Everyday Occupations Research Articles

Global need of Assistive Product and Assistive Technology for Individuals with Intellectual Disabilities: A Review

The concept of Assistive Technology (AT) has become increasingly widespread in education. Assistive technology play an instrumental role in setting the global roadmap for improving access to assistive technology for everyone, everywhere. We present a framework for understanding the complex interaction between intellectual disability, health and wellbeing, and assistive technology. The main objective of this paper focuses on conducting a systematic review of studies regarding the impact of global need of assistive product and assistive technology for individuals with intellectual disabilities. AT is recognized by the World Health Organization (WHO) to enhance functioning, independence, and autonomy and ultimately promote well-being for people living with disabilities. With the digitalisation of societies, the everyday lives and occupations of individuals are changing, becoming more reliant on digital solutions. The development of digital assistive technology (DAT) also offers opportunities for people with disabilities to access, interact, and pilot the digital world. In order to achieve the above, a review of relevant empirical studies published WHO & UNICEF- Global Report on Assistive Technology, WHO- Assistive Product list, WHO- Priority Assistive Product and Persons with Disabilities (Divyangjan) in India - A Statistical Profile : 2021, NATIONAL LIST OF ESSENTIAL ASSISTIVE PRODUCTS (NLEAP), 2023 was carried out. Findings of this study include that the use of Assistive Technologies is successful in increasing the inclusion and accessibility of students with disabilities, although barriers such as teacher education, lack of information or accessibility are found.

Promoting meaningful activities by occupational therapy in elderly care in Belgium: the ProMOTE intervention

BackgroundOlder people want to age in place. Despite advancing functional limitations and their desire of aging in place, they are not always faithful to therapy that maintains independence and promotes safety. Occupational therapists can facilitate aging in place. Occupational therapy is defined as the therapeutic use of everyday life occupations with persons, groups, or populations for the purpose of enhancing or enabling participation.AimTo describe the content a high-adherence-to-therapy and evidence-based occupational therapy intervention to optimize functional performance and social participation of home-based physically frail older adults and wellbeing of their informal caregiver, and the research activities undertaken to design this intervention.MethodsA roadmap was created to develop the occupational therapy intervention. This roadmap is based on the Medical Research Council (MRC) framework and is supplemented with elements of the Intervention Mapping approach. The TIDieR checklist is applied to describe the intervention in detail. A systematic review and two qualitative studies substantiated the content of the intervention scientifically.ResultsThe application of the first two phases of the MRC framework resulted in the ProMOTE intervention (Promoting Meaningful activities by Occupational Therapy in Elderly). The ProMOTE intervention is a high-adherence-to-therapy occupational therapy intervention that consists of six steps and describes in detail the evidence-based components that are required to obtain an operational intervention for occupational therapy practice.ConclusionThis study transparently reflects on the process of a high-quality occupational therapy intervention to optimize the functional performance and social participation of the home-based physically frail older adult and describes the ProMOTE intervention in detail. The ProMOTE intervention contributes to safely aging in place and to maintaining social participation. The designed intervention goes beyond a description of the ‘what’. The added value lies in the interweaving of the ‘why’ and ‘how’. By describing the ‘how’, our study makes the concept of ‘therapeutic use-of-self’ operational throughout the six steps of the occupational therapy intervention. A further rigorous study of the effect of the ProMOTE intervention on adherence, functional performance and social participation is recommended based to facilitate the implementation of this intervention on a national level in Belgium.

Worldwide Survey on Digital Assistive Technology (DAT) Provision.

