Occupational Disruption Research Articles

Imagined futures: Occupation as a means of repair following biographical disruption in the lives of refugees

ABSTRACT The transitions associated with forced migration create extensive disruption to the daily lives of refugees. Such change affects opportunities, expectations, and identity in ways associated with the concepts of occupational and biographical disruption. Biographical disruption reflects the way an individual’s life path is changed by illness, injury, or social circumstances; and occupational disruption focuses on the impact of change on occupational aspects of the individual’s life path. This article explores the findings from a phenomenological study of the lived experiences of 10 refugees from Africa and the Middle East who had sought asylum in the United Kingdom. They were invited to share their experiences through a series of up to three conversational interviews, which were analysed using the Stevick-Colaizzi-Keen method. Findings illustrate the impact of disruption and the potential for occupation to help promote a sense of constancy and biographical repair. Participants highlighted how important occupation was to their experience of biographical disruption. They reflected on how their drive to achieve constancy across their life path encouraged their return to valued, familiar occupations, which provided a means of repair following disruption. This information offers insight into the scope of disruption faced by refugees, and how the major changes in their life path influence and are influenced by occupation. Readers are encouraged to consider how they could help to reduce feelings of disruption and enable refugees to retain a better sense of their imagined future.

Occupational disruption during the COVID-19 pandemic: Exploring changes to daily routines and their potential impact on mental health

ABSTRACT The COVID-19 pandemic has had far-reaching consequences for health, in part due to the numerous changes to daily routines that arose due to public health measures and restrictions. The aim of this study was to examine the experience of occupational disruption during pandemic and the consequences for mental health among women living in Croatia. In May 2020, 661 women completed an online questionnaire exploring changes to time spent engaged in various occupations, changes to the quality of occupational participation, and psychological health. While most participants experienced changes to daily occupations, these changes were not universal across occupational domains or for all participants. Cluster analysis revealed three unique groups: participants who reported poorer quality of participation in all domains; those who reported reduced quality in most domains, but stable or improved quality in leisure and outdoor occupations; and those who reported stable or improved quality in most domains. Participants in the first cluster exhibited significantly greater levels of anxiety, depression, and stress compared to the other two clusters, suggesting that greater occupational disruption was related to poorer mental health. This study is among the first to demonstrate the way in which the pandemic and measures used to restrict the spread of the virus have contributed to occupational disruption. Findings indicating the varying degrees to which this disruption was perceived and experienced by participants shed new light on factors that influence potential vulnerability or resilience to the effects of occupational disruption. Findings are consistent with existing work demonstrating the role of participation in maintaining health and emphasize the importance of preserving daily routines during pandemic.

Mental Health Symptoms and Workplace Challenges among Australian Paramedics during the COVID-19 Pandemic.

Background: Paramedics are vital to the health system response to the COVID-19 pandemic; however, the pressures on this workforce have been intense and challenging. This study reports on mental health symptoms and the working environment among Australian paramedics during the COVID-19 pandemic and explores their experiences of work and wellbeing during this time. Methods: An anonymous, online survey of frontline healthcare workers examined work environment, psychological wellbeing, and contained four open-ended qualitative items. Using a mixed method approach, quantitative data were analysed descriptively and qualitative data were analysed using content analysis. Results: This paper reports findings from 95 paramedics who provided complete quantitative data and 85 paramedics who provided free-text responses to at least one qualitative item. Objectively measured mental health symptoms were common among paramedics, and almost two thirds of paramedics self-reported experiencing burnout. Qualitative analysis highlighted key issues of safety and risk in the workplace, uncertainty and upheaval at work and at home, and lack of crisis preparedness. Qualitative analysis revealed four themes; ‘the pervasiveness of COVID-19 disruptions across all life domains’; ‘the challenges of widespread disruption at work’; ‘risk, uncertainty and feeling unsafe at work’, and ‘the challenges of pandemic (un)preparedness across the health system’. Conclusions: The COVID-19 pandemic resulted in considerable occupational disruption for paramedics and was associated with significant negative impacts on mental health. Findings emphasise the need for more adaptive working conditions, mental health support for paramedics, and enhanced crisis preparedness across the health system for future crises.

