Influence of Occupation on Health and Well-Being in Adults (Part II) ~ Page 1 of 18
Wilma L. West Library Resource Notes
Influence of Occupation on Health and Well-Being in Adults
August 2003
As promised, here is the second half of:
Link between Activities, Occupation and/or role engagement
and Health or Quality of Life
References from 1990
Selected from OT SEARCH, July 18, 2003 and August 19, 2003
Aubin, G., Hachey, R., & Mercier, C. (1999). Meaning of daily activities and subjective quality of life in people with severe mental illness. Scandinavian Journal of Occupational Therapy, 6, 53-62.
The occupational therapy services for adults with severe and persistent mental illness are concerned with their quality of life. A correlational study explored the relationship between the meaning of daily activities and the subjective quality of life of this group of people. In this study, the meaning of activities was defined by three elements, related to the Human Occupation Model: perceived competence, value and pleasure, measured by the Occupational Questionnaire. The Wisconsin Quality of Life-Client Questionnaire provided a global score for the subjective quality of life. A total of 45 people with severe and persistent mental illness, living in downtown Montreal, participated in a semi-structured interview. The results suggest that perceived competence in daily tasks and rest, and pleasure in work and rest activities are positively correlated with subjective quality of life. The influence of occupation and its meaning on quality of life, an occupational therapy assumption, is supported by these results. It also supports occupational therapists' interventions with these clients when aiming to help develop their sense of competence and their enjoyment in the performance of activities.
Baum, C.M. (1995). The contribution of occupation to function in persons with Alzheimer's Disease. Journal of Occupational Science: Australia, 2, 59-67.
Occupation is known to play an important role in the maintenance of health. No study has explicitly explored the role that occupation (defined as continued engagement in instrumental, leisure and social activities) plays in the maintenance of self care skills and management of disturbing behaviors in individuals with dementia of the Alzheimer's type (DAT), nor has the relationship of memory, executive skills, and occupation been studied in this population. Seventy two couples, one spouse with DAT, were studied to explore these relationships and the role that occupation plays in their function. Individuals who remained active in occupation demonstrated fewer disturbing behaviors, required less help with basic self care, and their carers experienced less stress. Theoretical implications of findings are discussed.
Bedell, G. (1998). Finding balance: The daily lives of urban gay men with HIV/AIDS. New York, New York: New York University. (Doctoral Dissertation)
This study explored what daily life was like for eight gay men with HIV/AIDS living alone in New York City. Information about their daily life experiences was collected and analyzed using qualitative research methods. Data was collected using in-depth interviews and observations of the participants' home environments. This data was recorded and stored in a field log, which included interview transcripts, field notes and analytic memos. Constant-comparison and thematic analysis was used to identify categories and themes from the data that elucidated the participants' individual and shared daily life experiences. Four major themes and one overarching metatheme, "It's About Finding Balance in My Life," emerged from data analysis. The participants described the importance of having adequate financial resources and social supports. They also had to reconstruct their daily activities and routines due to HIV/AIDS-related factors. Work and the redefinition of work had a significant influence on the participants' lives. Activities that involved sharing something of themselves to others had become important such as establishing intimate relationships, doing creative projects, or helping sick friends or others in the community. Daily life entailed dealing with vast amounts of symptoms, treatments, side effects, information, and services. Dealing with fears, uncertainties, loss, and stigma was clearly a part of living with HIV/AIDS as well. The participants described some common and diverse experiences in their lives related to being gay men with HIV/AIDS such as disclosing their sexual orientation and HIV status, coming to terms with HIV/AIDS, caring for sick friends or lovers, and attending many funerals and memorial services. There were numerous examples of their attempts to find balance in their lives. This was illustrated by paying attention to physical and emotional signs of health and illness, modifying activities and life goals, managing resources, letting others help, and rethinking what they needed or wanted to do on a daily basis. The implications these findings have for consumers and health professionals were discussed in relation to service delivery, and assisting individuals with HIV/AIDS and other chronic illness with finding and maintaining balance in their lives.
Carlson, M., Clark, F. & Young, B. (1998). Practical contributions of occupational science to the art of successful ageing: how to sculpt a meaningful life in older adulthood. Journal of Occupational Science, 5, 107-118.