Occupational therapists have long been involved in assistive technology (AT) provision worldwide. AT is recognized by the World Health Organization (WHO) to enhance functioning, independence, and autonomy and ultimately promote well-being for people living with disabilities. With the digitalisation of societies, the everyday lives and occupations of individuals are changing, becoming more reliant on digital solutions. The development of digital assistive technology (DAT) also offers opportunities for people with disabilities to access, interact, and pilot the digital world. However, we do not know how occupational therapists are involved in DAT provision worldwide. A survey was conducted in the global occupational therapist's community in June 2022 to describe DAT provision and the factors influencing it. Occupational therapy practitioners were included (n = 660) in the analysis. In DAT provision, occupational therapists mostly provide advice to people, assess their needs, provide instruction or training, prescribe DAT, and fit DAT to people and their environment. The clients served through DAT provision are most frequently people with neurological impairments, chronic illnesses, sensory impairments, and older people. The reasons for providing DAT focus on education, work, school, and leisure. It is expected that DAT provision will enhance independence, self-esteem, occupational participation, and social relationships. Issues faced by occupational therapists when providing DAT are costs of product and funding schemes, sufficient knowledge, and access to knowledge sources. Survey respondents are mostly from Western countries with access to the Internet and the digital world, including having digital literacy, highlighting the digital divide that exists between world regions and countries, but also within countries worldwide. There is a need to continue research to better understand the issues related to digitalisation and the digital participation of people living with disabilities.

The everyday life occupations of older women in social vulnerability in Brazil

ABSTRACT Population aging is widely discussed due to the impacts of increased life expectancy, especially in socially vulnerable populations. This descriptive-exploratory qualitative study aims to understand older women’s perceptions of their occupations in a socially vulnerable community. The participants were 11 women, aged 60 years or older, living in Vila Marçola, Aglomerado da Serra, Minas Gerais, Brazil. Semi-structured interviews were carried out and the content was analyzed by using thematic analysis. Findings indicated four care dimensions: 1) Household care and caring for other people, 2) Community care, 3) Self-care, and 4) Expanding the experiences of care in old age. Older, mostly black, and poor women from Vila Marçola highlighted the unequal living conditions in Brazil. These women were overloaded with occupations, especially paid and unpaid household care, and did not have access to or stability in other occupations. However, retirement allowed them to participate in educational and social projects, increasing their occupational repertoire. This study contributes to the construction of intersectional knowledge in the field of occupational science, expanding the understanding of the socio-cultural dimensions that involve the diversity of people around the world, especially in situations of social vulnerability.

A scoping review and thematic analysis of the use of technology in everyday occupations amongst adults aged 55 years or older in supported housing

A scoping review and thematic analysis of the use of technology in everyday occupations amongst adults aged 55 years or older in supported housing

Test-Retest Reliability of the Electronic Instrumental activities of daily living Satisfaction Assessment (EISA): A Cohort Study.

Currently, no self-report instruments exist for assessing satisfaction with performing instrumental activities of daily living and occupations for people with disabilities using internet-connected assistive devices like accessible smartphones, tablets, laptops, and apps. To assess the test-retest reliability and internal consistency of the Electronic Instrumental activities of daily living Satisfaction Assessment (EISA) self-report outcome tool. Repeated-measures cohort study with a time frame of 7 to 21 days. Multicity online recruitment at assistive technology clinics, nongovernmental organizations, advocacy and peer support groups for people with disabilities, and higher education institutions. Eighty-four participants with disabilities, age 18 yr or older, with a mean age of 43.3 yr (range = 19-75 yr), and 57% female. Not applicable. The a priori study hypotheses were that the EISA test-retest reliability scores would be above the minimum acceptable level (Rs > .80) and that internal consistency would be good (Cronbach's α = .70-.90). On the basis of the study data, the EISA, Version 1.0, demonstrated good test-retest reliability (Rs = .81) and excellent internal consistency (Cronbach's α = .88). The results of the test-retest reliability and internal consistency analyses provide good support for the EISA to be used in clinical settings. What This Article Adds: This article documents the reliability and internal consistency of, to our knowledge, the first-ever self-report instrument for assessing satisfaction with performance of everyday occupations for people with disabilities using internet-connected assistive devices such as smartphones, tablets, laptops, and apps.

'Having the dog as part of our family gives us hope': Experiences of the impact of assistance dogs on the occupational engagement of children with autism and their families.

