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Online Advanced Release
Articles appearing in this "Online Advanced Release" section have been peer-reviewed and accepted for publication in the OTJR: Occupation, Participation and Health and posted online before print publication. Articles appear on this site after copyediting and author corrections, but before final proofing. The content of the article will usually remain unchanged, and possible further corrections are fairly minor. The final published article will specify the issue and page numbers. Once the final version is available in print, the version posted here will be removed from this site.
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Table of Contents
Belief in Doing and Knowledge in Being Mothers With Arthritis
Linda Del Fabro Smith, MSc, BSc(OT); Melinda Suto, PhD, OT(C); Andrew Chalmers, MD; Catherine L. Backman, PhD, OT(C)
Submitted 2/19/09; Accepted 12/1/09; Posted 2/25/10
The aim of this qualitative study was to provide insight on how mothers with inflammatory arthritis experience mothering occupations in the presence of arthritis and how this experience affects participation and occupational identity. Narrative inquiry explored the experiences of eight mothers with inflammatory arthritis who had children younger than 14 years. Data collection included two interviews, participant observation, and document review. Analysis focused on each full account as told by participants before comparing stories to develop an overarching storyline. Storylines are presented as narratives that describe the mother’s experiences of identifying with the role of mother, participation, fatigue, and the social context in which mothering occurs. “Just because I can’t do, doesn’t mean I’m not a mom” emerged as the main storyline. Belief in doing and knowledge in being mothers offset many of the negative effects of arthritis.
doi: 10.3928/15394492-20100222-01
[get full text]
Convergent Validity of the Engagement in Meaningful Activities Survey in a College Sample
Aaron M. Eakman, PhD, OTR/L
Submitted 7/9/09; Accepted 10/29/09; Posted 1/26/10
The Engagement in Meaningful Activities Survey (EMAS) (Goldberg, Brintnell, & Goldberg, 2002) demonstrated sufficient psychometric properties in a sample of 122 adults. The EMAS was found to have adequate test–retest (r = .71) and internal consistency (α = .88) reliability; significant positive correlations between the EMAS and the subscales of the Basic Psychological Needs Scale and the Sources of Meaning Profile and negative zero-order correlations were found with short form versions of the Boredom Proneness Scale and the Depression, Anxiety, and Stress Scales. Step-wise multiple regression analysis results showed the Sources of Meaning Profile, Boredom Proneness Scale, and Competence subscale of the Basic Psychological Needs scale best predicted the EMAS. These results lend additional construct validity evidence in support of the EMAS as a brief measure of meaningful activity participation. [get full text]
The Home and Caregiving: Rethinking Space and Its Meaning
Rachel Mayes, BAppSc (OT) Hons, PhD; Rosemary Cant, BEd(Hons), Med(WA), PhD(N’cle); Lindy Clemson, BAppSc (OT), MAppSc (OT), PhD
Submitted 3/26/09; Accepted 9/6/09; Posted 1/26/10
Occupational therapists are routinely engaged in the homes of their clients with disabilities, providing consultation on the use and modification of space to improve functional independence. The meaning of home space is currently underexplored. This study describes the meaning and use of home space for mothers who are primary caregivers for a child or adolescent with disabilities and high support needs. This article reports data from two empirical studies of mothers of children and adolescents with disabilities. In-depth interviews were conducted with 80 mothers across the two studies. Interview transcripts were analyzed with a grounded theory approach. Access around the home for a family member with disabilities allowed mothers to combine caring with other home management activities. However, preventing access or excluding the family member with a disability from some areas of the home enabled the mothers to resist the medicalization of their homes and create a personal space for themselves. Full access to the home for the child with disabilities was rarely a desirable outcome. Decisions about the home and how it should be modified to improve function become more complex when the needs of family members are taken into account. Meaning ascribed to space within the home is integral to how the space is used and whether a family member with a disability is included or excluded from the space. For occupational therapists, the meaning that clients and their families ascribe to various spaces within the home is as important as the use of space. [get full text]
Reliability and Validity of the Health Enhancement Lifestyle Profile (HELP)
Jengliang Eric Hwang, PhD, OTR/L
Submitted 6/22/09; Accepted 9/18/09; Posted 12/25/09
