The Power of “Doing”: How Enabling Engagement in Meaningful Life Activities Leads to Patient Health and Wellness ALEXA TROLLEY-HANSON MS OTR/L Discussion Focus:
Explore the relationship between engagement in meaningful life activities and health. Discuss the link between meaningful occupation and behavioral change Identify a ways to focus on meaningful occupation to promote health and wellbeing across various medical settings. What is Occupational Therapy?
“Man, through the use of his hands, as they are energized by mind and will, can influence the state of his own health.” Dr. Mary Reilly Ph.D, OTR/L, 1962 Foundations of OT
Patients have the ability to positively impact their own health and participation when given the right knowledge, tools, and supports Patients need to be the driver of their own behavioral change Patients need to be given opportunities to learn/practice behavioral change through “doing” Participation in a balanced life is key to health and independence Occupational Science
Behavioral and health science that “Employment (and occupation) is nature’s explores purposeful activity, or physician and is essential to human happiness” occupations and how these impact: Galen, Greek Physician and Philosopher (c 129- 215 AD) Health Forewell, S. (2015) Development Quality of Life Interdisciplinary links with: Psychology Neuroscience Physiology Rehabilitation Science Preventive medicine and public health Biomedical engineering Anthropology Sociology Occupations of Everyday Life
Activities of Work/School Daily Living (ADLs)
Instrumental Activities of Leisure/Play Daily Living (IADLs) Group Activity:
Turn to your neighbor and introduce yourself- What did you say? Your name? Your profession? What you do? Where you are from? Occupation-is closely tied to our identity Defines our roles Helps us understand relationships, status Understanding Occupation
Habits/Routines Identity Roles
Structure and Competence and Relationships with organize day Confidence others/community
Survive and Thrive Self Efficacy Belonging Group Discussion 2:
Imagine that you woke up one morning on a desert island all by yourself What would you do? How would this be different than what you normally do? How would this impact your survival? How would you feel about yourself and your skills? How confident would you feel? Who would you miss? How would this impact your health? What is Health?
World Health Organization Definition OT Perspective “Health is a state of complete “…not as the absence if organ physical, mental, and social pathology but as an well-being and not merely the encompassing, positive, absences of disease or dynamic, state of ‘well-being’ infirmity.” reflecting adaptability, a good quality of life, and satisfaction in https://www.who.int/about/wh one’s own activities.” o-we-are/frequently-asked- questions Yerxa (1998) Occupation and Health
Limits Illness or Occupational Disability Event Engagement or State Breaking this cycle requires: Grief/Adaptation to illness/disability Behavioral Change Addressing Occupational Engagement
Challenges Limits Habits/Routines, Occupational Identity and Engagement Roles Addressing Occupational Engagement
Occupations can: Lead to health-
Promote physical activity
Self-care activities
Occupational balance-decreased stress, anxiety, and depression
Self-acceptance, self-efficacy, identity development Hinder health-
Unhealthy habits-poor eating, sedentary lifestyle
Substance use or abuse
Occupational imbalance
Poor self-care routines Transactional Model of Occupation
Fisher, A., & Marterella, A. (2019). Occupational Engagement: Literature Review
Modification of existing habits/routines: Bjo¨rklund et al. (2015) and Laliberte Rudman et al. (1996) Skill development to improve occupational engagement: Lund et al (2015). Development of new occupations: Blank et. al (2015) and Luck & Beagan (2015). Group Activity-Holistic Health Wheel How Can I Address Occupation in Practice?
Listen: How are patients impacted by their health experience Validate the grief process that goes along with living with an illness/disability Ask: What would you like to do or get back to doing? Can you link your medical interventions to this occupation? When asking patients to engage in behavioral change: Consider-how is the problem-behavior tied into an occupation? Consider the meaning behind that occupation? Collaborate to come up with a substitute occupation that could address that behavior Set small goals Utilize an interprofessional team References
Blank, A., Harries, P. & Reynolds, F. (2015) ‘Without Occupation You Don't Exist’: Occupational Engagement and Mental Illness, Journal of Occupational Science, 22:2, 197-209, DOI: 10.1080/14427591.2014.882250 Bjo¨rklund, C., Erlandsson, L., Lilja, M., & Gard,G. (2015). Temporal patterns of daily occupations related to older adults’ health in Northern Sweden. Journal of Occupational Science, 22(2),127– 145. doi:10.1080/14427591.2014.913330 Christiansen, C. H. (1999). Defining lives: Occupation as identity: An essay on competence, coherence, and the creation of meaning. American Journal of Occupational Therapy,53(6),547– 558. doi:10.5014/ajot.53.6.547 Christiansen, C. H. (2004). Occupational identity: Becoming who we are through what we do. In C. H. Christiansen & E. A. Townsend (Eds.),Introduction to occupation: The art and science of living(pp. 121–139). Upper Saddle River, NJ: Prentice Hall. Fisher, A. & Marterella, A. (2019). Powerful practice: A model for authentic occupational therapy. Fort Collins, CO: Center for innovative OT solutions. Forwell , S. (2015). Editorial: Special Issue on Occupation, Health and Well-being, Journal of Occupational Science, 22:2, 125-126, DOI: 10.1080/14427591.2015.1020744 Hasselkus, B. (2002).The meaning of everyday occupation. Thorofare, NJ: Slack. Kielhofner, G. (2008).A model of human occupation: Theory and application(4th ed.). Philadelphia: Lippincott, Williams & Wilkins. References cont.
Laliberte Rudman, D., Valiant Cook, J., & Polatajko, H.(1996). Understanding the potential of occupation: A qualitative exploration of seniors’ perspectives on activity. American Journal of Occupational Therapy, 51(8), 640-650. Luck, K. & Beagan, B. (2015) Occupational Transition of Smoking Cessation in Women:“You're Restructuring Your Whole Life”, Journal of Occupational Science, 22:2, 183-196, DOI:10.1080/14427591.2014.887418 Lund, A., Mangset, M., Wyller, T. B., & Sveen, U. (2015). Occupational transaction after stroke constructed as threat and balance. Journal of Occupational Science, 22(2), 146–159. doi:10.1080/14427591.2013.770363 Reed, K. Hocking C., & Smythe, L. (2010) The interconnected meanings of occupation: The call, being‐with, possibilities, Journal of Occupational Science, 17:3, 140-149,DOI: 10.1080/14427591.2010.9686688 World Health Organization. (2019). Frequently asked questions. Retrieved from: https://www.who.int/about/who-we-are/frequently-asked-questions. Wilcock, A. A. (2006). An occupational perspective of health. Thorofare, NJ: Slack Yerxa, E. (1998). Health and the human spirit for occupation. American Journal of Occupational Therapy,52, 412–418. doi:10.5014/ajot.52.6.412 Questions
Contact me: Alexa Trolley-Hanson MS OTR/L Clinical Assistant Professor Department of Occupational Therapy University of New Hampshire [email protected]