Impact of eating disorders on paid or unpaid work participation and performance: a systematic review and meta-analysis protocol

BackgroundEating disorders (ED) can reduce quality of life by limiting participation and performance in social and occupational roles, including paid or unpaid work. The association between ED pathologies and work participation and performance must be well understood to strengthen vocational rehabilitation programmes and prevent occupational disruptions in the ED population. The aims of this study are: (1) to examine the degree of association between ED pathologies and work participation and performance in 15-year-olds and older; (2) to highlight the specific ED symptoms that are most correlated with changes in work performance and participation; (3) to compile the most common metrics and assessments used to measure work participation and performance with ED.MethodsMedline, Embase, CINAHL, Web of Science, PsycINFO, and Cochrane Library will be searched for observational and experimental studies that meet the following criteria: (1) a clinical sample of typical or atypical ED; (2) paid or unpaid employment or training; (3) an association between ED pathologies and work participation or performance. Unpublished data will also be examined. Title and abstract, and full-text screening will be conducted in duplicate. Risk of bias and quality of evidence assessments will be completed. A random-effect meta-analysis will be performed.DiscussionThis synthesis can clarify knowledge and gaps around the impact of ED on work functioning, thereby allowing better evaluation, improvements and development of current workplace assessments, interventions, and policies.Trial registrationThe registration number for this systematic review on PROSPERO is CRD42021255055.

The Hall of Shame: Reconstituting Dominant Masculinities in The New York Times’ Representation of U.S. #MeToo Offenders’ Apologias

ABSTRACT In a powerful journalistic moment of 2018, The New York Times published the article, “After Weinstein: 71 Men Accused of Sexual Misconduct and Their Fall from Power.” It presented one collective effect of the #MeToo movement: a compendium of elite men compelled to leave their jobs due to their sexual misconduct. Shifting from the scrutinizing focus on survivors, the article created a hall of shame that placed the perpetrators and their abridged apologias in the spotlight. Using feminist rhetorical criticism and Benoit’s image repair theory, we argue that, while the article succeeds in highlighting the perpetrators’ occupational disruptions, the apologias reify antiquated understandings of gender and rape culture, illuminating the constitutive power of image repair rhetoric in reasserting toxic masculinity and rape logic in the #MeToo era. Moreover, we intervene in Benoit’s theory, which focuses on delineating the efficacy of strategies by which elites regain their influence. By offering a critical feminist apologiast approach, we compel critics to also interrogate the diachronic rhetorical and ideological scaffolding that benefits the interests of powerful, white, western, hetero-cis-male citizens while rendering the lives of the marginalized precarious and denying them cultural recognition.

Occupational disruptions during lockdown, by generation: A European descriptive cross-sectional survey

Introduction The periods of lockdown during 2020 led to changes in daily occupations. As participation relies on dynamic interactions between the person, his/her occupations and his/her environment, we wondered whether people from different generations shared the same perception of occupational disruptions during the lockdown. Methods We performed an online survey based on the Canadian Occupational Performance Measure (COPM) of adults in 27 European Union countries, the United Kingdom and Switzerland. Three groups were compared: young adults (YAs, aged 18–39), middle-aged adults (MAs, aged 40–59) and older adults (OAs, aged 60 and over). Results 2865 participants (YAs: 47%; MAs: 33%; OAs: 20%) reported a total of 6549 disrupted occupations. The most frequently disrupted domain was leisure (83%), followed by productivity (16%) and self-care (2%); there were no significant intergroup differences ( p = 0.18). In a multivariate analysis, socializing disruptions were more likely to be associated with younger age (adjusted odds ratio (OR) [95% confidence interval (CI)] = 0.62 [0.50–0.76] for YAs versus MAs and 0.46 [0.30–0.71] for YAs versus OAs. Conclusion With the exception of socializing, the main disrupted occupations were similar from one generation to another. Our findings might enable the more accurate assessment of the risk of occupational disruption in a restrictive environment.

