Recognition During the Return-to-Work Process in Workers with Common Mental Disorders.

Purpose Considering worker's perspective, the purpose of this study was twofold: (1) to document the meaning of the experience of recognition in the return to work (RTW) process of work after a sick leave due to a common mental disorder (CMD) and (2) to investigate the phenomenon of recognition for workers in the process of RTW after a sick leave due to a CMD, by evaluating the presence or absence of marks of recognition from salient RTW stakeholders stemming from different systems. Methods The Relational Caring Inquiry phenomenological method was used to explore the meaning of recognition during the return-to-work process and marks of recognition in a group of 20 workers who returned to their employment after a sick leave due to a CMD. In depth individual interviews were conducted with each participant. Results The definition of recognition that emerged from workers experiencing the RTW process is related to the behaviours and attitudes of various stakeholders, stemming from the work, health, insurance and social systems that allow them to feel appreciated, valued and respected, throughout the RTW process. Recognition was most often described as showing support, trust, respect for recovery and pace, and providing positive feedback. Conclusion The findings from this study could serve as guidelines in organizations regarding the RTW process, and in particular clarifying the roles and actions that different stakeholders could take in the workplace to stimulate expressions of meaningful recognition.

An Exploration of the Occupational Adaptation of Older Adults Living in Low-Income Housing During the Pandemic.

Health restrictions enacted during the COVID-19 pandemic made it difficult for older adults living in low-income housing (hereinafter referred to as residents) to maintain a routine. The study aimed to explore the ways in which residents carried on, experienced and adapted their activities during the pandemic. An action research study, conducted in cooperation with a community partner, involved nineteen residents who participated in semi-structured interviews inspired by an occupation focused health promotion model. Qualitative data obtained was analyzed using thematic and cross-case analyses. Two thirds of the sample reported a high level of change in their daily routine. The need to connect with others and to live moments of pleasure and joy were the least satisfying dimensions of experience while performing their activities, which was not surprising. Three occupational adaptation profiles were identified based on the residents' perception of changes in routine and their degree of satisfaction with time spent in the different dimensions of experience. Among strategies and resources reported for overcoming the impact of the pandemic on their daily lives, having a supportive social network, access to communication technologies and a positive attitude seemed to be key to residents' successful occupational adaptation.

Feasibility of Lifestyle Redesign® for community-dwelling older adults with and without disabilities: Results from an exploratory descriptive qualitative clinical research design.

INTRODUCTION: Although Lifestyle Redesign® has been shown to be effective in improving older adults' health and well-being, little is known about the feasibility of implementing this programme to develop meaningful and health-promoting routines of community-dwelling older adults in Canada. This study thus aimed to explore the feasibility of implementing a culturally-adapted 6-month version of Lifestyle Redesign® with community-dwelling older French-Canadians with and without disabilities. METHODS: An exploratory descriptive qualitative clinical research design was used with 17 older adults living at home or in a seniors' residence, divided into two groups participating in Lifestyle Redesign®. Semi-structured interviews were conducted with participants and the occupational therapist who delivered the programme and recorded clinical notes. FINDINGS: Participants were aged between 65 and 90; they were mainly women (n = 11; 64.7%), and seven (41.2%) had disabilities. The intervention was tailored to the participants' needs, interests, and capacities in each group (e.g. modules selected, number of individual sessions, and assistance of volunteer). Over the 6-month period, older adults participated in an average of about 25 group sessions with the occupational therapist and in four or five outings with their group (e.g. restaurant, market, and museum) and attended between 5 and 11 individual sessions with the occupational therapist. The most common reasons for missing group sessions were being ill, working, or having another appointment. Personal facilitators and barriers to participation in the intervention were mainly related to abilities, needs, spiritual life, and health. Environmental facilitators were mostly the regularity of the sessions, group, and external support, including human resources to deliver the intervention, whereas barriers were the residence's time restrictions and staff's attitudes, cost of some activities targeted in the programme, and transportation problems. CONCLUSION: Lifestyle Redesign® is a feasible preventive occupational therapy intervention for community-dwelling older French-Canadians. These findings will guide future studies including large-scale clinical trials.

