There is a scarcity of rehabilitation methods for people with stress-related disorders that are effective in terms of return to work and reducing sick leave. This chapter describes the Redesigning Daily Occupations (ReDO^TM) program for women with stress-related disorders, the development, its main principles, and primary and secondary outcomes. The ReDO^TM program, which addresses people’s whole repertoire of everyday occupations, was effective in the primary healthcare context, compared to traditional rehabilitation provided by the Social Insurance Offices. Further research is needed, however, to establish a firm evidence base for the ReDO^TM intervention. © Springer Internatinal Publishing Switzerland 2015.

Purpose. The study compared the perceived value of occupation among a sample of individuals with long-term mental illness to a sample of people not diagnosed with mental illness. As well, it investigated whether diagnostic and demographic factors were related to perceived occupational value among the individuals with mental illness. Finally, the study examined the relationship between occupational value and ratings of health and well-being. Method. One hundred and three individuals with mental illness and 28 healthy individuals were recruited for the study. Results. Overall occupational value among the individuals diagnosed with mental illness differed only marginally from the healthy group, indicating that perceived occupational value was by and large not related to mental illness. Among the individuals with mental illness, having children living at home was related to occupational value. There were moderate to strong associations between occupational value and measures of health and well-being. Practice Implications. This study provides important insights into occupational value among individuals with persistent mental health problems and provides some preliminary evidence in support of the Value, Meaning and Occupation Model. © CAOT PUBLICATIONS ACE

This study investigated psychometric properties of an instrument for assessing perceived occupational value, the 26-item OVal-pd. Data from 225 Swedish subjects with and without known mental illness were analysed regarding fit to the Rasch measurement model (partial credit model), differential item functioning (DIF), and functioning of the OVal-pd four-category response scale. The reliability (index of person separation, analogous to Cronbach's alpha) was good (0.92) but there were signs of overall and item level (six items) misfit. There was DIF between people with and without mental illness for three items. Iterative deletion of misfitting items resulted in a new 18-item DIF-free scale with good overall and individual item fit and maintained reliability (0.91). There were no disordered response category thresholds. These observations also held true in separate analyses among people with and without mental illness. Thus, the first steps of ensuring that occupational value can be measured in a valid and reliable way have been taken. Still, occupational value is a dynamic construct and the aspects that fit the construct may vary between contexts. This has implications for, e.g., cross-cultural research and calls for identification of a core set of culture-free items to allow for valid cross-cultural comparisons. Copyright © 2009 Informa UK Limited

The working relationship between client and therapist can be important to enhance outcomes from vocational rehabilitation for women with stress-related disorders in primary health care. The aim was to investigate the working relationship, as perceived by clients and therapists in the Redesigning Daily Occupations (ReDO™) program, and its relationships to return to work and satisfaction with the rehabilitation. Another aim was to compare the ReDO™ group and a "care-as-usual" (CAU) group regarding perceptions of the working relationship with the social insurance officer. © 2015 Eklund et al.; licensee BioMed Central.

Patterns of daily occupations (PDO) and occupational balance (OB) are recurring phenomena in the literature. Both are related with health and well-being, which makes them central in occupational therapy practice and occupational science. The aim was to review how PDO and OB are described in the literature, to propose a view of how the two constructs may be linked, and elaborate on how such a view may benefit occupational science and occupational therapy. The literature was analysed by latent and manifest content analysis and comparative analysis. The findings were summarized in a model, framing PDO as the more objective and OB as the more subjective result from an interaction between personal preferences and environmental influences. The proposed model does not assume a cause–effect relationship between the targeted constructs, rather a mutual influence and a joint reaction to influencing factors. Indicators of PDO and OB were identified, as well as tools for assessing PDO and OB. The authors propose that discerning PDO and OB as separate but interacting phenomena may be useful in developing a theoretical discourse in occupational science and enhancing occupational therapy practice. Although the scope of this study was limited, the proposed view may hopefully inspire further scrutiny of constructs. © 2016 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Previous research has shown that the Redesigning Daily Occupations programme reduced the degree of sick leave and increased return to work rates among women on sick leave for stress-related disorders when compared with "care as usual". To further investigate the Redesigning Daily Occupations intervention, this study explored changes in the work situation from baseline to a 12-month follow-up in the Redesigning Daily Occupations group compared with the "care as usual" group and analysed any predictors of change. © 2012 Australian Occupational Therapy Journal.