Given that the longevity revolution has already arrived and will continue to flourish in the upcoming decades, Western societies are confronted with the urgent challenge of promoting the goal of successful ageing for untold millions of citizens. With regard to this goal, current thinking points to the optimistic conclusion that potentially controllable lifestyle factors play a crucial role in enabling people to experience health and satisfying lives well into older adulthood. In this paper, the importance of occupation as providing a fundamental, personally relevant context for the enactment of sustainable lifestyle choices that foster successful ageing is described. This stress on the significance of occupation is supported by the successful outcome of an experimental test of a preventive occupational therapy intervention designed to promote health and psychosocial well-being in community dwelling elders. Based on the theory and research that is discussed, a practically oriented synthetic overview is provided of the conditions conducive to successful ageing.
Christiansen, C.H. (2000). Identity, personal projects and happiness: self construction in everyday action. Journal of Occupational Science, 7, 98-107.
This study reviewed archival data from 120 adults ages 19-79 in order to explore the identity-related dimensions of their personal projects. Influenced by recent findings in action psychology that suggest a key link between the identity dimensions of projects, and both meaning and happiness or subjective-well being (SWB), it was hypothesized that project ratings on various dimensions would show the central influence of self-identity within project systems and significantly predict SWB. Analysis of factors extracted from project dimensions revealed that projects influence happiness based on their beneficial impact and their ability to enable self-expression, demonstrate social significance, and reflect confidence. The challenge offered by a project and the overall effort required completing it also account for variance in measures of well-being. For the overall sample, the self-expression factor emerged as a significant predictor of SWB. When individual sub samples grouped by age were analyzed, different patterns emerged. Only the perceived social significance of projects emerged as a predictor of SWB in all three age groups. Additional analyses designed to explore the project dimensions of integrity (being genuine) and efficacy (getting the job done) were also conducted. These also showed differences among the subgroups, which were interpreted in light of developmental theories of adulthood. Overall, the findings supported a constructionist view that goal directed projects provide important opportunities for shaping identity.
Christiansen, C.H., Backman, C., Little, B.R., & Nguyen, A. (1999). Occupations and well-being: a study of personal projects. The American Journal of Occupational Therapy, 53, 91-100.
OBJECTIVE. The purpose of this study was to explore the relationship between occupation and subjective well-being (SWB). METHOD. A convenience sample of 120 adults completed a personal projects analysis, a method of rating their current goal-directed pursuits. They also completed measures of SWB (Affect Balance Scale, Life Satisfaction Index Form A) and personality traits (Myers-Briggs Personality Inventory). Characteristics of personal projects were correlated with SWB scores. Multiple regression analysis was used to investigate possible predictors of well-being from among the characteristics of personal projects, personality traits, and demographic variables. RESULTS. The stress associated with personal projects was significantly and inversely correlated with well-being, as was project difficulty. Perceived progress in completing projects was significantly positively correlated with well-being. The strongest predictors for well-being were the composite project factors of stress and efficacy. Two personality traits, sensing and extraversion, interacted with the project dimension of stress to emerge as significant predictors of well-being. Together, these four variables explained 42% of the variance in well-being scores. CONCLUSION. These findings are consistent with assumptions that attributes of meaningful occupations are significantly related to people's perceived well-being.
Clark, F. (1997). Reflections on the human as an occupational being: biological need, tempo and temporality. Journal of Occupational Science: Australia, 4, 86-92.
Global health through occupation is contingent upon our understanding of the human as an occupational being. In this paper, I reflect upon two aspects of the human as an occupational being: 1) the biological need for occupation, and 2) tempo and temporality as a way of beginning to generate a blueprint for global health. Wilcock's theory on the human need for occupation proposes that people living in post industrial nations are diverted from engagement in occupations that function to meet biological needs. The theory largely addresses the issue of what kinds of occupations are likely to be health promoting, given a set of assumptions about the history of humans as occupational beings. On the surface it would appear that occupations that resemble those of prehistoric men and women would be optimal for promoting health and well-being, but these kinds of occupations are largely unsuitable for incorporation into contemporary lifestyles. Yet, there are elements from prehistoric occupations that can be recaptured in contemporary activity, and I speculate on the form such occupation might take as a way of addressing the general question of what kinds of occupations are likely to be health promoting. The beginning blueprint for global health through occupation must also take into account the nature of occupational beings in relation to tempo and temporality. I argue that there is an intersection between tempo and temporality. The tempo of occupation is simply defined as its pace and rhythm. Temporality, in contrast, has to do with how we understand occupation in relation to past, present and future events. When life is rushed as it is in the fast lane of modernity, the result can be the forgetting-of-being, or stated otherwise, doing without being. I suggest that a healthier people and a healthier world could result from a blueprint generated through occupational science research that identifies the patterns of occupation that are likely to be maximally health promoting and the pace at which they should be undertaken.
