens. However, reports of everyday discrimination leading to occupational deprivation and pathologising interpretations of people living with dementia in nursing homes highlight the need for further investigation. The purpose of this study was to investigate the transformative power of mundane and relational enactments of citizenship in nursing homes, exploring the potential of adding an activistic lens of citizenship to our interpretive practices. Through an ethnographic study in Norwegian nursing homes, a narrative analysis of fieldnotes and interview transcripts was conducted. Narratives were interpreted using narrative theory, occupational perspectives and theories of citizenship. Findings reveal a phenomenon of shared ownership between residents and staff, and a vulnerable balance between silence and active social and occupational engagement in the nursing homes. Further, they shed light on how group-based assessments of residents' abilities or occupational needs may constrain opportunities, and staffs' options, to facilitate co-ownership. We suggest that a lens of activistic citizenship implies interpreting residents' behaviours as mundane forms of subtle resistance. A professional and ethical responsibility building on such interpretive practices may turn attention towards structures that constrain residents' expressions of citizenship.

Improving sleep using mentored behavioral and environmental restructuring (SLUMBER): A randomized stepped-wedge design trial to evaluate a comprehensive sleep intervention in skilled nursing facilities

IntroductionPoor sleep is ubiquitous in skilled nursing facilities (SNFs) and is associated with a myriad of negative symptoms. Non-pharmacological interventions can improve sleep, yet sustainability has not been demonstrated. The Improving Sleep Using Mentored Behavioral and Environmental Restructuring (SLUMBER) trial will test whether a staff mentoring approach to address resident sleep issues positively impacts sleep quality and whether improved sleep benefits mood, cognitive performance, and activity engagement for residents living in SNFs. InterventionThis is a four-year hybrid type I effectiveness/implementation randomized stepped-wedge trial using a comprehensive sleep improvement program conducted in three urban SNFs. MethodsWe will provide SNF staff with sleep promotion strategies over a four-month intervention. Staff will have access to in-person workshops, webinars, weekly sleep pearls via text messaging, environmental data, and expert program mentors. We will consent residents for data collection (at baseline, end of intervention, and three- and six-months post-intervention) including resident observations, questionnaires, and wrist actigraphy (to objectively measure sleep). We will also use selected Minimum Data Set 3.0 (MDS) measures. ConclusionSLUMBER uses a unique strategy to iteratively improve sleep interventions through SNF staff buy-in, expert mentoring, and technological supports within a quality improvement framework. As a stepped-wedge trial, the initial SNF units provide opportunities for program improvement in subsequent units, accounting for variation across resident populations at different sites. Protocol limitations include strategies which may require substantial customization for greater spread. A comprehensive staff training program that addresses both sleep quality and related symptoms has the opportunity for considerable dissemination.Trial registration: USGOV Clinical Trials ID: NCT03327324

Betrokken bewoners in het verpleeghuis: dilemma’s, knelpunten en kansen

In the residential care sector we have witnessed throughout the previous decades a development from a rather paternalistic approach towards a more democratic way of care giving. In many care organizations, however, residents are still rarely involved in the daily routine. In a participatory study on a somatic care unit in the Netherlands, we examined the challenges around the involvement of residents in the care residence. We organized two homogeneous group sessions, with staff and residents separately; reflected on new ways for involving residents; and concluded with a heterogeneous focus group, bringing staff and residents together. Both staff and residents recognized the importance of resident involvement in daily care. However, the difference in perspective on what this should look like created challenges. We found three dilemmas that made the engagement of residents challenging: autonomy versus dependence, personal experiences versus privacy, and happiness versus honesty. We found different ways staff and residents dealt with these dilemmas in practice and defined them in terms of bottlenecks and opportunities. Attention to these dilemmas, pitfalls, and potentials, promotes mutual understanding and ultimately resident involvement in daily care.

Social participation of individuals with spinal injury using wheelchairs in rural Tanzania after peer training and entrepreneurial skills training.

Individuals with spinal cord injury (SCI) in less-resourced settings reported barriers to community integration, including inaccessible rehabilitation services, restricted environments and limited social integration. Peer training and entrepreneurial skills training are provided by Motivation, a nonprofit organisation, and Moshi Cooperative University to enhance occupational engagement of individuals with SCI in less-resourced settings. This study aimed to explore the impact of peer training and entrepreneurial skills training on the social participation of individuals with SCI living in Tanzania. Using a qualitative photovoice approach, 10 participants captured meaningful photos and provided captions according to five standardised questions (PHOTO technique) to convey their messages. Participants selected up to 34 photos that best illustrated their experiences in the community. A mixed inductive-deductive thematic analysis was guided by the International Classification of Functioning, Disability and Health. Two interrelated themes emerged: (1) 'influencing factors', which revealed how participants' inclusion in the community was influenced by their activities and personal and environmental factors and (2) 'empowerment', which highlighted participants' desire to advocate and promote awareness of needs and hopes. Participants emphasised the importance of accessibility and equal opportunities. Whilst some were able to overcome obstacles, others experienced continued inaccessibility that inhibited meaningful occupations. Daily participation challenges of individuals with SCI in rural Tanzania were highlighted. Although the Motivation programmes were perceived to have powerful impacts on social participation, continued efforts and advocacy are needed to overcome accessibility issues and to meet the physical, psychological and social needs of Tanzanians living with SCI. This article highlights the importance of accessibility and equal opportunities for individuals with disability living in rural Tanzania. Peer-training and entrepreneurial programs offer community-based rehabilitation services that were perceived by people with disabilities to have a powerful impact on social participation and vocation. However, continued efforts and advocacy are needed to meet the needs of Tanzanians living with spinal cord injury.

