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Occupational Engagement among Older People: Evaluation, Repertoire and Relation to Life satisfaction
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Occupational engagement among older people is important to investigate as older people are the fastest growing segment in our society, and because occupational engagement is viewed within occupational therapy as one of the basic premises for health. Three perspectives of engagement are highlighted in this thesis: evaluation of occupational engagement, the repertoire of occupational engagement, and finally, the relation between occupational engagement and life satisfaction. The overall aim of this thesis was to study aspects of occupational engagement among older people, with a special focus on evaluation of the experiences of an occupation-based group programme, evaluation of leisure, the leisure repertoire, and the relation between occupational engagement and life satisfaction.

The thesis is comprised of four studies which all contribute in different ways to an increasing understanding of occupational engagement among older people. In the first study (Study I), three older persons participated in a group activity programme and were interviewed about their experiences of occupational engagement. The qualitative interviews were done with each participant after each group session, in total 15 interviews. The other three studies (Studies II-IV) were based on a subgroup of a population studied in a cross-sectional population-based study, the Umeå 85+ study. Very old people with an MMSE score of 20 or more were included in Studies II, III, and IV (n=156). During home visits, they were interviewed about their occupational engagement (ADL and leisure) and their life satisfaction.

The qualitative interviews analysed using a Grounded theory approach, revealed two different dimensions of experiences while engaged in a group programme. The participants described experiences of activation, with a creative force and a place for learning, but also experiences of transformation with reflection, adaptation, and finally, a personal synthesis. Evaluation of occupational engagement through measurement using the modified NPS Interest Checklist (MNPS) was made possible using Rasch analysis. The results revealed preliminary evidence for internal scale validity and person response validity. Scale and person reliability were Rasch equivalents of Cronbach alpha of .98 for items and .66 to .75 for persons, respectively. In their leisure repertoire, very old people were more likely to endorse Social and Cultural activities and least likely to endorse Ballgames and Equipment sport. Traditional gender differences and some differences between older persons in rural versus urban areas and between persons with different cognitive levels were also found. Finally, significant correlations were found between life satisfaction and both engagement in ADL (r =.31) and engagement in leisure (r =.34) among very old people. A forced entry regression revealed that both variables together explained slightly more (12.4%) than leisure alone (11.2%).

As a conclusion and in relation to evaluation of occupational engagement during therapy, the experiences of engagement are described by the respondents from both a perspective of action and a perspective of inner reflection, and together they might support the developmental process among older people. Through using Rasch analysis, it was possible to convert ordinal data into linear measures and also to organize leisure occupations into a hierarchical repertoire of engagement. This repertoire gives further understanding for specific tasks and about the general relation between leisure dimensions. Finally, the contribution of occupational engagement to life satisfaction is likely essential, but explains only about 12% of total life satisfaction among very old people.

Place, publisher, year, edition, pages
Umeå: Samhällsmedicin och rehabilitering , 2006. , 82 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1043
Keyword [en]
Key words: Activities of daily living, Leisure activities, Hobbies, Aged: 80 and over; Aged, Occupational therapy, Rehabilitation, Health promotion, Rasch measurement
National Category
Occupational Therapy
Identifiers
URN: urn:nbn:se:umu:diva-863ISBN: 91-7264-145-2 (print)OAI: oai:DiVA.org:umu-863DiVA: diva2:144780
Public defence
2006-10-13, Aulan, Vårdvetarhuset, Umeå Universitet, Umeå, 13:00 (English)
Opponent
Supervisors
Available from: 2006-09-13 Created: 2006-09-13 Last updated: 2011-10-18
List of papers
1. Geriatric rehabilitation: Elderly clients' experiences of a pre-discharge occupational therapy group programme
Open this publication in new window or tab >>Geriatric rehabilitation: Elderly clients' experiences of a pre-discharge occupational therapy group programme
2003 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 10, no 3, 107-117 p.Article in journal (Refereed) Published
Identifiers
urn:nbn:se:umu:diva-5299 (URN)10.1080/11038120310016418 (DOI)
Available from: 2006-09-13 Created: 2006-09-13 Last updated: 2017-12-14Bibliographically approved
2. Evaluating leisure activities in the oldest old
Open this publication in new window or tab >>Evaluating leisure activities in the oldest old
2006 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 13, no 1, 31-37 p.Article in journal (Refereed) Published
Abstract [en]

Aim. To determine whether the Modified NPS Interest Checklist (MNPS) could be developed as a tool with linear measures of four dimensions of leisure: Interest, Performance, Motivation, and Well-being.