Untapped sources of contextualized knowledge: Exploring occupational disruption during COVID-19 as showcased through YouTube parodies

ABSTRACT The COVID-19 pandemic led to stay-at-home mandates and lockdowns around the globe. During this time of occupational disruption and social distancing measures, many engaged through online environments. Social media are ever-increasing hosts of occupation and participation, rich with research opportunities. In this study, we explored COVID-19 experiences by analyzing parody videos posted on YouTube by various content creators. We analyzed the lyrics of 27 viral videos (accrued 1 million or more views) by 20 content creators. Using a transactional framework, we identified five themes related to occupational disruption in the lyrics and explored the polarity of the concepts within each theme: old norms vs. new normal, time expanded vs. time condensed, control seeking vs. lack of control, social isolation vs. excess socialization, and cynicism vs. hope. Our findings demonstrated the complex transactions between previous habits and routines, changing spaces of occupation, and meaning of daily occupations within evolving social, economic, and physical contexts. While this study showcased YouTube videos as one untapped source of contextualized knowledge for occupational science, there is a need for further exploration of methodological and ethical challenges of studying digital content.

Occupational Disruption during the COVID-19 Pandemic: The Lived Experience of Community-Dwelling Older Adults

Abstract This qualitative descriptive study presents the experience of an abrupt disruption of daily activities among community-dwelling older adults during the early months of the COVID-19 pandemic. Sixteen older adults (age: 71 ± 6.4) were interviewed in April–June, 2020. Five themes were identified: (1) Understanding and applying COVID-19 guidelines: guidelines were clear and participants adhered closely to them, motivated mainly by fear; ageing-specific guidelines are needed. (2) Daily life during lockdown: the abrupt occupational disruption was managed by transitioning to virtual activities, and/or performing more activities at home. New daily activities were generally more sedentary and less meaningful. (3) Social context: family assistance aroused mixed feelings, as it compromised independence; limited compliance at the community level created stress. (4) Mood and affect: mood often fluctuated, and participants employed various coping strategies. (5) Aging: participants became more aware of their age and were concerned about negative health implications of adherence to COVID-19 guidelines.

Occupational changes during the COVID-19 lockdown in Jordan

Background Measures to limit the spread of COVID-19 have disrupted the lives of countless millions of individuals worldwide. Objective To explore the experiences of occupational disruption and changing social roles among Jordanians during COVID-19 lockdown in 2020. The specific aim was to explore the changing occupations, routines, roles and coping strategies. Material and Methods This qualitative study used a digital ethnographic approach. Data collection included online observations of Jordanian’s posts of comments, photos and videos on six public Facebook pages during the COVID-19 lockdown for the initial 3-week period. In addition, 150 Jordanians participated in an online interview answering four open-ended questions to achieve triangulation. Qualitative analyses included open coding of the photos, videos and text as well as the interviews independently and blindly by the research team. Results Four themes were identified: changing daily occupations; changing family roles; missing pre-lockdown life and coping strategies under lockdown. Conclusion The COVID-19 lockdown restrictions caused direct, significant and immediate changes to Jordanians’ occupations, routines and roles; enforcing new obligatory occupations and eliminating desired ones. Significance Knowledge from this study highlight the kinds of strategies and supports during and after lockdowns that need to be considered in future planning of occupational therapy practice in Jordan.

Occupational Disruptions during the COVID-19 Pandemic and Their Association with Healthcare Workers' Mental Health.

Background: The COVID-19 crisis has caused prolonged and extreme demands on healthcare services. This study investigates the types and prevalence of occupational disruptions, and associated symptoms of mental illness, among Australian frontline healthcare workers during the COVID-19 pandemic. Methods: A national cross-sectional online survey was conducted between 27 August and 23 October 2020. Frontline healthcare workers were invited to participate via dissemination from major health organisations, professional associations or colleges, universities, government contacts, and national media. Data were collected on demographics, home and work situations, and validated scales of anxiety, depression, PTSD, and burnout. Results: Complete responses were received from 7846 healthcare workers (82.4%). Most respondents were female (80.9%) and resided in the Australian state of Victoria (85.2%). Changes to working conditions were common, with 48.5% reporting altered paid or unpaid hours, and many redeployed (16.8%) or changing work roles (27.3%). Nearly a third (30.8%) had experienced a reduction in household income during the pandemic. Symptoms of mental illness were common, being present in 62.1% of participants. Many respondents felt well supported by their workplaces (68.3%) and believed that workplace communication was timely and useful (74.4%). Participants who felt well supported by their organisation had approximately half the risk of experiencing moderate to severe anxiety, depression, burnout, and PTSD. Half (50.4%) of respondents indicated a need for additional training in using personal protective equipment and/or caring for patients with COVID-19. Conclusions: Occupational disruptions during the COVID-19 pandemic occurred commonly in health organisations and were associated with worse mental health outcomes in the Australian health workforce. Feeling well supported was associated with significantly fewer adverse mental health outcomes. Crisis preparedness focusing on the provision of timely and useful communication and support is essential in current and future crises.