Autism is a developmental disorder characterised by changes in social, communication, and behavioural performance. Assistance dogs can support children with autism to engage in everyday occupations. Despite more children being partnered with assistance dogs, there is limited research regarding the impact of assistance dogs on the occupational engagement of children with autism and their families, and further research is needed to fully understand the impact of this type of support within the Australian context. To explore caregiver-reported experiences of an assistance dog on the occupational engagement of children with autism and their families. Using a qualitative approach, semi-structured interviews were undertaken with six caregivers of seven children with autism, who each had an assistance dog. Interviews ranged from 45 to 60 minutes in duration. Data were transcribed verbatim and thematically analysed. Trustworthiness was maximised through independent recruitment, research team discussions, member checking, and a researcher reflective journal. Three themes were identified: participation in everyday occupations prior to and after partnering with an assistance dog, increased engagement in everyday occupations, and impact of the assistance dog on the family unit. Assistance dogs were reported to progress children from community 'isolation' to 'freedom'. Participants reported the dog increased children's capacities through positively influencing completion of routines, increasing independence, and improving therapy engagement. Assistance dogs were viewed as supporting the whole family's occupational engagement. Some challenges were identified with the introduction of the assistance dog to thefamily unit, and with animal maintenance costs and time demands, public access rights, and limited government funding. This research identifies benefits and challenges for children who partner with autism assistance dogs. It provides insights to inform assistance animal referral, assessment, and support of assistance dogs in Australia for children with autism and occupational therapists working with them.

The ‘process of doing’ in everyday occupations – a challenge for young adults with cerebral palsy

Background: There is a lack of knowledge about how persons with cerebral palsy (CP) perceive their ‘process of doing’ while performing everyday occupations. As described in the Model of the Process of Doing (MPoD), performing an occupation is a complex process consisting of six phases (generate idea, plan, initiate, enact, adjust, end) and time management. Aim: To collect the experiences of young adults with CP, classified at Manual Ability Classification System (MACS) level I or II, regarding how they perceive challenges in their occupational performance in relation to the different phases of the ‘process of doing’. Method: Semi-structured interviews were performed with ten participants with CP aged 19–30 years, MACS level I or II. The interview material was related to the MPoD phases using directed content analysis. Results: The participants’ descriptions of how they perceived their personal ‘process of doing’ showed problems in all MPoD phases. All participants experienced difficulties in one or more phases, but none had difficulties in all phases. Difficulties were more frequent in some phases than in others. Conclusion/Significance: To understand the complexity of doing everyday occupations in young adults with CP, there is a need to address all phases of the ‘process of doing’.

How caring work of older women gets disappeared: The gendered dynamics of changing everyday occupations in an older German couple

ABSTRACT Background: In older couples, everyday occupations need to be adjusted when one of the partners experiences a health decline. Gender dynamics will play a role in this process, yet there is little understanding about how gender can influence and shape changes in couples’ occupations. Aim: To understand the changing occupations of old, independent-living couples when becoming caregivers and care receivers, through a gender lens. Methods: A narrative-in-action methodology with a case-study design has been chosen to enable an in-depth analysis of one couple. Besides joint and individual interviews with both partners, observations were made of their everyday occupations. The analytic process was interpretative, using gender theory as a lens for understanding. Results: In the couple’s narrative there was a difference in the time spent on, and meaning given to, occupations performed by each partner to sustain everyday life. The wife was heavily enrolled in taking care of her husband, a gendered pattern that was rooted in their spousal history. While her efforts were taken-for-granted, his efforts were acknowledged as special. Conclusion: The adjustment of the everyday occupations of this older couple were gendered, and led to a disappearing of the woman’s occupations and the care she was giving.

Examining the use of assistance dogs to enhance participation in everyday occupations for people with mobility challenges

Introduction: The impact of assistance dogs on an individual’s life is multifaceted. The occupational therapist must identify how assistance dogs enhance occupational performance and influence an individual’s life. This study aims to deepen our understanding about the benefits and challenges of assistance dogs for individuals with mobility challenges. Methods: The qualitative data analysis included codes and theme identification. Quantitative data were analyzed using descriptive analysis, including mean, standard deviation, and Cronbach’s alpha (score reliability). Results: Results indicate that the job of the assistance dog is comprehensive and complex. Assistance dogs support independence, provide hope through occupations, assist with general and client-specific needs, and provide companionship. The use of occupational therapy outcome tools to assess the benefits of service dogs adds to the body of literature. Conclusion: A service dog enhances occupational performance at home, work, school, and community. This unique study aims to deepen the understanding of the benefits and challenges of assistance dogs as an occupational therapy intervention for individuals with mobility challenges.

How do older women perceive the occupations and activities within their maternal role? Findings from an exploratory survey.