Methods. A cross-sectional descriptive study including 156 volunteers born between 1904 and 1917 and living in urban or rural northern Sweden. Each participant was individually interviewed at her/his place of residence. Subsequent data were subjected to a series of Rasch analyses using FACETS.

Major findings. The items and persons demonstrated acceptable goodness-of-fit across all four dimensions in the MNPS checklist. The Rasch equivalent of Cronbach's alpha was 0.98 for items, and ranged from 0.66 to 0.75 for persons.

Principal conclusion. The MNPS shows evidence for acceptable internal scale validity, person response validity, and scale reliability. This study provides initial evidence that the MNPS is a valid tool for measuring leisure among the oldest old. While this study provides the first psychometric examination of an assessment designed to evaluate different dimensions of leisure, more research is needed to further assess validity and reliability of this tool with the elderly and with other groups.

Keyword
Aged; 80 and over, Cross-Sectional Studies, Geriatric Assessment, Humans, Leisure Activities, Psychometrics/standards, Reproducibility of Results, Sweden
Identifiers
urn:nbn:se:umu:diva-7483 (URN)10.1080/11038120500360655 (DOI)16615413 (PubMedID)
Available from: 2008-01-10 Created: 2008-01-10 Last updated: 2017-12-14Bibliographically approved
3. Focus on leisure repertoire in the oldest old: the Umeå 85+ study
Open this publication in new window or tab >>Focus on leisure repertoire in the oldest old: the Umeå 85+ study
2006 (English)In: Journal of Applied Gerontology, ISSN 0733-4648, E-ISSN 1552-4523, Vol. 25, no 5, 391-405 p.Article in journal (Refereed) Published
Abstract [en]

This study elucidates the oldest olds’ leisure repertoire and how this repertoire varies due to gender, where they live, and cognitive status. A validated 20-item leisure interest checklist with four subscales was used to measure leisure participation and investigate the leisure repertoire among participants. The oldest old were most likely to be interested in, perform, be motivated for, and perceive well-being from social activities, cultural activities, and TV/video/movies. The respondents were least likely to be interested in, perform, be motivated for, and perceive well-being from equipment sports and ball games. Some gender, geographic differences, and differences in cognitive status were found. The oldest old were more likely to endorse the same activities across all subscales of the checklist, but the linear magnitude varied across sub-scales. The relationships between performance and the other subscales suggested that a sense of engagement or participation is related to actual performance.

Keyword
aged, 80 and older, measurement, leisure activities, hobbies
Identifiers
urn:nbn:se:umu:diva-7512 (URN)10.1177/0733464806292861 (DOI)
Available from: 2008-01-10 Created: 2008-01-10 Last updated: 2017-12-14Bibliographically approved
4. Occupational engagement and life satisfaction in the oldest old: the Umeå 85+ study
Open this publication in new window or tab >>Occupational engagement and life satisfaction in the oldest old: the Umeå 85+ study
Show others...
2007 (English)In: OTJR (Thorofare, N.J.), ISSN 1539-4492, E-ISSN 1938-2383, Vol. 27, no 4, 131-139 p.Article in journal (Refereed) Published
Abstract [en]

This study was designed to evaluate whether the level of occupational engagement is relatedto life satisfaction among the oldest-old. The study was performed as part of a cross-sectionalstudy of individuals 85 years and older in northern Sweden. The results revealed significantcorrelations between life satisfaction and engagement in both leisure and activities of daily living,and the effect sizes were interpreted as medium. This study adds some support to earlierfindings that a higher level of task performance is related to a higher level of life satisfaction.The results also give some clinical evidence to support a client-centered approach that includesconsideration of leisure tasks a person is motivated to perform.

Keyword
well-being, participation, leisure activities
Identifiers
urn:nbn:se:umu:diva-42977 (URN)
Available from: 2011-04-15 Created: 2011-04-15 Last updated: 2017-12-11Bibliographically approved

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