Occupational participation, stress, anxiety and depression in workers and students from Brazilian universities during the COVID-19 pandemic

Introduction The physical, social and occupational restrictions imposed by the COVID-19 pandemic have affected the health and well-being of the world population. Objective To identify the repercussions of the pandemic on the occupational participation of students, lecturers and technicians from three public universities in Northern Brazil, to compare the changes reported by participants in occupational participation before and during the pandemic, and to identify symptoms of depression, anxiety and stress self-reported. Method This is a Cross-sectional, descriptive and comparative study with a quantitative approach. One hundred and ninety-nine (n = 199) participants (students, lecturers and technicians) responded to an online questionnaire, the “Occupational Participation Checklist” and the Anxiety, Stress and Depression Scale (DASS-21). Data analysis were descriptive and also performed by applying the Wilcoxon and Mann-Whitney tests. Results During the pandemic, an increase in occupational participation was identified for all participants in domestic activities (p <0.001) and a decrease in work and study face to face (p <0.001). Students reported more symptoms of depression, anxiety and stress when compared to lecturers (p<0.001). Most students did not organise their time to fulfil their occupations with satisfaction. Such difficulties were associated with symptoms of depression, anxiety and stress, especially among the student's group (p<0.001). Conclusion This study provided preliminary evidence about differences in occupational participation before and during the Covid-19 pandemic. The organization of time and difficulties in occupational participation were associated to levels of anxiety, depression and stress, especially in the sample of students.

The impact of a power mobility device on occupational participation and quality of life for people with chronic diseases: A scoping review

Introduction The aim was to explore occupational participation and quality of life (QoL) for power mobility device users with chronic disease. Methods Arksey and O’Malley’s framework for scoping reviews was used. Six data bases were searched using keywords: wheelchair, scooter, QoL and participation. Data were extracted with coding and thematic analysis performed. Results Forty-one articles met the inclusion criteria. An overarching theme of enhanced QoL was identified with subthemes of (i) independence, (ii) enabling participation in instrumental activities of daily living, (iii) enhanced social participation and leisure, (iv) environmental barriers to occupational participation, (vi) power mobility device (PMD) performance concerns impacting occupational participation and (vii) overcoming risk of harm through PMD training. Conclusion The scoping review identified a heterogeneity of study designs and outcome measures, which makes comparison between studies difficult. For people with chronic diseases, PMDs improve independence in occupational participation, particularly in IADL, social participation and leisure. Unfortunately, improved QoL was often inferred, without the use of an outcome measure. Areas which impacted occupational participation for PMD users were environmental barriers and a lack of PMD training. Further research is needed to understand the impact of a PMD on QoL and occupational participation for those with chronic disease.

Impact of Spirituality on the Lived Experience of Christians During OT Rehabilitation

Date Presented 04/13/21 Results of a qualitative phenomenological study of the influence of spirituality on the lived experience of Christians during the rehabilitation process are shared. Findings show the pervasive impact of spirituality on occupational participation, performance, and engagement and align with the concepts of Humbert’s conceptual model of spirituality. This study of spirituality as expressed from a specific worldview perspective advances the provision of holistic, culturally relevant OT services. Primary Author and Speaker: Debra Hanson Contributing Authors: Heather Roberts, Angela Shierk

Occupational Participation of Latinx Cancer Survivors and Family Caregivers Living in Long-Term Survivorship

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Latinx cancer survivors experience worse physical and mental health during survivorship. This group's occupational participation during survivorship is a product of cultural values, environmental influences, and occupational gains and losses. To promote occupational justice, the OT profession is called to deliver culturally tailored care to capitalize on this group's strengths and prepare them for daily participation. Primary Author and Speaker: Ricardo Daniel Ramirez Additional Authors and Speakers: Susan Magasi

Collaborative relationship-focused occupational therapy: Evolving lexicon and practice

Background. Client-centred practice has been part of occupational therapists’ identity for several decades. However, therapists have begun to question whether the term obstructs critical relational aspects of therapy. Purpose. The purpose of this article is to summarize critiques of the use of the term client-centred and propose an expanded descriptor and a fundamental shift in how occupational therapists engage with individuals, families, groups, communities, and populations. Key Issues. Three themes summarize critiques of how client-centred practice has been envisioned: (a) the language of client-centred, (b) insufficient appreciation of how the therapist affects the relationship, and (c) inadequate consideration of the relational context of occupation. We propose collaborative relationship-focused practice that has key relational elements of being contextually relevant, nuanced, and safe, and promotes rights-based self-determination. Conclusion. We argue that these essential relational elements, along with a focus on occupations, are required to promote occupational participation, equity, and justice.

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.

Understanding the occupational identity of care-givers for people with mental health problems

Introduction There is recognition within the literature that the role of care-giving can have a negative impact on care-givers’ general well-being. Less is understood about the role of care-giving on an individual’s occupational participation and in turn occupational identity. Occupational therapists have a unique understanding of the interplay between occupational participation and health, though this is an area that has been under researched in relation to mental health care-givers. Therefore, the current research aims to understand how the role of care-giving for an individual with a mental illness impacts on occupational participation and identity. Method A qualitative semi-structured interview the Occupational Performance and History Interview–Version 2 was utilised to understand life experiences. Six mental health care-givers were interviewed, and these interviews were transcribed for thematic analysis. Findings Three main themes were identified: being me, roles and responsibilities associated with care-giving and services. Conclusion The findings suggest being a mental health care-giver does have a detrimental impact on occupational participation and therefore occupational identity. As care-givers gained more experience in their role, they used occupational adaption as a positive coping mechanism that helped them achieve occupational balance. Using their unique understanding of occupational participation and occupational identity, occupational therapists are well placed to utilise their knowledge and skills to work in a systemic way supporting both the person with mental illness and their care-giver.

Developing an Intervention to Improve Occupational Participation for Justice-Involved People with a Personality Disorder: Defining and Describing Intervention Components

Occupational participation is undertaking personally meaningful and socially valued activities and roles. It is an important outcome for health and justice interventions, as it is integral to health and desistance. We report the third of a four-stage research project to develop an intervention to improve occupational participation for justice-involved people with a personality disorder in the community. We completed a Delphi survey to produce expert consensus on intervention components and their content, ascertain participant ratings of 28 factors for their level of influence on occupational participation, and the modifiability of the factors with this population. Thirty multi-disciplinary participants completed three survey rounds. Most factors were rated very influential, but few were considered easily modifiable. Participants agreed 121 statements describing intervention components and content. Twenty-seven statements did not reach consensus. In targeting specific factors in intervention, practitioners must balance their degree of influence with potential modifiability. The results will inform intervention manualization and modeling.