Participation in meaningful everyday occupations and life-roles is crucial to the health and wellbeing of older adults. However, little is known regarding meaningful life-roles of older women. Although the maternal-role remains meaningful to women throughout their life, previous literature focused on earlier stages of motherhood. To describe the occupations and perceptions within the maternal-role of older women. An online survey was distributed via social media. It included closed and open-ended questions regarding the engagement and relatedness of occupations to the maternal-role; and the perceptions of older women towards their maternal-role. Quantitative data was analyzed using descriptive statistics, and thematic analysis was used to analyze data from open-ended questions. The survey was answered by 317 community-dwelling older mothers (aged 65-87). High frequency of engagement and relatedness of occupations to the maternal-role were found. Most participants perceived the maternal-role as a never-ending and evolving life role. Seven categories, describing both 'doing' and 'being' aspects of the maternal-role, were identified. The maternal-role is meaningful to older women. It continues to develop over time, and includes new occupations which have not been central at earlier stages of motherhood. These findings have significant implications for healthcare professionals striving to promote healthy aging by enhancing the participation of older women in meaningful occupations. Further research is needed to broaden the understanding of the unique characteristics of the maternal-role at older age.

Participation in Everyday Occupations Among Rohingya Refugees in Bangladeshi Refugee Camps

Abstract Importance: Bangladesh hosts a large number of Rohingya refugees from Myanmar. Living in refugee camps, the Rohingya refugees face challenges in everyday occupations because of violence, limited opportunities, and corporal punishment by the community. Objective: To explore how Rohingya refugees experience participation in everyday occupations while living in temporary refugee camps in Bangladesh. Design: Phenomenological study to describe, understand, and interpret the meanings of life experiences in particularly adverse conditions. Setting: Rohingya refugee camps in Bangladesh. Participants: Fifteen purposively selected participants from the camps. Outcomes and Measures: In-depth semistructured interview, as well as participant and environmental observations. Researchers used line-by-line data analysis to capture quotations and patterns using interpretive phenomenological analysis, which included establishment of initial codes, interpretation, determining selected codes, and categorization. Results: The research identified four major themes—(1) mental stress, sleep disturbances, and daily occupations; (2) adjustment to inconsistent daily activities; (3) complex relationships and limited social roles that decreased occupational engagement; and (4) involvement in precarious occupations that exacerbated severe health risks—and four subthemes—(1) fragmented family relationships, (2) formation of new relationships to perform social roles, (3) inconvenient and inaccessible living conditions, and (4) continuation of unlawful work to survive. Conclusions and Relevance: Rohingya refugees should receive comprehensive health and rehabilitative care because of their perilous mental health conditions, precarious occupations, and lack of trustworthy relationships with family and neighbors. What This Article Adds: Rohingya refugees experience imbalanced, deprived, and maladapted occupations in refugee camps. Suggestions to improve their lived experience with further peer support programs may help them participate in occupation-based rehabilitation services to facilitate their social integration.

«Ақырзаман» теориясының онтологиялық желісі

One of the actual problems of philosophy is the process of the future development of mankind. Since a person's achievements are related to the assimilation of time, this time is usually divided into different periods. For the Turkic peoples, the division of time into times has developed as a habitual, everyday occupation. The allocation of ancient time, modern time, and the apocalypse in historical time is so firmly rooted in consciousness that, without hesitation, we affirm that this is the absolute truth. In the article we tried to analyze the concept of “apocalypse”, its essence and character, reflection in consciousness and hypotheses about this phenomenon. The purpose of the article is a philosophical analysis of theories related to the concept of “the end of the world” through the prism of axiological (value) understanding of the end of human history. Moreover, the phenomenon of the “apocalypse” in close connection with the idea of an infinite heavenly world has always been considered in philosophy as the main philosophical problem. A person not only tries to understand and explore the problems associated with time, but also lives in this phenomenon. No matter how deeply we try to reason, it is impossible to find and accurately determine the future of human history, which is contained in itself. Uncertainty is always worrying. But it can be dispelled in an attempt to approach the understanding of the ontological meaning of the “apocalypse” and the realization of our close connection with it.