The importance of patterns of daily occupations to health has been emphasised ever since occupational therapy was founded, but little is known about this relationship. The aim of this study was to describe in detail one woman’s pattern of daily occupations as an initial step in developing strategies for further studies of patterns of daily occupations. Four different methods were used, one on each of four days. Three types of occupations were discerned; main occupations, hidden occupations, and unexpected occupations, which intertwined and formed an occupational pattern. The occupations were, in turn, composed of actions. Using the diary method gave an overall picture of main occupations during a whole day. Direct observation and video-recorded observation added additional information about the actions that were the building blocks of the occupations, as well as about hidden and unexpected occupations. The fourth method, a variant of the experience sampling method, gave deeper knowledge about the informant’s reflections when performing an occupation. It was assumed that a detailed description of patterns of occupation is needed to understand its relationship to health. Therefore, if the diary method is used, it has to be combined with a subsequent interview. Direct observation was the single method that best captured the complexity of the pattern of daily occupations as captured in this study. Copyright © 2001 Informa UK Limited.

The study builds on a previous study of the everyday occupations of 100 women who worked at home and in the paid workforce. Their pattern of daily occupations was depicted using time-occupation graphs inspired by the time geography method, whereby the women’s pattern of occupations were categorised and clustered according to complexity. For each woman, the level of complexity was operationalised as the frequency of shifting between three categories of occupation (main, hidden, and unexpected) and sleep, along with the frequency of unexpected occupations and whether shifts in type of occupation were concentrated in limited parts of the day, e.g., the mornings. The study had two aims. First, to test the hypothesis that among women who work at home and in the paid workforce, those with low-complex patterns of daily occupations would rate their health and well-being higher than women having medium-complex patterns. As well, those with medium-complex patterns would rate their health and well-being better than women with highcomplex patterns. Secondly, the study aimed to investigate differences among these subgroups in relation to sociodemographic factors. The hypothesis was partly confirmed. Increasing complexity was associated with lower levels of self-rated health, but not with lower levels of sense of coherence and well-being. With respect to sociodemographic factors, the women in the three subgroups differed in terms of level of education. The results tentatively confirm theoretical assumptions of a link between patterns of daily occupations and experiences of health, and provide an incentive for further research on this relationship. © 2006, Taylor & Francis Group, LLC. All rights reserved.

Swedish women are more ill than men are, often explained by women's heavier total workload. A balanced pattern of daily occupations is believed to promote health. The aim of this study was to investigate the relationship of aspects of the pattern of daily occupations and lifestyle factors to working mothers' health and well-being, and whether control influenced any relationships. One hundred working, cohabiting mothers took part in semi-structured interviews targeting health and well-being, control, lifestyle variables, and hassles and uplifts in the pattern of daily occupations. All variables were dichotomised according to a median cut and subjected to logistic regression analyses. Working more and having a university diploma were found to be risk factors for experiencing more hassles. Risk factors for fewer uplifts were having more than two children and fewer leisure occupations. Experiencing less control constituted a risk of low self-rated health and with an additional high level of hassles impacted on the experience of well-being. © 2003 The Haworth Press, Inc. All rights reserved.

