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Occupational Performance in Individuals with Severe Mental Disorders: Assessment and Family Burden
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
2002 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of the present thesis was three-fold. The first was to study occupational performance in individuals with severe mental disorders and their experiences of occupational therapy, the second to study experienced burden of family caregivers and the third to test the validity and the homogeneity of assessment tools in this area. The samples consisted of individuals with severe mental disorders participating in organised occupations (n= 112), occupational therapy records (n=64), occupational therapists working in mental health care (n=7) and family caregivers of individuals with severe mental disorders (n=256). Data were collected by questionnaires, structured and narrative interviews, observations and occupational therapy records. Individuals with severe mental disorders reported problems related to leisure and work activities and the occupational therapists recorded problems concerning how to organise and structure occupational performance. Individuals functioning on a high cognitive level experienced problems related to work and productive activities. Participation in occupational therapy strengthened their confidence in their own ability. The “Experience of Occupational Performance Questionnaire” (EOPQ) was developed from data on the experiences of women participating in occupational therapy. A principal component analysis gave seven factors with acceptable homogeneity. There is a need for assessment tools to evaluate occupational therapy. The EOPQ represents an attempt to fulfil this need. Family caregivers experienced limitations of daily activities as a burden. The ability to perform daily activities was studied from three perspectives, the individuals’, the occupational therapists’, and the experienced burden of the family caregivers. These perspectives are complementary and thus necessary for planning and implementation of individually adapted occupational therapy as well as for the evaluation of outcomes.

Place, publisher, year, edition, pages
Uppsala: Uppsala University, Tryck & Medier , 2002. , 41 p.
Series
Comprehensive summaries of Uppsala Dissertations form the Faculty of Social Sciences, ISSN 0282-7492 ; 118
Keyword [en]
Mental disorders, occupational performance, activities in daily life, factor analysis.
National Category
Social Sciences
Research subject
Occupational therapy
Identifiers
URN: urn:nbn:se:oru:diva-37423ISBN: 01-554-5432-1 OAI: oai:DiVA.org:oru-37423DiVA: diva2:751914
Public defence
2002-11-08, Uppsala, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2014-10-21 Created: 2014-10-02 Last updated: 2016-12-06Bibliographically approved
List of papers
1. The meaning and form of occupational therapy as experienced by women with psychoses: A phenomenological study
Open this publication in new window or tab >>The meaning and form of occupational therapy as experienced by women with psychoses: A phenomenological study
2002 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, no 1, 103-110 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to illuminate the experiences of occupational therapy interventions in individuals with psychoses. Repeated tape-recorded narrative interviews were conducted with six women participating in occupational therapy immediately after an intervention. The subsequent analyses followed a phenomenological approach. Key constituents integrated in two structures, are the main ®ndings. The meaning of occupational therapy as expressed in the key constituents relief, selfknowledge, belief in the future, capability, resistance and satisfaction formed one structure. The form of occupational therapy as expressed in the key constituents time, environment, guidance, voluntariness and collaboration represented the other structure. These ®ndings con®rm and give empirical support to beliefs and assumptions expressed in occupational therapy literature. The results form a conceptual base for developing an evaluative assessment instrument for individuals with psychoses participating in occupational therapy.

Place, publisher, year, edition, pages
Oxford: Blackwell, 2002
Keyword
occupational therapy, individuals with psychoses, phenomenology
National Category
Nursing
Research subject
vårdvetenskap
Identifiers
urn:nbn:se:oru:diva-6032 (URN)10.1046/j.1471-6712.2002.00064.x (DOI)
Available from: 2009-03-18 Created: 2009-03-18 Last updated: 2014-10-21Bibliographically approved
2. The factor structure of the Burden Assessment Scale and the perceived burden of caregivers for individuals with severe mental disorders
Open this publication in new window or tab >>The factor structure of the Burden Assessment Scale and the perceived burden of caregivers for individuals with severe mental disorders
2004 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, no 2, 396-401 p.Article in journal (Refereed) Published
Abstract [en]

The aims of this study were to test the construct validity and the homogeneity of the Swedish version of the Burden Assessment Scale (BAS) and study perceived burden in daily life among family caregivers of individuals with severe mental disorders. A total of 256 caregivers took part in the study. The participants completed two questionnaires. One was the BAS, a brief scale that focuses on specific subjective and objective consequences of families caring for individuals with severe mental disorders. The other one was a questionnaire constructed for the study including demographic data. A principal component analysis yielded three factors: 'activity limitation', 'feelings of worry and guilt' and 'social strain'. The internal consistency calculated by Cronbach's alpha coefficients varied between 0.73 and 0.88 for the three factors. The findings indicated that the caregivers experienced more 'activity limitation' and 'social strain' in relation to the youngest and to those who had an elementary educational level than they did for comparison groups. There were no differences found between the caregivers in relation to clients' daily occupation outside home. The results confirm that family caregiver burden is complex and includes several areas such as activities in daily life, worry and social strain. Given this knowledge about caregivers' situation, it is critical that families be given opportunities to identify what support might help. Further research is needed to identify such support.