Living with myalgic encephalomyelitis/chronic fatigue syndrome: Experiences of occupational disruption for adults in Australia

Introduction Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a poorly understood, highly stigmatised health condition that has widespread impacts on the individual. Currently, there is limited understanding of the ME/CFS experience from an occupational perspective within Australia. This study aimed to explore the lived experience of ME/CFS and subsequent disruption to occupational participation for adults living in Australia. Methods Using descriptive case study design, five participants with ME/CFS in Australia completed semi-structured interviews. Reflexive thematic analysis was used to analyse the qualitative data. Findings Themes identified were organised using the Person-Environment-Occupation model. Participants reported systemic changes to previous levels of physical, cognitive and affective functioning, resulting in significant occupational disruption and poor well-being. Occupational prioritisation was followed by a loss of occupations starting with leisure, then productivity and eventually self-care. Environmental barriers to participation included stigma and misunderstanding of ME/CFS, financial hardship, lack of appropriate health services and strains on personal support networks and relationships. Conclusion Changes to occupational performance following the onset of ME/CFS caused significant occupational disruption and resulted in limited participation which narrowed over time. There is a clear role for occupational therapy to intervene early to prevent significant negative impacts on occupational participation for people with ME/CFS.

Leisure and Productivity in Older Adults with Cancer: A Systematic Review.

Introduction Self-care, leisure, and productivity are important occupational domains for older adults' quality of life, which might be affected by cancer and its treatment. A great number of publications about older adults focus on function or self-care, so we aimed to analyse how cancer and its treatments affect leisure and productivity. Secondary objectives were to identify whether particular clinical and/or sociodemographic factors were associated with occupational disruptions and to assess the impact of rehabilitation approaches on leisure and productivity in this population. Methods A systematic review of the 2009-2019 literature performed on Medline, Embase, and the Cochrane Central Register of Controlled Trials. Results 1471 publications were retrieved: 48 full texts were assessed; seven of these (four cross-sectional studies, two cohort studies, and a case report) were reviewed, including data on 16668 people (12649 healthy controls, 3918 cancer survivors, and 101 ill patients). Older adults with comorbidities and a low level of activity before cancer diagnosis may be more at risk of occupational disruptions. However, studies focused more on physical activity than leisure and productivity. Two studies mentioned occupational therapy. Discussion. As cancer can become a chronic disease, it appears important to also offer occupation-centred assessments and follow-up. Conclusion An occupation-centred approach could be developed; its effectiveness must be assessed.

Occupational disruption during a pandemic: Exploring the experiences of individuals living with chronic disease

ABSTRACT The aim of this study was to explore the experiences of occupational disruption during a pandemic among individuals living with chronic disease, with particular attention to experiences related to managing disease(s) and routine healthcare. This qualitative descriptive study using virtual semi-structured interviews was conducted with 23 participants diagnosed with chronic disease(s) for at least 2 years, living in New Brunswick, Canada. Three overarching themes, and seven sub-themes emerged from the thematic analysis: 1) reactions (sub-themes: occupational loss and loneliness; fear and vulnerability); 2) adaptations (sub-themes: engaging in new or re-discovered occupations; prioritizing self-management; changing perspective); and 3) barriers (sub-themes: limited access to care; environmental challenges). Individuals living with chronic disease modified what they did to provide structure and purpose in response to restrictions imposed on their regular day-to-day occupations and the feelings this evoked. Notably, participants reported a heightened engagement in occupations focused on maintaining health and well-being; however, not all adaptations resulted in positive outcomes. Reactions such as fear and vulnerability influenced behavior and contributed to apprehension to seek out medical care. Changes in the environment also created barriers and challenged the participants’ ability to adapt. This research offers the first glimpse inside this occupational paradigm, to not only enhance understanding of the impact of COVID-19 on individuals living with chronic disease, but also to strengthen knowledge of what is needed to improve communication, organization, and the provision of care for individuals living with chronic disease both during a pandemic and in everyday life.

