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1.
Work ; 70(1): 125-134, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34487010

RESUMO

BACKGROUND: People with mental illness may have difficulties related to work and employment, especially if they experience additional difficult life situations. OBJECTIVE: To explore how subgroups with mental illness and additional adversities perceived their situation with respect to work and employment prospects. METHODS: Three subgroups were included, exposed to an additional difficult life situation: i) psychosis interrupting their career development at young age (n = 46), ii) having a history of substance use disorder (SUD) (= 57) or iii) having recently immigrated (n = 39). They responded to questionnaires addressing sociodemographics, work-related factors, everyday activity, and well-being. A professional assessed their level of functioning and symptom severity. RESULTS: The young people with psychosis had a low education level, little work experience, the poorest worker role resources, and a low level of functioning, but a high quality of life. The SUD group had the fewest work experiences, were the least satisfied with work experiences, and had the lowest activity level, but had the least severe psychiatric symptoms. The immigrant group had severe psychiatric symptoms, but high ratings on work experiences, work resources, and activity level. CONCLUSIONS: Each group presented unique assets and limitations pertaining to work and employment, suggesting that they also needed unique support measures.


Assuntos
Saúde Mental , Transtornos Psicóticos , Atividades Cotidianas , Adolescente , Emprego , Humanos , Transtornos Psicóticos/complicações , Qualidade de Vida
2.
BMC Psychiatry ; 21(1): 383, 2021 07 31.
Artigo em Inglês | MEDLINE | ID: mdl-34332573

RESUMO

BACKGROUND: Work and other everyday activities are beneficial for well-being among people with mental illness, but poor circumstances can create detrimental effects, possibly aggravated by additional vulnerabilities linked with their mental illness. This study aimed to investigate how activity factors were related to well-being and functioning among three vulnerable groups using outpatient mental health care - young people with psychosis, people with a history of substance use disorder (SUD), and immigrants with post-traumatic stress disorder (PTSD) - while controlling for vulnerability group, age and gender. METHODS: Participants represented the three types of vulnerability (n = 46/57/39). Data collection, using self-report and interviewer-rated questionnaires, concerned aspects of everyday activity (work experiences; views of the worker role; satisfaction with everyday occupations; activity level), well-being (quality of life: life and health; quality of life: environmental aspects; recovery) and functioning (psychosocial functioning; symptom severity). Spearman correlations and General Linear Modelling were used. RESULTS: Activity satisfaction was positive (p < 0.001) but recent work experience negative (p = 0.015) for the life and health aspect of quality of life. Activity satisfaction was positive for the environmental aspects of quality of life (p < 0.001). Resources for having a worker role (p < 0.001) and belief in having a future worker role (p = 0.007) were positively associated with better recovery. Activity level (p = 0.001) and resources for having a worker role (p = 0.004) showed positive associations with psychosocial functioning. Belief in a future worker role (p = 0.011) was related with symptom level. Women had less severe symptoms in the young group with psychosis. Regarding vulnerability group, young people with psychosis perceived better quality of life; those with a history of SUD had less severe psychiatric symptoms; and the recent immigrants with PTSD had the highest level of psychosocial functioning. CONCLUSION: Work experience may not be conducive to well-being in itself; it is satisfaction with work and other activities that matters, and worker and employer expectations need alignment. No vulnerability group seemed consistently more disadvantaged regarding well-being and functioning, but the fact that differences existed is vital to acknowledge in activity-based rehabilitation. Inquiring about meaningful activities and providing opportunities for executing them would be a fruitful way of support.


Assuntos
Transtornos Psicóticos , Transtornos de Estresse Pós-Traumáticos , Atividades Cotidianas , Adolescente , Estudos Transversais , Feminino , Humanos , Qualidade de Vida
3.
BMC Psychol ; 9(1): 123, 2021 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-34419148