Clark, F., Carlson, M., Zemke, R., Frank, G., Patterson, K., Ennevor, B.L., Rankin-Martinez, A., Hobson, L.A., Crandall, J., Mandel, D., & Lipson, L. (1996). Life domains and adaptive strategies of a group of low-income, well older adults. The American Journal of Occupational Therapy, 50, 99-108.
Older adults are at increased risk for a variety of physical and functional limitations that threaten their ability to lead independent and fulfilling lives. Consequently, they stand to benefit from personalized strategies of adaptation that enable them to achieve successful outcomes in their daily activities and desired goals. In the current investigation, a qualitative descriptive methodology was used to document the perceived life domains of importance and associated strategies of adaptation of 29 residents of Angelus Plaza, a federally subsidized apartment complex in downtown Los Angeles for low-income, well older adults. On the basis of interview data, 10 life domains were identified, and within each domain, a typology of adaptive strategies was derived. The domains were activities of daily living (ADL), adaptation to a multicultural environment, free time usage, grave illness and death - spirituality, health maintenance, mobility maintenance, personal finances, personal safety, psychological well-being and happiness, and relationships with others. Although the typology should not be generalized to a geriatric population, therapists may wish to refer to it to gain a sense of the extent to which certain adaptive strategies may be applicable to the lives of particular older adults to whom they deliver services. The teaching of these adaptive strategies could then be incorporated into an individualized treatment plan. The typology also provides a broad picture of the kinds of adaptive strategies used by the older adults as a way of coping and adapting to their setting. Although some of the domains do not differ from those typically addressed in occupational therapy textbooks on geriatric care (e.g., ADL, health maintenance), others seem uniquely tailored to the specifics of the Angelus Plaza context (e.g., personal safety). Finally, certain domains emerged that may be highly relevant to older adults in most settings but are not typically the focus of occupational therapy programs (e.g., grave illness and death - spirituality, relationships with others). The emergence of these domains from our data suggests that therapists may wish to consider them more in treatment if they are convinced that they possess local relevance.
Classen, S. (2001). The long-term effectiveness of two occupational therapy interventions on the lives of people MS: A randomized controlled trial. Ft. Lauderdale FL: Nova Southeastern University. (Doctoral Dissertation)
Statement of the Problem: Multiple sclerosis (MS) is the most common demyelinating disease of the central nervous system. It affects over 2.5 million people worldwide and approximately 350,000 Americans with new cases diagnosed weekly. MS significantly impacts activity participation, general health status, and quality of life. An extensive literature review reveals a gap in the rehabilitation programs or occupational therapy wellness programs to improve the activity participation, general health and well-being, and quality of life for people living with MS. Methods: This randomized controlled trial (RCT) compared the long-term impact of an occupational therapy rehabilitation program, an occupational therapy wellness program, and a social activity program (control), on the occupational performance, general health and well-being, and quality of life of people living with MS, through repeated measures. Assessment tools used to measure occupational performance, general health and well-being and quality of life were the Occupational Self-Assessment, the SHORT Form-36 version 2 and the Quality of Life Inventory. Quality of life is a primary outcome in the provision of healthcare services for the chronically ill, and is the predominant measure in this clinical research, hence the choice of these assessment tools. Results: The effect of each of the group programs, rehabilitation, wellness and a social activity group was compared. Data were analyzed with MANOVA. The results yielded that the occupational therapy wellness group demonstrated a statistically significantly positive difference in the mental component summary measure of the SF-36v2 over the occupational therapy rehabilitation group (p=.093), two months post intervention. The results further revealed that the occupational therapy wellness group demonstrated a statistically significantly positive difference in the environmental impact scale of the OSA over the occupational therapy rehabilitation group (p=.15) and the social activity group (p=.065), over a period of three months. Conclusions: In this study an occupational therapy wellness approach showed statistically significantly positive effects on the environmental impact and mental health of people with MS over the long-term. This study also demonstrated the clinical significance associated with an occupational therapy rehabilitation and an occupational therapy wellness approach. These findings therefore contribute to evidence-based practice for the most effective occupational therapy interventions for persons with MS.
This study was supported by grant #NSU012001 from the National Sclerosis Foundation and the Nova Southeastern University President's Scholarship Award 2001.