Revealing the Meaning of Cannabis Use as an Occupation: A Scoping Review.

Background: Occupational science and occupational therapy typically perceive occupations as promoting health and well-being. However, this perspective overlooks the many occupations that are viewed as illegal, unhealthy, or risky, such as drug use. Due to its negative association with health, drug use is perceived as not holding significance or meaning in people's lives. Objective: This study explores how individuals perceive and describe the meaning of their cannabis use in the context of their lives, from an occupational perspective. Methods: A scoping review was conducted using Levac et al.' modifications to Arksey and O'Malley's framework. To examine the peer-reviewed literature, 7 databases were searched using terms related to cannabis and meaning. Descriptive statistics were used to describe the selected studies, and reflexive thematic analysis identified cross-study themes. Results: Fourteen studies were selected. Most studies have been published since 2008, with 5 published in the last 2 years. Four themes were identified across the studies: (a) preserving life; (b) navigating the routines of everyday life; (c) understanding the self, identity, and belonging; and (d) expanding the view of the world. Conclusions: Cannabis use was revealed in this study as a support for navigating occupational routines and enhancing occupational repertoires and engagement, feelings of belonging, and collective user identities. As such, substance abuse treatment practices, including those provided by occupational therapists, should recognize the potential significance of cannabis use within people's lives. Using a harm reduction approach, occupational therapists can acknowledge the ways in which clients use cannabis to manage their daily routines, while also focusing on supporting clients to reduce the ill-effects of cannabis. As individuals become more engaged in occupations that are significant in their lives, their need for and meaning of cannabis use may change leading to a possible reduction in its use and a shift in their identity construction.

Training clinicians in a problem-solving fatigue programme for patients receiving maintenance haemodialysis.

BACKGROUND: Personal Energy Planning is a problem-solving based programme that guides people receiving maintenance haemodialysis treatment to use energy management strategies to address life participation challenges. The feasibility of training dialysis clinicians to become Personal Energy Planning coaches (i.e., programme administrators) is currently unknown. OBJECTIVES: To explore the feasibility of training dialysis clinicians to administer the Personal Energy Planning programme. DESIGN: Feasibility study involving an adherence evaluation of two trained dialysis clinician coaches' problem-solving facilitation skills, and one qualitative interview with each coach. PARTICIPANTS: Two Personal Energy Planning coaches with nursing backgrounds who administered the programme to 10 patients receiving maintenance haemodialysis treatment over a total of 34 sessions. APPROACH: Audio recordings of one session per treatment recipient (n = 10) were evaluated using an established treatment adherence checklist. The proportion of treatment sessions where the item was observed by two adherence raters was calculated. In addition, coaches were interviewed about their experiences learning and administering the programme; interviews were analysed using inductive thematic analysis. FINDINGS: Some core facilitation skills (e.g., patient-centred goal setting and analysis of performance breakdowns) were consistently used; however, other facilitation skills (e.g., guided discovery and global problem-solving strategy) were not regularly implemented. The coaches discussed challenges (e.g., supporting patient problem-solving and fluctuating patient health) with administering the intervention. Certain training resources (e.g., coaching handbook and expert consultation) were identified as valuable to their learning. CONCLUSIONS: With modifications to training materials, it might be feasible to train dialysis clinicians to administer Personal Energy Planning with people receiving maintenance haemodialysis treatment.

Exploring the occupational lives of Syrians under temporary protection in Turkey.

INTRODUCTION: Persons who become displaced due to situations such as war and natural disasters face extreme challenges in maintaining their occupational repertoires. This study aimed to explore the occupational lives of Syrians under temporary protection in Turkey. METHODS: This mixed method study used a cross-sectional design with a predominantly qualitative focus. Syrians living under temporary protection in Turkey were interviewed using the Canadian Occupational Performance Measure (COPM) to identify their perceived performance problems in the areas of self-care, productivity, and leisure. Additional probes were used to explore participants' reasoning for the choice of occupations and scoring, and occupational changes since arriving in Turkey. Socio-demographics were collected on the participants' age, gender, educational level, marital status, monthly house budget, social security, and number of persons within the household. Thematic analysis was used to undercover themes from the qualitative data. RESULTS: Thirty Syrians living under temporary protection in Turkey in Hatay province participated in this study (mean age: 29.66 ± 7.97 years [range = 18 to 50 years]): 16 women (mean age: 28.64 ± 8.04 years) and 14 men (mean age: 30.56 ± 8.05 years). Participants identified more significant problems in their performance of productive and leisure occupations than in self-care occupations. The following themes emerged: (a) having a house of our own: meeting basic needs and completing activities of daily living; (b) no money for shopping: past everyday occupations now luxuries; (c) feeling valued and important: having the ability but no job; (d) living day to day: Education, career, and marriage on hold; and (e) enjoyment in life: leaving behind family, friends, and occupational spaces. CONCLUSION: Syrians living in temporary protection in Turkey experience uncertainty within their occupational lives. Participants were able to meet their basic needs; however, precarity of employment limited their participation in previous occupations contracting their repertoires.