Influence of Lifestyle Redesign® on Health, Social Participation, Leisure, and Mobility of Older French-Canadians.

IMPORTANCE: Developed in California to enable community-dwelling older adults to maintain healthy and meaningful activities, Lifestyle Redesign® is a well-known cost-effective preventive occupational therapy intervention. The impact of a newly adapted French version on older French-Canadians was, however, unknown. OBJECTIVE: To explore the influence of Lifestyle Redesign on older French-Canadians' health, social participation, leisure, and mobility. DESIGN: A mixed-methods design included a preexperimental component (questionnaires administered before and after the intervention and 3 and 6 mo postintervention) and an exploratory descriptive qualitative clinical study. Individual semidirected interviews were digitally audiotaped and transcribed, then underwent thematic content analysis using mix extraction grids. SETTING: Community. PARTICIPANTS: Sixteen volunteers (10 women) aged 65-90 yr (mean = 76.4, standard deviation = 7.6), 10 without and 6 with disabilities. Inclusion criteria were age ≥65 yr, normal cognitive functions, residence in a conventional or senior home, and French speaking. INTERVENTION: French-Canadian 6-mo version of Lifestyle Redesign. OUTCOMES AND MEASURES: Health, social participation, leisure, and mobility were measured using the 36-item Short Form Health Survey, Social Participation Scale, Leisure Profile, and Life-Space Assessment, as well as a semistructured interview guide. RESULTS: The French-Canadian Lifestyle Redesign had a beneficial effect on participants' mental health (p = .02) and interest in leisure (p = .02) and, in those with disabilities, social participation (p = .03) and attitudes toward leisure (p = .04). Participants reported positive effects on their mental health, leisure, mobility, and social participation, including frequency and quality of social interactions, and indicated that having an occupational routine fostered better health. None of the participants reported no effect. CONCLUSION AND RELEVANCE: The translated and culturally adapted Lifestyle Redesign is a promising occupational therapy intervention for community-dwelling older French-Canadians. WHAT THIS ARTICLE ADDS: This study sheds light on the influence of the French-Canadian version of the intervention not only on older adults' health and social participation but also on their leisure activities and life-space mobility, two important outcomes not addressed in previous Lifestyle Redesign studies. Moreover, this study provides an in-depth understanding of the Lifestyle Redesign experience of French-Canadian older adults with and without disabilities, including participants with significant communication and mobility disabilities.

Comparison of Objective and Subjective Life Balance Between Women With and Without a Personality Disorder.

Life balance is associated to health, well-being and quality of life and is a target of psychiatric rehabilitation interventions. However, little is known about this life dimension in women living with personality disorders. The purpose of this descriptive-correlational study was to compare and explore relationships between subjective life balance, objective time use, quality of life and perceived stress in women without a mental health disorder (n = 43) and women with a personality disorder (clusters B and C) (n = 30), aged between 18 and 50 years old. The variables were measured with the Life Balance Inventory (subjective life balance), the Occupational Questionnaire (objective time use), the Depression Anxiety Stress Scale (perceived stress) and the Quality of Life Index (satisfaction and importance with life domains). The analyses showed that women with a personality disorder spend significantly less time in work but more time in daily tasks and leisure. Subjective life balance, quality of life and perceived stress were significantly lower in women with a personality disorder (p < 0.05). In women with a personality disorder, subjective life balance was explained by quality of life (R2 = 27.5 %). In women without a mental illness, subjective life balance was explained by quality of life and motherhood (R2 = 36.1 %). To support the recovery of women with personality disorders and their quality of life, it is important to address objective and subjective time use to enable accomplishment of a variety of meaningful activities.