Keyword
family burden; severe mental disorders; daily occupation; factor analysis
National Category
Nursing
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-37315 (URN)10.1111/j.1471-6712.2004.00298.x (DOI)000226103100008 ()
Available from: 2014-10-01 Created: 2014-10-01 Last updated: 2014-10-28Bibliographically approved
3. Performance of occupations in daily life among individuals with severe mental disorders
Open this publication in new window or tab >>Performance of occupations in daily life among individuals with severe mental disorders
2004 (English)In: Occupational Therapy in Mental Health, ISSN 0164-212X, E-ISSN 1541-3101, no 2, 33-50 p.Article in journal (Refereed) Published
Abstract [en]

The aims of this study were to describe self-perceived capability to perform daily occupations, functional cognitive ability and differences between self-perceived capability to perform daily occupations and cognitive levels among individuals with severe mental disorders. Fifty-one persons participated in the study. The participants completed a structured interview concerning their own perceived experiences of daily occupations, they were also observed during performance of a standardized task and assigned a cognitive level score. The results showed that most participants perceived small problems in Activities of Daily Living. On the other hand, Play and Leisure Activities seemed problematic to them. The participants' cognitive levels seem to correlate with their performance of Work and Productive Activities. The results also showed that a structural tool focusing on capability to perform daily occupations enabled mentally disabled persons to have a perspective of their own. Together with observed assessment it gave complementary information about these people's occupational performance. These shared identified occupational problems could serve as a foundation for planning individually adapted interventions

Keyword
Severe mental disorders, occupations in daily living, structured assessments
National Category
Occupational Therapy
Research subject
Occupational therapy
Identifiers
urn:nbn:se:oru:diva-37319 (URN)2-s2.0-3242688723 (Scopus ID)
Available from: 2014-10-01 Created: 2014-10-01 Last updated: 2014-10-28Bibliographically approved
4. Goal, intervention and outcome of occupational therapy in individuals with psychosis: content analysis through a chart review
Open this publication in new window or tab >>Goal, intervention and outcome of occupational therapy in individuals with psychosis: content analysis through a chart review
2000 (English)In: Occupational Therapy International, ISSN 0966-7903, E-ISSN 1557-0703, Vol. 7, no 1, 21-41 p.Article in journal (Refereed) Published
Abstract [en]

The purpose of the study was to analyse the content of occupational therapy records documenting treatment for individuals with psychoses. A retrospective content analysis of occupational therapy records regarding treatment goals, interventions and outcome was undertaken using a coding scheme, the Template of Occupational Therapy (TOT). Twenty-five occupational therapists chosen at random contributed 64 occupational therapy records, generating 2992 statements.

The patients’ disorders and functional and activity limitations (n=1723) were comprehensively described. Ability to manage self-care and the home environment, and to engage in a daily occupation, emerged as the prominent treatment goals. The content of the occupational therapy interventions was characterized by descriptions of a wide range of activities, which were used as therapeutic resources.

The occupational therapist had a client-centred approach, combining the use of the current activity with the use of herself/himself as a resource. A few statements in the records were interpreted as relating to outcomes of treatment for this patient group. Statements related to outcome were the patients’ self-reports and how they were able to manage activities of daily living. This retrospective study was found to be a useful conceptual model for designing studies of evidence-based occupational therapy in mental health

Keyword
content analysis, mental health, occupational therapy, psychoses, patient record
National Category
Occupational Therapy
Research subject
Occupational therapy
Identifiers
urn:nbn:se:oru:diva-37321 (URN)2-s2.0-0002082209 (Scopus ID)
Available from: 2014-10-01 Created: 2014-10-01 Last updated: 2014-10-28Bibliographically approved
5. Developement of the experience of occupational performance questionnarie: validity and reliability in a sample of individuals with severe mental disorders
Open this publication in new window or tab >>Developement of the experience of occupational performance questionnarie: validity and reliability in a sample of individuals with severe mental disorders
2002 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 9, no 4, 184-191 p.Article in journal (Refereed) Published
Abstract [en]

The purpose of this study was to assess the validity and reliability of a new tool called the Experiences of Occupational Performance Questionnaire (EOPQ) and also to investigate whether there were any gender differences in the answers. The EOPQ was completed by 32 women and 73 men with severe mental disorders, who participated in an occupation arranged by the healthcare system in Sweden. The EOPQ was originally developed from interviews with six women participating in occupational therapy. An analysis of the content validity of the EOPQ was performed with the help of seven occupational therapists. Forty-six of the 49 items in the EOPQ were valued as representative of the concept occupation as a resource in therapy. Principal component analysis performed in two steps yielded seven factors called: "Satisfaction with own ability"; "Confidence in own ability"; "Capability to perform"; "Challenge"; "Ability to handle difficult situatio"; "Forgetting time and self"; and "Identification with others". The internal consistency calculated by Cronbach's &#102 values varied between 0.63 and 0.91 in the seven factors. No gender differences were found on the factor level but differences in five items were found. The results showed that EOPQ could be used as a tool to measure therapeutic potentials in occupations and could also contribute to knowledge to secure the use of occupations as a therapeutic resource for individuals with severe mental disorders.

Keyword
factor analysis, occupation, resource, severe mental disorders, therapeutic
National Category
Occupational Therapy
Research subject
Occupational therapy
Identifiers
urn:nbn:se:oru:diva-37320 (URN)
Available from: 2014-10-01 Created: 2014-10-01 Last updated: 2014-10-28Bibliographically approved

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