The Health Enhancement Lifestyle Profile (HELP) is a self-report measure for examining various aspects of health-related lifestyle in older adults through seven scales (Exercise; Diet; Work, Education, and Social Participation; Leisure; Activities of Daily Living; Psychological Wellness and Spiritual Participation; and Other Health Promotion and Risk Behaviors). The current study examined the reliability and validity of the HELP scales through classic test theory. The resultant alpha coefficients ranged from .75 to .92 among the scales, indicating acceptable to good internal consistency reliability. Construct validity was also supported by the interrelationships found among the HELP scales and the statistically significant correlations shown between HELP results and global health status (i.e., number of chronic conditions, self-related health). HELP scales can help occupational therapists identify and monitor health promotion occupations and risk behaviors and measure the outcome of services aimed at promoting healthy lifestyles in older adults. [get full text]
Falls Self-Efficacy Among Adults With Multiple Sclerosis: A Phenomenological Study
Elizabeth W. Peterson, PhD, OTR/L, FAOTA; Gary Kielhofner, DrPH, OTR/L, FAOTA; Kerstin Tham, PhD, OT reg; Lena von Koch, PhD, RPT
Submitted 4/16/09; Accepted 9/18/09; Posted 11/25/09
This phenomenological study explored and described the lived experience of falls self-efficacy (i.e., perceived self-efficacy in avoiding a fall during basic activities of daily living) among six individuals with multiple sclerosis and its relationship to their overall volition and occupational lives. Participants were interviewed three times over a 3-month period. All interviews were analyzed using the Empirical, Phenomenological, Psychological method. One main theme (managing fall risk as a means of supporting activity) and six subthemes were reflected in participants’ lived experiences: (1) understanding personal multiple sclerosis symptoms, abilities, and fall risk; (2) accepting one’s changed capacity; (3) focusing on what you can control; (4) ongoing learning by doing; (5) vigilance while doing; and (6) taking personal responsibility to reduce fall risk. The findings show how falls self-efficacy operates as part of a larger volitional process and can be used to inform the development of fall prevention programs for individuals living with multiple sclerosis. [get full text]
The Meaning of Occupational Gaps in Everyday Life in the First Year After Stroke
Gunilla Eriksson, OT, PhD; Kerstin Tham, OT, PhD
Submitted 1/8/09; Accepted 9/6/09; Posted 11/25/09
This longitudinal study identified how occupational gaps were characterized in people’s lived experiences of performing everyday occupations during the first year after stroke. Four participants were interviewed four times during the year after stroke. The data were collected and analyzed using the Empirical, Phenomenological, Psychological method. Five main characteristics were identified: (1) encountering occupational gaps in formerly taken-for-granted activities, (2) striving to narrow gaps in desired occupations, (3) recognizing oneself in doing, (4) searching for a new sense of self through doing, and (5) creating strategies to enable doing. The findings show the importance of being able to preserve some sense of self in everyday doings after a life course disruption caused by stroke. Important implications for clinical practice include sensitivity to clients’ experiences during this process, enablement of experiences in occupations promoting recognition, and support of clients in recapturing desired occupations. [get full text]
Predictors of Research Utilization Among Pediatric Occupational Therapists
Ted Brown, PhD, MSc, MPA, BScOT (Hons), OT(C), OTR, AccOT; Mei Hui Tseng, ScD, OTR; Jacqueline Casey, MSc, BSc (Hons) OT, PgCHEP; Rachael McDonald, PhD, PGDip(Biomech), BAppSc(OT); Carissa Lyons, Bpsych
Submitted 3/14/09; Accepted 7/22/09; Posted 10/26/09
Evidence-based practice and research utilization activities by clinicians enable clients to receive the best, most current health care available. This study investigated the factors predicting pediatric occupational therapists’ attitudes toward evidence-based practice and research utilization in Australia, the United Kingdom, and Taiwan. Questionnaires were received from 696 participants (response rate = 56.58%) who completed the Edmonton Research Orientation Survey (EROS), the Research Knowledge, Attitudes and Practices of Research Survey (KAP Survey), and the Barriers to Research Utilization Scale (BARRIERS). The results of the multiple linear regression analysis indicated the strongest predictor of research utilization was “level of academic occupational therapy qualification,” which was found to be predictive of all of the EROS subscales. The second EROS subscale, “research involvement,” had the largest number of predictive factors. To increase research utilization among pediatric occupational therapists, it is important to be mindful of which aspects of research require improvement so that strategies with the greatest impact and influence can be implemented. [get full text]
Place Integration Through Daily Activities 1 Year After Stroke
Anette Erikson, OT, Lic. Degree in Med.; Melissa Park, OTR/L PhD; Kerstin Tham, OT, PhD
Submitted 5/18/08; Accepted 6/25/09; Poster 9/25/09