Além da inclusão: espaços sociais coletivos de segurança, comunhão e reconhecimento

Abstract This paper unsettles taken-for-granted understandings of social inclusion in the field of occupational therapy and links with the concept of radical inclusion developed in social occupational therapy. It traces the ways that, over time, inclusion has been reduced to a position within the inclusion/exclusion binary. Pierre Bourdieu’s reflexive theory of practice is introduced to expand understandings of how the negative value accorded to disability is reproduced through exclusionary social conditions and relations. Drawing on the results of a qualitative study that examined the everyday lives, practices and occupations of 13 Canadian youth who used augmentative and alternative communication (AAC) modes as a result of physical impairments, three elements of more inclusive social spaces - safety, communion, and recognition - are presented alongside implications of each for occupational therapy. These alternative approaches for thinking beyond inclusion are grounded by narratives illustrating elements of social spaces that can foster a sense of belonging and connection. The perspectives shared by youth in the study add complex insights into how they made ‘practical sense’ of prevailing calls for social inclusion. Their stories show how even as they struggled for inclusion, they were subject to and internalized negative valuations of disability. Importantly, the paper highlights strategies employed by youth to reformulate inclusion on their own terms. These reformulations go beyond over-simplified conceptions of inclusion and hold potential to inform the ways that occupational therapists work alongside individuals and collectives to improve life chances, expand occupational possibilities, and support flourishing for disabled children and youth.

SELF-TAILORED SUCCESSFUL AGING: OLDER ADULTS’ POINTS OF VIEW

Abstract The study aimed to map out the main constructs involved in aging successfully, as perceived by older adults, and highlight the importance of self-management. This qualitative study was comprised of eighteen interviewees and sixty participants across nine focus groups, including: Independent older adults aged 65 to 84 years living at home, health professionals working with older adults, and family members of older adults. Participants shared experiences concerning their everyday occupations and routines. Focus groups were recorded, transcribed verbatim, and qualitatively analyzed, using the constructivist grounded theory principles. Results: Three successful aging theoretical categories emerged: self-management abilities, daily lifestyle, and individual differences. An example for self-management abilities can be described by a 67-year-old man’s son, who said: “He is a very busy man, he doesn’t have any commitments, but he always creates things for himself to do”. Results revealed diversity in how older adults perceive successful aging. For example, a 68-year-old woman said: “Retirement is like heaven, I enjoy every moment, there’s a lot to do”, whereas a 69-year-old man claimed: “Nobody needs you anymore… I retired a year ago and I still haven’t succeeded in organizing a daily schedule”. Additional results and quotes reflecting the categories will be represented. Conclusion: Older adults who succeed in managing their daily life, and experience control of their own life, delineate successful aging. The diversity accentuates that each older adult needs to tailor their own self fitted “suit” to wear as they stride successfully into their aging years.

Participation in Everyday Occupations Among Rohingya Refugees In Bangladeshi Refugee Camps

<h3>Research Objectives</h3> This research explores how the Rohingya refugees experience participation in everyday occupations while living in temporary refugee camps in Bangladesh. <h3>Design</h3> A phenomenological study was conducted to describe, understand, and interpret the meanings of experiences of human life in particularly adverse conditions. Fifteen adults were purposively selected to participate in an in-depth semi-structured interview and participant observations. Researchers used line-by-line data analysis for capturing quotations and patterns using the strategy of interpretive phenomenological analysis. <h3>Setting</h3> Bangladesh. <h3>Participants</h3> Rohingya Refugees. <h3>Interventions</h3> No. <h3>Main Outcome Measures</h3> Qualitative. <h3>Results</h3> The research identified three major themes: 1) mental health conditions impacted the ability to participate fully in daily activities, 2) complex relationships and limited social roles decreased occupational engagement, and 3) involvement in precarious occupations exacerbated severe health risks. Six sub-themes were identified: a) past incidents destroying peaceful sleep, b) adjusting to inconsistent daily activities, c) fragmented family relationships, d) forming new relationships to perform social roles, e) inconvenient and inaccessible living conditions, and f) continuing unlawful work to survive. <h3>Conclusions</h3> Conclusion and Relevance: Rohingya refugees should receive comprehensive health and rehabilitative care because of their perilous mental health conditions, precarious occupations, and lack of trustworthy relationships with family and neighbors. Peer-led support may help the refugees participate in occupation-based rehabilitation services that may facilitate their social integration. <h3>Author(s) Disclosures</h3> This research doesn't have any conflict of interest.