[Translation and validation of the Life Balance Inventory: An occupational therapy questionnaire]. / Traduction et validation du questionnaire ergothérapique l'Inventaire de l'équilibre de vie

BACKGROUND: Despite the interest in the concept of life balance, no questionnaire is currently available in French to measure it well. PURPOSE: This study aimed to translate the Life Balance Inventory (Objective 1) and to verify the convergent validity of the French version (Objective 2). METHOD: A cross-cultural validation was first carried out, followed by a cross-sectional descriptive study, with 152 adults ages 40 and over, with and without physical disabilities. Questionnaires were used to measure the following variables, life balance, stress, health, and quality of life. RESULTS: A better life balance is associated with a lower degree of stress (r = -.36; p < .01) as well as higher physical health (r = .42; p = .01), mental health (r = .36; p = .01), and quality of life (r = .54; p < .01). IMPLICATIONS: The French version of the Life Balance Inventory is a valid questionnaire to assist occupational therapists when assessing time use of their clients.

Participation needs of older adults having disabilities and receiving home care: met needs mainly concern daily activities, while unmet needs mostly involve social activities.

BACKGROUND: Participation is a key determinant of successful aging and enables older adults to stay in their homes and be integrated into the community. Assessing participation needs involves identifying restrictions in the accomplishment of daily and social activities. Although meeting participation needs involves older adults, their caregivers and healthcare providers, little is known about their respective viewpoints. This study thus explored the participation needs of older adults having disabilities as perceived by the older adults themselves, their caregivers and healthcare providers. METHODS: A qualitative multiple case study consisted of conducting 33 semi-structured interviews in eleven triads, each composed of an older adult, his/her caregiver and a healthcare provider recruited in a Health and Social Services Centre (HSSC) in Québec, Canada. Interview transcripts and reviews of clinical records were analyzed using content analysis and descriptive statistics based on thematic saliency analysis methods. RESULTS: Aged 66 to 88 years, five older adults had physical disabilities, five had mild cognitive impairment and one had psychological problems, leading to moderate to severe functional decline. Caregivers and healthcare providers were mainly women, respectively retired spouses and various professionals with four to 32 years of clinical experience. Participation needs reported by each triad included all domains of participation. Needs related to daily activities, such as personal care, nutrition, and housing, were generally met. Regarding social activities, few needs were met by various resources in the community and were generally limited to personal responsibilities, including making decisions and managing budgets, and some community life activities, such as going shopping. Unmet needs were mainly related to social activities, involving leisure, other community life activities and interpersonal relationships, and some daily activities, including fitness and mobility. CONCLUSIONS: This study highlights the complexity of older adults' participation needs, involving daily as well as social activities. Properly assessing and addressing these needs is thus necessary to improve older adults' health and well-being. Discrepancies in the various actors' perceptions of participation needs must be further explored. Additional research would help better understand how to optimize the contribution of community organizations and caregivers.

Recovery, as Experienced by Women with Borderline Personality Disorder.

Studies examining recovery through the service users' perspectives have mainly included persons with schizophrenia or bipolar disorder. Giving voice to those with borderline personality disorder (BPD) would enrich our understanding of recovery, as their specific experiences may bring new dimensions, obstacles and facilitators. The objective of this study was to qualitatively capture the experience of recovery in women with BPD. Participants were women between 18 and 65 years old who had a diagnosis of BPD and completed at least 2 years in a program for persons with BPD. During the first meeting, they produced a picture collage, followed by an interview on their experience of recovery. The second meeting was a phone interview to discuss new thoughts. In addition, their medical records were reviewed. A thematic analysis of the interviews was conducted and organized with the Person-Environment-Occupation model. Although recovery was not the best term to name their experience, they all talked about a process towards stability and wellbeing (n = 12). Dimensions of recovery included, for example, letting go of the past (person), being involved in meaningful activities (occupation) and having healthy relationships (environment). Facilitators included social support and participation in a specialized therapy program. The main obstacle was unstable family relationships. The findings from this study showed similar dimensions to previous recovery studies, new perspectives on certain dimensions, as well as new ones. They also reinforced the importance to incorporate intervention outcomes that target the person with BPD, their social environment and meaningful occupations.

[Home safety and severe mental disorders: Developing an evaluation tool]. / Sécurité a domicile et troubles mentaux graves: elaboration d'un outil d'evaluation.