Actions link meaning to particular places over time. This study examined how familiar places, in turn, inspired or influenced actions in the rehabilitation process for individuals who had experienced stroke. The aim of this study was to describe the meanings of actions in different places during 1 year of rehabilitation after stroke. The interview data were longitudinal and collected on four occasions during the first year after stroke (e.g., at 1, 3, 6, and 12 months). Seven themes emerged from the data analysis using a constant comparative method: (1) workplace in mind, (2) experiences at home enabling reflection, (3) rehabilitation setting creates uncertainty, (4) retrieving inspiration from familiar places, (5) matching the complexity of tasks across places, (6) understanding the reality by confrontation, and (7) on the way to place integration. From these themes, a core or overarching theme emerged: the desire for place integration inspires engagement in rehabilitation. The central finding in this study revealed a strong relationship between the desire to be reintegrated into familiar places, such as work and home, and motivation to engage in rehabilitation. Further, this desire for place integration was a constant driving force over the year that motivated the participants to find activities on their own that matched the task demands at their workplaces. [get full text]
Occupation and Meaning: Narrative in Everyday Activities of Women With Chronic Rheumatic Conditions
Sissel Alsaker; Staffan Josephsson, PhD, OTR
Submitted 10/30/08; Accepted 6/7/09; Posted 8/25/09
This ethnographic study explored how processes of meaning take place in the everyday activities of women with chronic rheumatic conditions. Using the French philosopher Ricoeur's theory of narrative in action, the results showed how processes of meaning were closely linked to action and how the participants enacted possible meaning-related stories in their everyday lives. When enacting meaning, the women linked together events in ways that varied according to the situation. Thus, the enacted processes of meaning were not goal directed or clear but rather complex processes embedded in the women's network of cultural activity. Sometimes they enacted meaning as part of a complete story; at other times, meaning appeared as fragments with unclear connections. The results were relevant for occupational science and occupational therapy because the women's everyday activities functioned as interpretative spaces providing opportunities for "trying out" significant issues of meaning and to communicate with their social and material worlds. [get full text]
Hands-On Learning Versus Learning by Demonstration at Three Recall Points in University Students
Morna Kathleen Hearns, MOT, OTR/L; Barbara Kopp Miller, PhD; David L. Nelson, PhD, OTR/L, FAOTA
Submitted 2/28/09; Accepted 5/4/09; Posted 8/25/09
This randomized study compared the effect of two teaching/learning methods (hands-on versus demonstration) on immediate, 15-minute, and 24/48-hour recall in 60 university students. Each student either made no-bake cookies or observed the demonstrated process. Inter-rater reliability concerning recall scores was strong (intraclass correlation coefficient = .98). Analysis of variance across all three levels of recall supported the hands-on condition (F [1,58] = 4.45, p = .039). However, only one of the three t tests (recall at 24/48 hours) comparing hands-on learning to demonstration at the three points of recall, was statistically significant (t [58] = 2.48, p = .008, with effect size d = .648). Generally, the results are consistent with occupational therapy theory, but the lack of a statistically significant difference in terms of immediate recall requires probing as to the meaningfulness of the occupational form to the particular individuals being observed. Meta-analysis of various studies investigating this important principle of occupational therapy is needed to clarify the results of this study in the context of other related studies. [get full text]
No One Dresses Accidentally: A Research Synthesis on Intentional Occupational Performance
Jeffrey L. Crabtree, MS, OTD, FAOTA
Submitted 11/2/08; Accepted 4/4/09; Posted 7/25/09
The fields of philosophy, psychology, and neuroscience have differing but comparable perspectives on intention. Taken together, these perspectives help explain intentional occupational performance. This rich body of research and theory also offers insight into the critical role of intention in the therapeutic use of occupation. This synthesis examines these perspectives of intention as they relate to the concept of occupational performance and discusses the implications of intention for the therapeutic use of occupation, which ultimately include the need for occupational therapists to renew their professional focus on occupation as their single level of intervention. [get full text]
Exploring Occupational Balance in Adults With Rheumatoid Arthritis
Mary Forhan, MHSc.BSc.OT Reg (Ont); Catherine Backman, PhD, OT(C), FCAOT
Submitted 12/12/08; Accepted 3/25/09; Posted 6/25/09
Chronic illness disrupts participation in daily living. The objective of this study was to identify factors associated with three indicators of occupational balance: perceived satisfaction with performance of one’s primary occupation, the balance of time spent on occupations, and daily achievements. One hundred sixty-nine adults (78% women) with rheumatoid arthritis completed the Occupational Questionnaire and a survey of health and functional status. Using multiple linear regression, general health status was a significant predictor of all three indicators of occupational balance. Self-efficacy with respect to arthritis symptoms, work limitations, and self-care ability were additional predictors of satisfaction with achievements; social function, pain, and work ability were additional predictors of satisfaction with performance; and the proportion of time spent in occupations deemed as enjoyable was an additional predictor of satisfaction with balance of time spent across occupations. Study results provide support for emerging models of occupational balance as a multidimensional concept. [get full text]
