Women's perceptions of everyday occupations: outcomes of the Redesigning Daily Occupations (ReDO) programme.

Abstract Aims: The aim was to (i) assess the outcomes of the 16-week Redesigning Daily Occupations (ReDO) programme for women on sick leave due to stress-related disorders, in terms of occupational value, satisfaction with everyday occupations, and participation level; (ii) investigate the relationships between those outcomes and return-to-work rate. Methods: A total of 42 women receiving ReDO and 42 receiving care as usual (CAU) were included in a matched-control study with measurements before and after the rehabilitation. Seventy-eight participated on both occasions. They completed self-report questionnaires regarding the aforementioned outcomes. Return-to-work data were obtained from the registers of the Social Insurance Offices. Results: Increases in concrete, symbolic, and self-reward values were found in both groups, but no statistically significant difference between the groups was demonstrated. The ReDO group improved more than the CAU group, however, on satisfaction with everyday occupations and participation level. Occupational value, but not satisfaction with everyday occupations, was related to return to work. Conclusions: Everyday occupations were shown to be relevant outcomes after work rehabilitation and could play an important role in future development of profession-specific evidence of occupational therapy. Further support was obtained for viewing occupational value and satisfaction with everyday occupations as theoretically distinct phenomena

Psychometric properties of a Swedish version of the Pearlin Mastery Scale in people with mental illness and healthy people.

Background: Mastery refers to the degree to which people perceive that they can control factors that influence their life situation, and has been found important for people's quality of life and well-being. It is thus essential to be able to measure mastery in a valid and reliable way. Aim: This study aimed at using the Rasch measurement model to investigate the psychometric properties of a Swedish version of the Pearlin Mastery Scale (Mastery-S). Methods: A sample of 300 healthy individuals and 278 persons with mental illness responded to the Mastery-S. Item responses were Rasch analysed regarding model fit, response category functioning, differential item functioning (DIF) and targeting, using the partial credit model. Results: The Mastery-S items represented a logical continuum of the measured construct but one item displayed misfit. Reliability (Person Separation Index) was 0.7. The response categories did not work as expected in three items, which could be corrected for by collapsing categories. Three items displayed DIF between the two subsamples, which caused a bias when comparing mastery levels between subsamples, suggesting the Mastery-S is not truly generic. Conclusions: The Mastery-S may be used to obtain valid and reliable data, but some precautions should be made. If used to compare groups, new analyses of DIF should first be made. Users of the scale should also consider exempting item 6 from the scale and analyse it as a separate item. Finally, rewording of response categories should be considered in order to make them more distinct and thereby improve score reliability

Activity of Daily Living Performance amongst Danish Asylum Seekers: A cross-sectional study

Objective: The aim of this study was to evaluate the extent of Activities of Daily Living (ADL) ability impairment in newly arrived Danish asylum seekers. It was hypothesized that exposure to trauma and torture would negatively influence ADL performance and that measures of ADL ability would be lower in individuals exposed to torture as compared to the non-tortured. Subjects: Forty-three newly arrived asylum seekers aged 20-50 years, from Iran, Afghanistan, and Syria, were consecutively included in the study. Method: ADL ability was assessed with the observation-based test Assessment of Motor and Process Skills (AMPS). Interviews were based on questionnaires about torture exposure, WHO-5 Wellbeing Index, Major Depression Inventory and Pain Detect Questionnaire. All participants were interviewed and tested using a linguistic interpreter. Results: Thirty-three (77%) participants reported exposure to torture. The tortured did not differ significantly from the non-tortured on measures of ADL ability (two-sample t-tests: Motor, p= 0.36; Process, p= 0.82). ADL performance impairment was observed in the overall study sample. Twelve had motor and 15 process ability measures below age norms and 2 below both AMPS motor and process cut-offs for effortless and efficient ADL performance. There were statistically significant - weak to moderate - correlations between self-reported psychological distress, VAS average pain, pain distribution, and the AMPS measures. Conclusion: The study results supported significant ADL ability impairment in tortured as well as non-tortured newly arrived asylum seekers. Implementation of performance-based evaluation of ADL ability as part of the initial medical screening of this particular population should be considered