Occupational performance and prioritized problematic everyday occupations among people with advanced cancer living alone versus living with someone

Background People living at home with advanced cancer wish to maintain and preserve domestic life, but they experience several barriers in their everyday occupations and thereby occupational performance. There is little knowledge of these barriers experienced by people living alone versus people living with someone. Objective/Aim To investigate differences in self-perceived occupational performance and the prioritisation of getting self-reported problematic everyday occupations solved among people with advanced cancer, taking living status into consideration. Method A cross-sectional study using baseline data from an RCT including 174 participants with advanced cancer living at home. Difficulty and priorisation of everyday occupations were assessed using the Individually Prioritised Problem Assessment (IPPA). Results In total, 731 problematic everyday occupations were reported, mainly related to the categories of housework, self-care and leisure. Conclusions/significance Overall, no statistically significant difference in self-reported occupational performance was found. However, people living alone perceived statistically significantly more frequently showering/bathing and doing laundry as difficult and therefore important to address. In contrast, people living with someone prioritised social interaction and home maintenance statistically significantly more frequently.

Opportunities and barriers for occupational engagement among residents in supported housing

Opportunities and barriers for occupational engagement among residents in supported housing. Background Research shows that people with psychiatric disabilities view supported housing (SH) as a possibility for social contact, but also as entailing a risk of deprived self-determination. There is, however, little research on the target group’s engagement in everyday occupations. Aim To explore SH residents’ opportunities and barriers for occupational engagement. Materials and methods Sixteen participants were interviewed, and data was analysed using content analysis. Results An overarching theme, Struggling to create meaning and seeking affection, and three underlying categories, emerged. Finding meaning through self-chosen occupations and support focussed on receiving support, doing self-chosen occupations, and having social contacts. Feeling neglected and insecure limits engagement in occupations was related to feelings of not being seen by staff, and insecurity, which hampered daily life. The third theme was Having a negative self-image and low level of ability hinders an active life. Conclusion Residents’ self-view and ability to create an inner drive for being active was important for occupational engagement, which was linked to social connectedness. Occupational based interventions and a personal recovery approach is warranted in order to facilitate needs for meaningful occupations. Significance The results from the study can be used to further develop optimal support within SH units.

Caste and Occupation

Access to, and participation in, occupation is necessary for human health and well-being. However, humans exist in a socio-political-cultural context, which has the potential to systemically and structurally impede occupational engagement. Within the Indian milieu, caste is one dimension of the socio-political context impacting people's occupational participation, depriving them of the choice for agency in their occupation. We begin with a brief history of the caste system in India, before considering the effects of caste on everyday occupation within the domains of education, media, and manual scavenging. Drawing on these examples, it is argued that caste creates a context that perpetuates occupational injustice. Taking learnings from the anti-racism movement, suggestions are offered for how occupational therapists and researchers might bear witness to and respond to caste in their work, both with clients and in their own lives.

Vulnerable, recalcitrant and resilient: a Foucauldian discourse analysis of risk and older people within the context of COVID-19 news media

Abstract Risk is an innate and integral part of everyday life and is present in simple, everyday occupations and complex actions. Age-related stereotypes can mean older people have little opportunity to engage in activities that present some degree of risk. The present study explores the discourse around risk and older people in the context of the COVID-19 pandemic. We investigated news media as a reflection of the dominant public discourse around older people's behaviour to identify how risk is represented in relation to occupational engagement. Texts relating to older people and COVID-19 were sourced from the West Australian newspaper for a period of two months. Seventy texts were subject to Foucauldian discourse analysis to identify subject positions, location of risk and discursive features. Findings indicate that older people were segregated from the rest of society, with their behaviours framed in mostly negative ways. We identified three areas of discourse: vulnerable, and in need of protection; recalcitrant, and in need of management; and resilient, deserving of respect. While we recognise competing representations, implicit within the dominant discourse was the premise that older people were not capable of mediating risks and required ‘management’. These findings highlight the role of surveillance in restricting occupational engagement for older people and carry implications for older people, the public and therapists.