BACKGROUND: Home safety evaluation is an important issue within the context of current perspectives on accommodation for people with a serious mental illness who favour a more independent way of life. PURPOSE: This paper describes the development and content validation of the Evaluation de la sécurité a domicile et de la gestion des risques (ESGR), an occupational therapy assessment tool for people with a serious mental illness. METHOD: The ESGR was developed from scientific knowledge and clinical experience. Assessing content validity was done in two phases and involved the consultation of 11 experts. FINDINGS: In its current form, the ESGR includes 67 items organized into three categories (environment, occupation, person). IMPLICATIONS: According to the experts consulted, there is a clinical interest in using the ESGR to support occupational therapists in the assessment of home safety for people with serious mental illness. The statements are clear and representative of the concept and the target audience.

"Do-Live-Well": a Canadian framework for promoting occupation, health, and well-being.

BACKGROUND: Occupational therapists can bring a unique and valuable perspective to the national dialogue on health promotion. Current approaches have a narrow focus on diet and exercise; a broader focus on occupation has the potential to enrich understanding regarding forces that contribute to health and well-being. PURPOSE: A new "Do-Live-Well" framework will be presented that is grounded in evidence regarding the links between what people do every day and their health and well-being. KEY ISSUES: Elements of the framework include eight different dimensions of experience and five key activity patterns that impact health and well-being outcomes. Personal and social forces that shape activity engagement also affect the links to health and well-being. IMPLICATIONS: The framework is designed to facilitate individual reflection, community advocacy, and system-level dialogue about the impact of day-to-day occupations on the health and well-being of Canadians.

Revisiting the Do-Live-Well Health Promotion Framework: A Citation Content Analysis.

Background. The Do-Live-Well (DLW) framework was first published in 2015 and aimed to fill a theoretical gap in the health promotion literature related to the links between occupational patterns and health. However, the extent of uptake and use of the framework since publication is unknown. Purpose. To explore and reflect on the adoption and application of DLW in the literature. Method. Citation content analysis of two seminal DLW publications was conducted from 2015 to November 2022 across six databases. Findings. Seventeen citations directly applied DLW to inform research (n = 10), practice (n = 5) and knowledge translation (n = 2). Implications. The findings highlight uptake of the framework in a range of settings, and how it can inform an occupation-based understanding of health and well-being. Ongoing knowledge dissemination, development of practice tools, and research to update evidence and examine relevance are needed to further advance the utility and application of the framework.

[Translation of the Occupational Balance Questionnaire in French and its Validation]. / Traduction de l'Occupational Balance Questionnaire en français et sa validation.

Background. Questionnaires measuring occupational balance have been created in recent years, but those available in French are limited. Purpose. This study aimed to translate and transculturally adapt the Occupational Balance Questionnaire and to examine the internal consistency, test-retest reliability and convergent validity of the French version. Methodology. A cross-cultural validation was conducted with adults in Quebec (n = 69) and in French-speaking Switzerland (n = 47). Results. Internal consistency was good in both regions (α > 0.85). Test-retest reliability was satisfactory in Quebec (ICC = 0.629; p < 0.001), but a significant difference was found between the two measurement times in French-speaking Switzerland. Significant associations were found between the results of the Occupational Balance Questionnaire and those of the Life Balance Inventory (Quebec, r = 0.47; French-speaking Switzerland, r = 0.52). Implications. These initial results support the use of the OBQ-French in the general population of two French-speaking regions.

Description. Des questionnaires visant à mesurer l'équilibre occupationnel ont été créés ces dernières années, mais ceux disponibles en français sont limités. But. Cette étude visait à traduire et adapter transculturellement l'Occupational Balance Questionnaire et à examiner la cohérence interne, la fidélité test-retest et la validité convergente de la version en français. Méthodologie. Une validation a été effectuée auprès de personnes adultes au Québec (n = 69) et en Suisse romande (n = 47). Résultats. La cohérence interne est bonne dans les deux régions (α > 0,85). La fidélité test-retest est satisfaisante au Québec (ICC = 0,629 ; p < 0,001), mais une différence significative est relevée entre deux passations en Suisse romande. Une relation significative est démontrée entre l'équilibre occupationnel et l'équilibre de vie (Québec r = 0,47 ; Suisse romande r = 0,52). Conséquences. Ces premiers résultats soutiennent l'utilisation de l'OBQ-français auprès de la population générale de deux régions francophones.