Impact of COVID-19 Pandemic in Filipino Occupational Therapy Practice Across Regions

The Philippine Government has implemented community quarantine throughout the country to respond to the COVID-19 pandemic that has since profoundly affected the lives, health, and well-being of individuals, families, and communities. This has also created an impact on the practice of occupational therapy in the country as the pandemic presents occupational disruptions in the new normal. This paper summarizes the current conditions of the practice of occupational therapy in times of the unprecedented disaster highlighted by the COVID-19 crisis and the situation of practitioners and recipients of service across the regions of the country. Findings conclude that there are: (1) emerging delivery service patterns, (2) consequences of COVID-19 to therapists, and (3) insights moving forward.

Typologies of coping in young adults in the context of the COVID-19 pandemic

The COVID-19 pandemic has created major upheavals in the lives of people worldwide. The virus has mostly affected elderly populations, but there may be corollary effects on young adults’ psychosocial adjustment due to educational, economic, and occupational disruptions. Using latent class analysis, we examined unique typologies of coping in response to the pandemic among young adults. We used an expanded set of indicators including traditional measures of problem- and emotion-focused coping as well as measures of resilience and coping flexibility. We also examined whether class membership could be predicted by demographics, stress appraisal, and psychosocial characteristics including catastrophic thinking and impulsivity. The sample of 1,391 young adults (ages 18–35) was recruited via Amazon’s Mechanical Turk (MTurk) and snowball methods from late-April to early-May 2020. Six classes were identified: (1) Resilient Flexible Problem-Focused Copers, (2) Resilient Inflexible Problem-Focused Copers, (3) Non-Resilient Flexible Problem-Focused Venters, (4) Non-Resilient Flexible Problem-Focused Copers, (5) Non-Resilient Flexible Non-Copers, and (6) Non-Resilient Inflexible Non-Copers. Using Class 1 as the reference class, we found perceived centrality and uncontrollability of the pandemic as well as catastrophic thinking and impulsivity were significant predictors of class membership. The mean levels of stress appraisal and psychosocial characteristics varied significantly between the classes, reinforcing the structural validity of these classes. The findings suggest the importance of training young adults to develop resilience and flexibility as well as specific coping skills that can help offset the psychological effects of dramatic lifestyle changes that may result from pandemics or other health crises in the future.

The Health-Related Quality of Life of South African Paediatric In-patients with Cancer

ABSTRACT Introduction : South African children with cancer are admitted to specialised oncology units for the duration of their treatment in the public health system. These units are thus a temporary environment for varying periods of time, which disrupts the children’s participation in daily activities and consequently their Health Related Quality of Life (HRQoL). Methodology: A quantitative, descriptive, cross-sectional study was conducted in a tertiary hospital with a specialist oncology unit in Gauteng to determine the HRQoL of children admitted with cancer from their own and their parent’s perspective. Structured interviews were conducted with the children aged 8-12 years using the PedsQL TM Generic Core Scale (4.0) and Cancer Module (3.0). The parent’s perspective was explored using the Parents proxies form of the PedsQL TM scales. Results : Twenty-five children and their parents participated in the study. Most children in the sample were males and Leukaemia and chemotherapy being the most common diagnosis and treatment received. All children and parents reported the children’s functioning at an intermediate level on the Generic Core Scale (4.0) and on the Cancer Module (3.0) that schooling and emotional functioning were most affected. This suggests that these children are at risk for HRQoL deficits. This study also found that parents under- and over-estimated their children’s HRQoL in various domains Conclusion : This study indicates the need for occupational therapists to understand the occupational disruption experienced by children during the treatment of cancer and monitor and provide support for this, to reduce the effect of impaired HRQoL.