Short-Term Impact of Social Distancing Measures During the COVID-19 Pandemic on Cognitive Function and Health Perception of Brazilian Older Adults: A Pre-Post Study.

Social distancing, a critical measure to manage COVID-19 transmission, is consistently associated with social isolation, a major health issue. Social isolation negatively impacts mental and physical health, particularly among older adults. A pre-post comparison study examined changes in cognitive function and perceived health among 36 community-dwelling Brazilian older adults, assessed pre and post social distancing measures enacted due to COVID-19. A significant increase in cognitive function was found 1 month into social distancing (M = 16.3, p = .002, power = 0.88), with declining scores for vitality (M = -29.3, p < .001, power = 0.99) and mental health (M = -38.1, p < .001, power = 0.99), particularly among participants who lived alone (t = -3.8, p = .001). Older adults exhibit rapid changes in perceived health when excluded from participation in social activities. Health care professionals should consider holistic approaches when addressing the impacts of social isolation on this population.

Interventions for Women With Substance Abuse Issues: A Scoping Review.

OBJECTIVE: The aim of this scoping review was to describe the characteristics and features of substance abuse interventions for women in North America and discuss the findings from an occupational perspective. METHOD: A scoping review was conducted to examine North American peer-reviewed literature published between 2001 and 2014. Four databases were searched using terms related to intervention, substance abuse, and women only. Descriptive statistics of categorical groupings were used to describe the data sources and characteristics and features of the interventions. RESULTS: Forty-two articles met the inclusion criteria, with the majority citing a harm-reduction approach and using multifaceted interventions with various targets for change. CONCLUSION: Substance abuse interventions for women are typically multifaceted and follow a harm-reduction philosophy. Further research into the efficacy of interventions that more specifically target occupation beyond substance use is needed.

Clarifying the Construct of Occupational Engagement for Occupational Therapy Practice.

Occupational engagement (OE) has been presented as a core construct in occupational therapy; however, its broad conceptualization and confounding definitions are problematic. Clarifying the construct of OE would help occupational therapists to explicate the nature of their practice. The purpose of this study was to explore occupational therapists' perspectives of the construct of OE. Qualitative descriptive methodology was used to collect data using semistructured interviews with nine practicing occupational therapists in the Greater Toronto Area. Qualitative content analysis, using an inductive approach, was employed to uncover emerging categories. Participants spoke about transitioning from therapeutic engagement to OE with a client by following a client's path of choice. The essential elements and influencers of OE were highlighted, and the relationship between OE and occupational performance was discussed. The findings provide an initial understanding of essential elements necessary to enable clients to initiate engagement in therapy and then, subsequently, in occupations of their choice.

Toward the reconceptualization of the relationship between occupation and health and well-being

BACKGROUND: Foundational to the occupational therapy profession is the belief that engagement in occupation is health promoting; however, this belief fails to account for occupational engagement that may be risky or illness producing. Consensus regarding the nature of the relationship between occupation and health has yet to be achieved. PURPOSE: The purpose of this study is to provide a comprehensive description of how the relationship between occupation and health and well-being is discussed within the occupational therapy and occupational science literature. METHOD: The methodological framework outlined by Arksey and O'Malley served as the basis for this scoping review of the occupational therapy and occupational science literature. FINDINGS: One hundred and twelve articles were identified as meeting the criteria for inclusion. The dominant discourse portrays the relationship between occupation and health as positive. IMPLICATIONS: The broader literature suggests that occupational engagement can have both positive and negative effects on health and well-being. As such, the reconceptualization of the relationship between occupation and health and well-being is warranted to enable occupational therapists to practise in a more client-centred manner.

Toward the reconceptualization of the relationship between occupation and health and well-being.

BACKGROUND: Foundational to the occupational therapy profession is the belief that engagement in occupation is health promoting; however, this belief fails to account for occupational engagement that may be risky or illness producing. Consensus regarding the nature of the relationship between occupation and health has yet to be achieved. PURPOSE: The purpose of this study is to provide a comprehensive description of how the relationship between occupation and health and well-being is discussed within the occupational therapy and occupational science literature. METHOD: The methodological framework outlined by Arksey and O'Malley served as the basis for this scoping review of the occupational therapy and occupational science literature. FINDINGS: One hundred and twelve articles were identified as meeting the criteria for inclusion. The dominant discourse portrays the relationship between occupation and health as positive. IMPLICATIONS: The broader literature suggests that occupational engagement can have both positive and negative effects on health and well-being. As such, the reconceptualization of the relationship between occupation and health and well-being is warranted to enable occupational therapists to practise in a more client-centred manner.