The aim of this study was to investigate experiences of hassles and uplifts among women. One hundred working mothers were interviewed using the Target Complaints instrument. Content analysis, resulting in both qualitative categories and quantitative variables, was used. Working mothers' hassles were mainly generated by their social, temporal and doing contexts and illustrate the importance of considering women's total patterns of everyday occupations and not focusing one-sidedly on the work situation when treating occupation-related ill-health. Women's uplifts were experienced through the social context and by doing such different occupations as going to the movies, cleaning the house, or attending a class. This indicates the appropriateness of using a client-centred approach in interventions with openness to the client's unique situation. Unexpected occupations were identified almost exclusively among the hassles. This is important knowledge for occupational therapists since women will continue to be dual workers and at potential risk of developing unbalanced and detrimental patterns of occupations, in turn causing ill health. Copyright © 2003 John Wiley & Sons, Inc. All rights reserved.

This study investigates the theoretical assumption of the Value and Meaning in Occupations model. The aim was to explore the relationship between occupational value, perceived meaning, and subjective health in a sample of individuals of working age, 50 men and 250 women. Frequency of experienced values in occupations was assessed through the Occupational Value instrument with pre-defined items. Perceived meaning was operationalized and assessed by the Sense of Coherence measure. Subjective health was estimated by two questions from the SF-36 questionnaire. The analyses implied descriptive analyses, correlations, and logistic regression analyses in which sociodemographic variables were included. The findings showed highly significant relationships between occupational value and perceived meaning and when belonging to the high group of occupational value the likelihood was tripled of belonging to the high group of perceived meaning. When married or cohabitating there was double the likelihood of belonging to the high group of perceived meaning. Although perceived meaning was found to be positively associated with subjective health, working full time was the most important factor in explaining subjective health, compared with working less than full time. The results confirm assumptions in the ValMO-model, and the importance of focusing on occupational value in clinical practice is highlighted. © 2011 Informa Healthcare.

It has been proposed that it should be possible to identify patterns if daily occupations that promote health or cause illness. This study aimed to develop and to evaluate a process for analysing and characterising subjectively perceived patterns of daily occupations, by describing patterns as consisting if main, hidden, and unexpected occupations. Yesterday diaries describing one day if 100 working married mothers were collected through interviews. The diaries were transformed into time-and-occupation graphs. An analysis based on visual interpretation of the patterns was performed. The graphs were grouped into the categories low, medium, or high complexity. In order to identify similarities the graphs were then compared both pair-wise and group-wise. Finally, the complexity and similarities perspectives were integrated, identifying the most typical patterns of daily occupations representing low, medium, and high complexity. Visual differences in complexity were evident. In order to validate the Recognition of Similarities (ROS) process developed, a measure expressing the probability if change was computed. This probability was found to differ statistically significantly between the three groups, supporting the validity of the ROS process. © 2004, Taylor & Francis Group, LLC. All rights reserved.

The aim of the present study was to investigate how people with persistent mental illness, with various types of work and employment conditions, experience and describe the meaningfulness of work. The study had a qualitative approach and twelve informants living in the community were purposefully selected and interviewed according to overarching themes. The interviews were analysed using qualitative content analysis, and all of the authors were involved in the analysis process. The findings resulted in four main themes: 1) work per se has certain characteristics, 2) participation in different contexts gives a feeling of normality, acceptance, belonging and fulfilment of norms and values, 3) work affords structure, energy and a balanced daily life, and 4) work increases well-being and strengthens one's identity. A tentative model is described concerning perceived meaningfulness in work among individuals with persistent mental illness, in which the first three aspects of meaning are a prerequisite for meaning in terms of increased well-being and strengthened identity. Furthermore, it seems important that work has to bring the just right challenge to the individual in order for him or her to perceive the identified aspects of meaningfulness. © 2009 IOS Press. All rights reserved.