[Design and logic model of the BIWI intervention on work reintegration of people with borderline personality disorder]. / Conception et modèle logique de l'intervention BIWI sur la réinsertion au travail de personnes avec un trouble de personnalité limite.

Objectives The objective of this study is to develop the logic model and the content of the Borderline Intervention for Work Integration (BIWI). Methods The creation of BIWI was based on Chen's (2015) recommendations for establishing the change model and the action model. Individual interviews with four women with a borderline personality disorder (BPD) and focused groups with occupational therapists and service providers in community organizations from three Quebec regions (n=16) were conducted. The group and individual interviews began with a presentation of data from studies in the field. This was followed by a discussion of the challenges of people with BPD in relation to job choice, performance, tenure, and the essential components to be included in an ideal intervention. Transcripts of the individual and group interviews were examined using content analysis. The components of the change and action models were validated by these same participants. Results The change model of the BIWI intervention addresses six themes, which seem appropriate to focus on for a population with BPD in the process of reintegration into the workplace: 1) meaning given to work; 2) self-awareness and sense of competence as a worker; 3) management of internal and external factors that affect mental workload; 4) interpersonal relationships in the work context; 5) disclosure of the mental disorder in the work context; and 6) more satisfying routines outside of work. The action model of BIWI reveals that this intervention is deployed in collaboration with health professionals from the public and private sectors and service providers from community or government agencies. It combines group (n=10 sessions) and individual meetings (n=2), in face-to-face and online modes. The prioritized outcomes are to reduce the number of perceived barriers to work reintegration and to improve mobilization towards a sustainable employment reintegration project. Conclusion Work participation is a pivotal target in the interventions for people with BPD. With the support of a logic model, it was possible to identify the key components to be considered in the schema of such an intervention. These components relate to central issues for this clientele, such as: their representations of work, self-knowledge as a worker, maintenance of performance and well-being at work, relations with the work group and external partners, and work embedded in one's occupational repertoire. These components are now included in the BIWI intervention. The next step will be to test this intervention with unemployed persons with BPD who are motivated to reintegrate the workforce.

[Services and Treatments for People with Borderline Personality Disorder: State of the Situation in Quebec and Future Prospects]. / Services et traitements offerts aux personnes ayant un trouble de personnalité limite : état de situation au Québec et perspectives d'avenir.

Objectives People with borderline personality disorder experience significant health challenges, both in terms of their mental and physical health, resulting in significant functional repercussions. In Quebec and elsewhere in the world, it is reported that the services in place are often poorly adapted or inaccessible. The purpose of this study was to document the current situation in the different regions of Quebec for clients with borderline personality disorder, to describe the main challenges associated with the implementation of services for this clientele, and to identify possible recommendations to meet the needs of this clientele applicable in different practice settings. Method The design used was a qualitative single case study, with descriptive and exploratory aims. Twenty-three interviews were conducted in most Quebec regions with resources working in various CIUSSSs, CISSSs and non-merged institutions offering adult mental health services. In addition, where available, clinical programming documents were consulted. Mixed data analyses were conducted to provide insights based on different types of settings: urban, peripheral, and remote regions. Results Findings show that in all regions, recognized psychotherapeutic approaches are integrated but tend to need to be adapted. In addition, there is a desire to develop a continuum of care and services and some projects are already underway. Difficulties in implementing these projects and harmonizing services on the territory, due in part to financial and human resource issues, are frequently reported. Territorial issues are also to be considered. Conclusion Enhanced organizational support and the creation of clear guidelines to facilitate the development of borderline personality disorder services would be recommended, as well as the validation of rehabilitation programs and brief treatments.