COVID-19 and child development: educational material for family members

Abstract Objectives: to describe methodological procedures, theoretical foundation, activities and guidelines that compose an educational material designed for family members with a focus on the development of babies and children from 0 to 5 years old during the pandemic period. Methods: methodological research was applied to the preparation and validation of the educational material. The elaboration involved a literature review, graphic material creation and a validation by experts. Results: the literature review provided materials and background on child development principles and forms of stimulation through the realization of child occupations. The stage of validation by specialists provided a greater degree of reliability regarding the potential to stimulate activities and adequacy of the written elements of the material. Conclusions: the methods employed made it possible to develop, evaluate and improve the educational material, ensuring greater quality to guide and assist families in the daily stimulation of their children and in the management of occupational disruption. The material can also be useful for education and health professionals, support undergraduate education and/or university extension activities that focus on child development.

Heidegger and human occupation: An existential perspective

ABSTRACT Human occupation has long been a source of philosophical reflection. This article aims to revisit ideas of German philosopher Martin Heidegger, from the existential tradition, who explored questions around meaning of life and occupations as being central and not a separate entity. Heidegger’s core concept of Dasein, ‘inhabiting the world’, is discussed, having particular links to the richness of networks of meaning through accomplishment of occupations and all its intricacies. It also invites reflection when people face occupational disruptions that challenge living in an automatic way or built by external social “chatter” and diversions. Heidegger’s ideas can inspire occupational scientists to view meaningful occupations as a way of reflecting on one’s world or to embrace an occupational disruption as a journey to making consciously explicit our ‘Being-in-the-world’. Finally, it is a philosophical orientation that supports guiding persons in a transformative process of reconfiguring their occupational self embedded in their contexts.

OCCUPATIONAL MOBILITY AND CHRONIC ILLNESS IN LATE LIFE: A SYSTEMATIC REVIEW

Objectives: Occupational mobility at various stages in the life course may have a cumulative influence on health outcomes in later life. This study aims to (1) systematically review the association between occupational mobility and chronic illness in late life; and (2) identify potential mechanisms underlying this relationship. Methods: A systematic review of literature was carried out by searching two databases (PubMed and SocIndex) and reference lists. Eligible studies examined associations between occupational mobility and at least one measure of chronic illness among adults aged 50 years or above. Occupational disruptions (e.g., job loss) were reviewed as special cases of occupational mobility. Results: Downward occupational mobility and mid-life occupational disruptions have been consistently shown to predict higher risk of chronic illness in older adults. Several potential mechanisms were identified from the literature: (1) health behaviors, including dietary practices and alcohol consumption; (2) psychosocial factors, including stress, stigma, job control, job demands, and job satisfaction; (3) economic factors, including financial incentives or constraints; and (4) other individual characteristics, including personality traits and coping skills. There is also evidence that the timing of job mobility and the duration of (each) occupation modify the association between occupational mobility and health in late life. Discussion: These findings suggest that experiencing involuntary occupational mobility at various stages in the life course can increase the risk of chronic illness in late life. Health professionals and policymakers should target more resources to disadvantaged older adults who experience involuntary occupational transition.

Education of Teachers with Chronic Low Back Pain Based on Integrative Model of Behavioral Prediction

Background: Individuals suffering from chronic low back pain (CLBP) experience major physical, social, and occupational disruptions. Strong evidence confirms the effectiveness of Alexander technique (AT) training for CLBP. Objectives: The present study applied an integrative model of behavioral prediction (IM) to design AT training for education of teachers with CLBP. Methods: This was a quasi-experimental study conducted on female teachers with non-specific LBP in southern Tehran in 2014. The intervention group consisted of 42 teachers (AT training based on IM) and the control group included 35 teachers (AT training only). The validity and reliability of the 108-item AT questionnaire based on IM constructs were confirmed using content validity (CVR 0.87, CVI 0.96) and Cronbach’s α (0.84). Data were analyzed by Independent and Paired Sample t-test, Mann-Whitney U test, Wilcoxon, and covariance. Results: The results of the study indicated that AT behaviors, skills and abilities, direct and indirect perceived behavioral control, indirect subjective norms, direct and indirect attitude, and perceived risk were higher in the intervention group three months after the intervention (all P values < 0.05). Disability score (P < 0.001), hand to floor test (P = 0.023), and pain frequency (P = 0.022) showed a significantly higher reduction in the intervention group. Conclusions: The IM educational framework coupled with AT training may facilitate applying AT directions and finally, lead to pain reduction in CLBP.