This study investigated how people with persistent mental illness who work or study, attend a community-based activity centre or have no regular activities, experience and describe the meaningfulness of their daily occupations. Data were gathered from 102 randomly selected individuals who were interviewed regarding their daily occupations and perceived meaningfulness using a ‘yesterday activity diary’. Content analysis revealed five main themes of meaningfulness: 1) Connection with others and the world around them, 2) Enjoyment and fun in life, 3) Being productive and having a sense of achievement, 4) Being occupied and having routines and projects in the stream of time and 5) Taking care of oneself to maintain health. Their connections, enjoyment and fun, and taking care of oneself were the aspects of meaningfulness that occurred most frequently. Participants who worked or studied more frequently identified connections, and made fewer statements about taking care of their health. The findings contribute to the knowledge of perceived meaningfulness in daily occupation, showing that despite different occupational structures and settings, all themes of meaningfulness were represented in the three groups. Thus, people with persistent mental illness create and find meaning within their daily occupations, although the occupations that generate these aspects of meaningfulness may differ. © 2008 Taylor & Francis Group, LLC. All rights reserved.

The aim of this study was to investigate time use in work/education, self-care/self-maintenance, play/leisure, rest/relaxation, and sleep in people with persistent mental illness. A further aim was to investigate how time use in the daily activities was associated with health-related variables and social interaction. The study comprised 103 participants with a diagnosis of persistent mental illness who completed self-ratings and interviews in order to assess (1) time use of activities during one 24-hour day, (2) social interaction and (3) health-related factors. The major results indicated that the total time in activity (TTA) and the time spent on work/ education and sleep seemed to be related to the majority of the target variables. Four groups of daily rhythm were identified and the daily rhythm groups differed concerning perceived mastery and social interaction. Although the results of this study were statistically significant they did not indicate clinical significance. Therefore, the assumption that there is a relationship between occupation and well-being could not be clearly verified. This study had a cross-sectional design based on a one-time measure, which is an important limitation for the validity of the study. Furthermore, no Bonferroni corrections were made for mass significance and some of the findings would have disappeared if such corrections had been made. More studies concerning time use in daily activities, and daily rhythm in relation to health and well-being are needed. Copyright © 2006 John Wiley & Sons, Ltd.

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 nontortured 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.

In occupational therapy and occupational science, it is important to clarify the perspective from which the analysis of occupation is addressed. The purpose of this paper is to present a tentative structure for describing occupation, allowing for analysis in a lifelong panorama as well as for the immediate experience a person acquires from performing a single occupation. The concept of occupational value is introduced as a prerequisite for meaning, defining three different dimensions: concrete, symbolic, and self-reward value. A dynamic categorisation of single occupations is presented, considering each unique occupational performance viewed from a macro, meso, and a micro perspective, inspired by dynamic systems theory. It is proposed that all occupations are meaningful if they are integrated parts of a person's occupational continuity, and that it is the interaction between the mentioned three perspectives that determines their meaningfulness. With an explicit focus on value and meaning as perceived by the unique person, occupational therapists will become more skilled in designing meaningful occupational therapy interventions. This paper is a contribution to the development of occupational science as well as to occupational therapy, but the theoretical framework presented must be empirically tested in order to demonstrate its validity. Copyright © 2019 Informa UK Limited.

This study, carried out in a work rehabilitation unit in Sweden, investigated how clients perceived their work experiences after a one-year follow up. A semi-structured interview was administered to 14 former clients and a content analysis was applied. Seven categories were derived from the results: 'Expectations of the rehabilitation process'; 'Social relationships'; 'Client influences on the rehabilitation process'; 'Occupations engaged in during the rehabilitation programme'; 'Perceived outcome'; 'Current occupations'; and 'Future aspirations'. The dominating expectations were to find a job, with an overall desire for change. The social relationships with the staff and other clients were of great importance. The positive outcome of the rehabilitation was described as feeling better or having new skills. The perceived negative outcome was that the rehabilitation programme had not turned out as the client expected. The clients reported varying daily occupations after the rehabilitation experience and a majority were contented and optimistic about their future. The main conclusions of the study are that when planning a work rehabilitation programme, efforts have to be made to examine clients' interests and skills, and to develop a dialogue between clients and staff. Further research is needed to evaluate the work rehabilitation experience from the clients' perspective. Copyright © 2007 John Wiley & Sons, Ltd.