Occupational therapists' application of the Do-Live-Well framework: A Canadian health promotion approach.

Background. The Do-Live-Well (DLW) framework is an occupation-focused health promotion approach. Online and in-person DLW educational workshops were offered to encourage occupational therapists to apply the DLW concepts. Purpose. The purpose of this study was to understand workshop participants' experiences of and perspectives on using the DLW framework to support its application in the future. Method. Interpretative description was used to understand workshop participants' perspectives on benefits, facilitators, and challenges of using DLW. Semi-structured interviews were conducted and analysed using a thematic analysis. Findings. Eight themes were identified as follows: (a) environmental factors of practice settings, (b) co-workers' support, (c) DLW enhanced occupational therapy practice, (d) confidence in using DLW, (e) nature of the DLW framework, (f) DLW promoted healthy occupational engagement, (g) DLW was not suitable for everyone, and (h) pandemic effects. Implications. The DLW framework supports occupationally focused practices, and continuous learning support will be needed.

Comparing Web-Based and In-Person Educational Workshops for Canadian Occupational Therapists and Understanding Their Learning Experiences: Mixed Methods Study.

BACKGROUND: The Do-Live-Well (DLW) framework is an occupation-focused health promotion approach. Occupational therapists (OTs) have been interested in training opportunities regarding this framework. Traditionally, in-person continuing educational interventions are the main way that OTs obtain knowledge, but web-based learning has become popular among health care professionals. However, its effectiveness and learners' experience in web-based learning have not been well-studied in occupational therapy education. OBJECTIVE: This study aims to evaluate the effectiveness of the web-based and in-person educational DLW workshops for Canadian OTs and to understand their experiences in both workshop types. METHODS: An explanatory sequential mixed methods study design was used, where quantitative data were collected first, then qualitative data were used to explain the quantitative findings. A quasi-experimental design and interpretative description methodology were used in the quantitative and qualitative phases, respectively. RESULTS: Quantitative results were as follows: a total of 43 OTs completed pre-, post-, and follow-up evaluations (in-person group: 21/43, 49%; web-based group: 22/43, 51%). Practice settings of the participants varied, including geriatric, hospital, long-term, mental health, pediatric, and primary settings. The primary outcome was as follows: there were no statistically significant differences in knowledge changes at the 3 time points (P=.57 to P=.99) between the groups. In the web-based group, the knowledge scores at follow-up were lower compared with the posttest results, meaning that knowledge gain was reduced over time (P=.001). The secondary outcomes were as follows: there were statistically significant differences between the groups in factors influencing DLW adoption at posttest (P=.001) and in satisfaction with the workshop (P<.001) at posttest in favor of the in-person group. Qualitative results were as follows: a total of 18 OTs (9/18, 50% from each group) participated in an individual interview. Five themes were identified regarding learners' workshop experiences: relevance to their practices and interests may improve learning, a familiar learning environment may facilitate learning, synchronous in-person interaction is valuable in the learning process, ease of access to learning should be considered, and flexibility in web-based learning can be both beneficial and challenging. CONCLUSIONS: The quantitative results of this study reported no difference in knowledge acquisition between the in-person and web-based groups, indicating that web-based education is as effective as in-person workshops. However, participants' satisfaction with the workshop was statistically significantly higher for the in-person workshop. The qualitative findings described the participants' perceived benefits and challenges of each educational format. The participants in both the web-based and in-person workshop groups valued in-person interactions in learning, but the participants in the web-based workshop group expressed web-based learning lacked in-person-like interactions. Thus, adding synchronous in-person interactions to web-based learning may improve learners' educational experiences in web-based occupational therapy and continuing education.

Fatigue self-management led by occupational therapists and/or physiotherapists for chronic conditions: A systematic review and meta-analysis.

