Exploring return to work barriers through the lens of model of human occupation. The NOW WHAT project.

BACKGROUND: The challenges of returning to work after sickness absence demands a wide conceptual understanding of what hinders the employee's work participation. Thus, there is a need to know more about self-perceived barriers for Return to Work (RTW). AIM: This study aimed to investigate RTW barriers experienced by employees on long-term sick leave, through the lens of the Model of Human Occupation (MOHO). MATERIAL AND METHODS: The study was a large-scale qualitative interview study (n = 85) using semi-structured telephone interviews. Eligible participants had received sick leave benefits for between 6 months and 1.5 years. The data were analysed with quantitative and qualitative content analysis. A deductive approach using the MOHO concepts guided the analysis process. RESULTS: The study generated 941 coded meaning units describing barriers for RTW, of which we were able to code 895 within the framework of MOHO. In the person-specific concepts, performance capacity barriers were most often described (n = 303), followed by volitional barriers (n = 165) and barriers related to habituation (n = 66). Barriers related to the environmental components amounted to 361. Barriers in the occupational environment was dominant (n = 214). CONCLUSION: Experienced barriers related to both environmental components and person-specific concepts. SIGNIFICANCE: The habituational and volitional perspective on barriers can contribute to the identification and communication of performance capacity-related barriers not previously identified.

Participation in Everyday Occupations Among Rohingya Refugees in Bangladeshi Refugee Camps.

IMPORTANCE: Bangladesh hosts a large number of Rohingya refugees from Myanmar. Living in refugee camps, the Rohingya refugees face challenges in everyday occupations because of violence, limited opportunities, and corporal punishment by the community. OBJECTIVE: To explore how Rohingya refugees experience participation in everyday occupations while living in temporary refugee camps in Bangladesh. DESIGN: Phenomenological study to describe, understand, and interpret the meanings of life experiences in particularly adverse conditions. SETTING: Rohingya refugee camps in Bangladesh. PARTICIPANTS: Fifteen purposively selected participants from the camps. OUTCOMES AND MEASURES: In-depth semistructured interview, as well as participant and environmental observations. Researchers used line-by-line data analysis to capture quotations and patterns using interpretive phenomenological analysis, which included establishment of initial codes, interpretation, determining selected codes, and categorization. RESULTS: The research identified four major themes-(1) mental stress, sleep disturbances, and daily occupations; (2) adjustment to inconsistent daily activities; (3) complex relationships and limited social roles that decreased occupational engagement; and (4) involvement in precarious occupations that exacerbated severe health risks-and four subthemes-(1) fragmented family relationships, (2) formation of new relationships to perform social roles, (3) inconvenient and inaccessible living conditions, and (4) continuation of unlawful work to survive. CONCLUSIONS AND RELEVANCE: Rohingya refugees should receive comprehensive health and rehabilitative care because of their perilous mental health conditions, precarious occupations, and lack of trustworthy relationships with family and neighbors. What This Article Adds: Rohingya refugees experience imbalanced, deprived, and maladapted occupations in refugee camps. Suggestions to improve their lived experience with further peer support programs may help them participate in occupation-based rehabilitation services to facilitate their social integration.

Self-Management Embedded in Daily Activities: A Photoelicitation Focus Group Study among Persons with Spinal Cord Injury and Their Primary Caregivers in Bangladesh.

Purpose: This study explored how community-dwelling persons with spinal cord injury (SCI) and their primary caregivers execute self-management strategies in daily activities. These strategies were mapped to a preexisting self-management framework. Methods: Photoelicitation focus group discussions were conducted among 14 adults with SCI and their primary caregivers (in two groups). Moreover, a constant comparative framework was used to analyze the data. Results: This study identified nine groups of self-management strategies, some of which could not be categorized under the three main self-management components generally accepted in the literature. Accordingly, a new component is proposed based off of this analysis, entitled management of social complexities, which includes crucial strategies such as (1) relocating to another environment, (2) behaving in an assertive manner, and (3) advocating for social change. Conclusion: The results show that self-management, traditionally described as medical, emotional, and role management, should also include the management of social complexities. The identified strategies could be considered in the development of self-management enhancement programs in lower-middle-income countries.