Aaron M. Eakman, PhD, OTR/L; Mike E. Carlson, PhD; Florence A. Clark, PhD, OTR/L
Submitted 12/22/08; Accepted 3/19/09; Posted: 5/25/09
This study evaluated the psychometric properties of the Engagement in Meaningful Activities Survey (EMAS) (Goldberg, Brintnell, & Goldberg, 2002) in a sample of older adults living in the greater Los Angeles area. The EMAS evidenced moderate test–retest reliability (r = .56) and good internal consistency (α = .89). Exploratory factor analysis (principal components) discerned a two-component structure within the EMAS, indicative of Personal–Competence and Social–Experiential meaning. The EMAS demonstrated theoretically predicted zero-order correlations with measures of meaning and purpose in life, depressive symptomology, life satisfaction, and health-related quality of life. Regression analyses discerned that purpose and meaning in life consistently predicted the EMAS and its components. Furthermore, individuals reporting greater levels of Social–Experiential relative to Personal–Competence meaning had the lowest levels of physical health-related quality of life. This study offers initial evidence in support of the EMAS as a valid measure of meaningful activity in older adults. [get full text]
Empathy in the Play of Children With Attention Deficit Hyperactivity Disorder
Reinie Cordier, BSocSc Hons (Clin Psych), MoccTher; Anita Bundy, ScD, OTR, FAOTA; Clare Hocking, PhD, MHSc(OT); Stewart Einfeld, MD, DCH, FRANZCP
Submitted: 9/10/08; Accepted 2/18/09; Posted: 5/25/09
Many children with attention deficit hyperactivity disorder (ADHD) have serious social and peer difficulties that can lead to adverse outcomes in adolescence and adulthood. Play provides a natural context to explore those interactional problems. This study aimed to examine the similarities and differences in play behavior of children as having ADHD and typically developing children. Participants were children (aged 5 to 11 years) diagnosed as having ADHD (n = 112) and typically developing peers (n = 126) who were matched based on age, ethnicity, and gender. The Test of Playfulness (ToP) was used to measure play. Children with ADHD performed similarly to typically developing peers on ToP items that related most directly to the primary symptoms of ADHD but scored significantly lower on several ToP social items; however, they also scored higher on one difficult social item and no differently on two others, suggesting that the problems may be developmentally inappropriate lack of empathy rather than simply poor social skills. [get full text]
Elizabeth Larson, PhD, OTR
Submitted 12/9/08; Accepted: 2/18/09; Posted: 4/29/09
This study examines how meanings of caregiving occupations differ between caregivers of children with disabilities with high versus low self-rated psychological well-being. Thirty-nine caregivers completed in-depth interviews about their caregiving and Psychological Well-being Scales. A nonparametric test confirmed that differences in well-being were not associated with income, education, or depressive symptoms. The qualitative analysis revealed one global meaning dimension for caregiving (broadening of self, family, and world) and five situational level meaning dimensions of caregiving (intensity of caregiving, diminished personal control, perspective on caregiving demands, depth of conviction about the value of this life course, and present dwelling). For the global meaning and one dimension (broadening of self and personal control), triangulation between a relevant scale and the qualitatively generated dimension confirmed qualitative findings of differences between the high and low well-being groups. Findings suggest that 75% of caregivers describe frequently challenging caregiving demands. Those with self-rated high well-being construct a more positive view of the meaning of this experience that bolsters their capacity to engage in caregiving work. [get full text]
Debbie Laliberte Rudman, PhD, OT Reg. (ON); Suzanne Huot, MA; Lisa Klinger, MSc., OT Reg. (ON); Beverly D. Leipert, PhD, RN; Marlee M. Spafford, OD, PhD, FAAO
Submitted: 9/22/08; Accepted: 12/23/08; Posted 3/25/09
The primary aim of this descriptive phenomenological study was to describe the core aspects of living with low vision in later life among older adults (aged 70 years and older) who had not accessed rehabilitation services for low vision. Thirty-four older adults from urban and rural areas participated in a semi-structured qualitative interview and a telephone follow-up. Drawing on an occupational science perspective and using Giorgi and Giorgi’s (2003) method of analysis, the essence of the experience of living with low vision was identified as struggling to maintain valued and necessary occupations while dealing with risk. Additional themes included enhanced sense of risk, striving for independence, and shrinking physical and social life spaces. Findings are interpreted in relation to occupational adaptation and environmental influences on occupation, and implications for the role of occupational therapists are discussed. [get full text]
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