OBJECTIVE: The aim of this study was to investigate the effectiveness of occupational therapist-/physiotherapist-guided fatigue self-management for individuals with chronic conditions. METHODS: Eight databases, including MEDLINE and EMBASE, were searched until September 2019 to identify relevant studies. Randomised controlled trials and quasi-experimental studies of self-management interventions specifically developed or delivered by occupational therapists/physiotherapists to improve fatigue symptoms of individuals with chronic conditions were included. A narrative synthesis and meta-analysis were conducted to determine the effectiveness of fatigue self-management. RESULTS: Thirty-eight studies were included, and fatigue self-management approaches led by occupational therapists/physiotherapists were divided into six categories based on the intervention focus: exercise, energy conservation, multimodal programmes, activity pacing, cognitive-behavioural therapy, and comprehensive fatigue management. While all exercise programmes reported significant improvement in fatigue, other categories showed both significant improvement and no improvement in fatigue. Meta-analysis yielded a standardised mean difference of the overall 13 studies: 0.42 (95% confidence interval:-0.62 to - 0.21); standardised mean difference of the seven exercise studies was -0.55 (95% confidence interval: -0.78 to -0.31). DISCUSSION: Physical exercises inspired by the self-management principles may have positive impacts on fatigue symptoms, quality of life, and other functional abilities.

Psychotherapy Within Occupational Therapy Literature: A Scoping Review.

Background. Recent changes in the Canadian regulatory landscape have prompted reflections on the role and scope of occupational therapy in the provision of psychotherapy. Purpose. To document how psychotherapy has been explored in occupational therapy literature. Method. We conducted a scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review (PRISMA-ScR) guidelines by searching eight databases (e.g., Medline, AMED, CINAHL, EMBASE, PsycINFO, Cochrane Database of Systematic Reviews, Sociological Abstracts, and ProQuest Dissertations & Theses). Articles included at the full-text stage were subjected to a narrative synthesis. Findings. A total of 207 articles met the criteria for inclusion, spanning 93 years. 47.3% of these articles represented non-empirical literature, with only 14% representing effectiveness studies, suggesting that this body of literature remains in an early stage of development. Implications. Occupational therapists have been writing about and practicing psychotherapy for nearly a century, yet there remains an important opportunity to develop and evaluate occupation-based psychotherapy approaches. Effectiveness studies are needed.

Multifaceted impact evaluation of a day hospital compared to hospitalization on symptoms, social participation, service satisfaction and costs associated to service use.

OBJECTIVE: This study compared clinical and functional changes, satisfaction with services and costs associated to service use, in participants treated in a day hospital for adults and seniors organized by diagnostic groups, with clients hospitalised. METHODS: A quasi-experimental design was used. The experimental group was composed of clients (N = 40) treated in a day hospital. The comparison group included clinically and demographically similar clients hospitalised in the same institution (N = 13). Outcomes were symptoms, social participation, self-esteem, service satisfaction, utilization and associated costs. RESULTS: During the index intervention, the level of improvement was significantly greater in the day hospital group regarding symptoms (P = 0.047), self-esteem (P = 0.01) and social participation (accomplishment: P = 0.02; satisfaction: P = 0.008). Following discharge, there was no significant difference in the level of change between the two groups on all variables. Day hospital participants were significantly more satisfied of several dimensions of services (P ≤ 0.01). Comparison of total mean costs of services used 6 months before and after index treatment showed a cost reduction of 38% in the day hospital group and 7% in the hospitalisation group. CONCLUSIONS: Day hospitals organized by diagnostic groups lead to positive clinical and economical outcomes over time.

[Revisiting the therapeutic experience in a psychiatric day hospital six months after discharge: path and perceptions of people with mental disorders]. / Revisiter l'expérience en hôpital de jour six mois après le congé: parcours et perceptions des personnes utilisatrices.

This article presents a qualitative study on the therapeutic experience in a psychiatric day hospital six months after discharge. The study explores the impact of this experience on the lives of people with mental disorders. A qualitative design using semi-structured individual interviews was completed with 18 participants six months after their discharge of a day hospital. Results showed that the day hospital experience was particularly helpful to improve symptoms and relationship with self. It activated a self-transformational process that continued afterwards. Termination created for many, an abrupt void. Issues at stake during the first six months were continuity of care, social support and maintaining skills and knowledge acquired.