Kunskapsunderlag för ekosystembaserad havsförvaltning i Bottenhavet

Ekosystembaserad havsförvaltning anges som ett viktigt verktyg för att nå Sveriges miljömål. Denna rapport tar ett första steg i riktning mot ett vetenskapligt underlag för att stödja ekosystembaserad havsförvaltning i ett pilotområde i södra Bottenhavet. Ekosystemkomponenter (dvs. arter och livsmiljöer) som är viktiga för modellering av ekosystemet identifieras och deras status samt faktorer som påverkar dem redovisas. Även kunskapsluckor kopplade till påverkansfaktorer diskuteras, samt hur dessa påverkansfaktorer integreras med ekosystemkomponenterna, liksom vilka ekosystemtjänster som ekosystemkomponenterna bidrar till. Många av ekosystemkomponenterna har inte god miljöstatus, särskilt grunda bottnar som har ett högt exploateringstryck. Oroväckande nog saknas det övervakning av både grunda kustnära mjukbottnar och utsjöbankar, fastän dessa områden är av intresse för exploatering samtidigt som de har hög biodiversitet och är kopplade till många ekosystemtjänster. Dock finns det en del data tillgängligt i området som kan användas vid modellering för att ta fram kartor över ekosystemkomponenter och även ekosystemtjänster, som kan vara viktiga underlag för ekosystembaserad förvaltning i södra Bottenhavet. I flera fall är kunskapen om belastningar i södra Bottenhavet och hur de kopplar till statusen av ekosystemkomponenter relativt god, men det saknas information om kumulativa effekter av påverkansfaktorer. Många av de marina arter som finns längst in i Östersjön lever här vid sin nordliga utbredningsgräns, vilket kan innebära att de är extra känsliga för mänskliga belastningar och klimatförändring. Storskaligt fiske efter strömming i utsjön och dess effekter på strömmingsbestånden kan påverka ekosystemets funktion. Strömmingen är talrik och spelar en stor roll i södra Bottenhavets ekosystem. Eftersom strömming vandrar mellan utsjön och kusten kan den koppla samman näringsvävar i kust och utsjö. I Bottenhavets område kan man se tydliga intressekonflikter gällande resursförvaltning. Traditionella lokala näringar baserar sig mycket på fiske av strömming och laxfisk, men vikande fångster av den mer storvuxna strömming som fiskas för humankonsumtion, liksom av laxfisk, skapar problem för det kustnära yrkesfisket. Här finns en uppenbar konkurrenssituation både med det storskaliga pelagiska fisket i utsjön och med naturliga predatorer. Dessa konflikter är svåra att lösa med de förvaltningsmetoder som används idag. Södra Bottenhavets ekosystem skulle sannolikt gynnas av en mer helhetsbaserad förvaltning av fiskbestånden och livsmiljöer, utifrån samtliga faktorer som påverkar dem. I kustområdet gäller detta även, inte minst, de områden där gösens och sikens status är mycket svag, liksom viktiga områden för rekrytering av gädda. En sådan mer helhetsbaserad förvaltning innefattar en samplanering av fiskeregleringar, skyddade områden och åtgärder för att restaurera och skydda diverse livsmiljöer. Förbättring av livsmiljöer för fisk förväntas även gynna andra delar av den biologiska mångfalden och ekosystemtjänster, inklusive olika arters motståndskraft och förmåga att anpassa sig till pågående klimatförändringar

101 Women's patterns of daily occupations. Characteristics and realtionships to health and well-being

This thesis investigated the concept of balance in daily occupations. The overarching aim was to explore women’s patterns of everyday occupations and to investigate relationships between different aspects of patterns of daily occupations and health and well-being. The participants were working, cohabitant women with pre-school children. The methods used focused on exploring patterns of daily occupations and assessing sociodemographic aspects, self-rated health, and well-being. The results imply methodological development for documenting patterns of daily occupations, measuring occupation-related experiences associated with daily occupations, and categorising patterns of daily occupations according to complexity. This thesis identified the building blocks of patterns of daily occupations as main, hidden and unexpected occupations. Women’s hassling experiences associated with daily occupations were generated mainly by the social environment and their uplifting experiences resulted primarily from performing occupations. Moreover, typical patterns of daily occupations with respect to complexity were identified, and relationships of complexity in patterns of daily occupations to health and well-being were investigated. The result indicated that more hassles in combination with low control and high complexity in pattern of daily occupations mean an increased risk of experiencing low health and well-being. The findings contribute to the knowledge base of occupational science by further illuminating the concept of pattern of daily occupations: its constituents and its complexity. The results contribute to research on women’s total workload in relation to a sense of well-being and give implications for occupational therapy intervention for people who have taken ill due to imbalance in their pattern of daily occupations

Stability in women's experiences of hassles and uplifts: a five-year follow-up survey

Hassles and uplifts, a concept used in measuring daily stress events, was applied to working mothers' everyday life. The aim was to explore the stability in working mothers' experiences in patterns of daily occupations, operationalized as hassles and uplifts, between the year 2000 (baseline) and the year 2005 (follow-up). Further, the intention was to reveal possible differences in the number, origins, and ratings of hassles or uplifts between baseline and follow-up. The baseline study comprised 100 women, of whom 77 agreed to participate in the follow-up study. At baseline the questionnaire THU-5 was applied in the form of an interview, and at follow-up it was adapted to a self-response questionnaire sent home to the respondents. Stability was explored qualitatively by investigating the reported causes of hassles and uplifts, and quantitatively by comparing the numbers and ratings of the experiences at baseline and at follow-up. The results indicate a certain amount of stability, although the cause of the experiences changes in line with changes in life stage. It was concluded that the methodology used (THU-5 and THU-3) was sensitive to these changes and could be applied in clinical settings, providing occupational therapists with a tool for detecting daily hassles that could be dealt with. Likewise, detected uplifts can be useful in the process of re-clesigning patterns of daily occupations affected by stress