Engajamento ocupacional: alguns pressupostos para informar a terapia ocupacional

Abstract Occupational engagement has been conflated with other concepts, such as participation, active occupational performance, and therapeutic engagement. This critical review will discuss occupational engagement as a unique concept that describes a form of involvement in doing that does not require performance and foregrounds the subjective-affective and cognitive experiences of doing. We present some attributes of occupational engagement and the implications for the lack of clarity of this concept within the literature. The difference between occupational engagement and therapeutic engagement is discussed by comparing the foundational tenets of the Model of Human Occupation (MOHO) and the Canadian Model of Occupational Performance and Engagement (CMOP-E). Through one illustrative narrative, we discuss how occupational engagement can be understood as a phenomenon that is not performance-dependent and has different levels of engagement. To conclude, we point out some assumptions about occupational engagement that can inform occupational therapy research and practice.

Processamento sensorial e engajamento: uma revisão sistemática

Abstract The ability of children to organize themselves sensorially in a school environment to remain engaged in their routine activities has been minimally explored by occupational therapists. This study aimed to identify research on sensory processing and engagement carried out by occupational therapists over the past decade. Moreover, it seeks to analyze the depth and quality of discussions regarding the relationship between sensory processing and children’s engagement in their occupations. A systematic review was conducted utilizing the descriptors: sensory processing, engagement, and occupational therapy. These descriptors were combined through the AND operator in the VHL, PubMed, and Web of Science databases. Included articles, whether in English or other languages, defined and measured sensory processing; highlighted a relationship between child sensory processing and occupational engagement; were published within the past 10 years (2008 to 2018); underwent peer-review; are available in full; involved participants aged 0 to 7 years; and were authored by occupational therapists. The review process was performed by two authors using predefined data fields, which included study quality indicators. The results identified a mere nine articles on this specific theme. An assessment based on the OT Seeker scale revealed scores of moderate magnitude. This suggests a pressing need for occupational therapists to invest in the expansion of discerning research, aiming to elevate scientific evidence regarding the relationship between sensory processing and occupational engagement.

Older adults' adaptiveness to disruptions during South Africa's COVID-19 lockdown: Keep your head up and continue breathing

INTRODUCTION: Adaptiveness fosters resilience through increasing capacity to transcend barriers in individuals, their environment and occupational engagement. The COVID-19 pandemic and lockdown may have decreased adaptiveness in older adults by disrupting occupational engagement, thus negatively influencing health and well-being METHODS: A qualitative, meta-analytic design was used to explore the adaptiveness of older adults to disruptions experienced during South Africa's COVID-19 lockdown. Four student researchers' primary studies were reviewed and findings synthesised for this paper. Individual, semi-structured interviews were conducted with 16 participants during April and May 2020. The transcripts were analysed thematically and reported in the primary studies. The authors conducted thematic analysis across all four primary studies to develop themes for this paper FINDINGS: Three dominant themes emerged: (1) COVID-19 as an illness, (2) occupational disruptions experienced by older adults, and (3) developing a state of adaptiveness. Older adults developed adaptiveness through changing perspective, adapting to new environments, learning to use technology, expanding roles and routines, and strengthening the spiritual self through engagement in eudemonic occupations CONCLUSIONS: The study provides insights into challenges and adaptiveness of older adults during the COVID-19 lockdown. Findings inform interventions with older adults presenting with reduced adaptiveness Implications for practice This study is valuable as it provides occupational therapists with a deeper understanding of older adults' experiences and challenges during the COVID-19 lockdown, thus, laying the potential for strengthening client-therapist interpersonal relationships. Although the sample observed in this study was older adults, the findings can be considered among other vulnerable clients such as individuals with disease, illness and/or disability. Additionally, these findings may provide occupational therapists with insights that can assist in framing intervention strategies for clients with a decreased state of adaptiveness. This is significant as adaptation requires reasonable social, emotional, and cognitive processes. Lastly, this study aimed to contribute to a wealth of research exploring adaptiveness, rooted in the reality that change is inexorable; however, how we respond to change can be transformative for individual and population well-being.