RESUMO

BACKGROUND: Stress-related illnesses constitute a huge problem in society. The primary care services in Sweden form the first line of care whose role is to coordinate interventions for reducing symptoms, as well as health-promoting interventions. There is lack of knowledge concerning health-promoting interventions for these illnesses. The aim of this study is to evaluate whether photo-supported conversations about well-being (Be Well™) as an intervention, in addition to care as usual within the primary care services, improves health and well-being for patients with stress-related illnesses. The intervention will be compared to a control group, who receive care as usual. A further aim is to conduct a process evaluation. METHODS/DESIGN: This ongoing project has a quasi-experimental design, using quantitative and qualitative methods, and includes patients from primary care centres in two Swedish counties. Seventy patients, 20-67 years, with stress-related illnesses will be recruited. They constitute an intervention group, which receive the intervention together with care as usual, and a control group, which receive care as usual. The intervention, photo-supported conversations about well-being, involves 12 sessions. Care as usual entails medication, occupational therapy, physiotherapy and/or psychotherapy. Data collection is carried out at baseline, and outcomes are assessed directly after the intervention, as well as six months after completion of the intervention. The outcomes are evaluated based on factors related to health, well-being and everyday occupations. Furthermore, data concerning experiences of well-being and perceptions of the intervention will be collected in interviews. The therapists will also be interviewed about their experiences of performing the intervention. Data will be analysed with non-parametric statistics, and qualitative methodology. DISCUSSION: The project is based on the concept that focusing on well-being despite living with stress-related illness may positively impact health and well-being as well as activity-related aspects, and that photo-supported conversations about well-being can contribute a complement to other treatment and rehabilitation. A strength is the use of a wide range of methods: such as quantitative measures, photographs, and qualitative interviews with participants and therapists. The results will thus provide knowledge about potential effects of this health-promoting intervention. Trial registration Clinical Trials.gov: NCT04832295; retrospectively registered 2nd April 2021 https://clinicaltrials.gov/ct2/show/NCT04832295.


Assuntos
Terapia Ocupacional , Psicoterapia , Comunicação , Humanos , Projetos de Pesquisa , Suécia
4.
Scand J Prim Health Care ; 39(3): 322-331, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34128751

RESUMO

OBJECTIVE: To analyse and describe general practitioners' perceptions of the notion of a 'personal responsibility for health'. DESIGN: Interview study, phenomenographic analysis. SETTING: Swedish primary health care. SUBJECTS: General Practitioners (GPs). MAIN OUTCOME MEASURES: Using the phenomenographic method, the different views of the phenomenon (here: personal responsibility for health) were presented in an outcome space to illustrate the range of perceptions. RESULTS: The participants found the notion of personal responsibility for health relevant to their practice. There was a wide range of perceptions regarding the origins of this responsibility, which was seen as coming from within yourself; from your relationships to specific others; and/or from your relationship with the generalized other. Furthermore, the expressions of this responsibility were perceived as including owning your health problem; not offloading all responsibility onto the GP; taking active measures to keep and improve health; and/or accepting help in health. The GP was described as playing a key role in shaping and defining the patient's responsibility for his/her health. Some aspects of personal responsibility for health roused strong emotions in the participants, especially situations where the patient was seen as offloading all responsibility onto the GP. CONCLUSION: The notion of personal responsibility for health is relevant to GPs. However, it is open to a broad range of interpretations and modulated by the patient-physician interaction. This may make it unsuitable for usage in health care priority settings. More research is mandated to further investigate how physicians work with patient responsibility, and how this affects the patient-physician relationship and the physician's own well-being.Key PointsThe notion of personal responsibility for health has relevance for discussions about priority setting and person-centred care.This study, using a phenomenographic approach, investigated the views of Swedish GPs about the notion of personal responsibility for health.The participants found the notion relevant to their practice. They expressed a broad range of views of what a personal responsibility for health entails and how it arises. The GP was described as playing a key role in shaping and defining the patient's responsibilities for his/her health.The notion was emotionally charged to the participants, and when patients were seen as offloading all responsibility onto the GP this gave rise to frustration.


Assuntos
Clínicos Gerais , Atitude do Pessoal de Saúde , Feminino , Humanos , Aprendizagem , Masculino , Relações Médico-Paciente , Atenção Primária à Saúde , Pesquisa Qualitativa
5.
Scand J Occup Ther ; : 1-9, 2021 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-33587863

RESUMO

BACKGROUND: Stress-related disorders cause suffering and difficulties in managing occupations and relationships in everyday life. A previous study of women with stress-related disorders, who photographed well-being and talked about the photographs in interviews, showed that moments of well-being still exist but further knowledge is needed about their perceptions of participating in such a study. AIM: To describe how people with stress-related disorders experience taking photographs related to well-being in everyday life and reflecting on and talking about these photographs. MATERIAL AND METHODS: Twelve women, 27-54 years with stress-related disorders were recruited from primary healthcare centres. They participated in interviews based on the photographs and qualitative content analysis was used. RESULTS: One theme 'catching a glimpse of and momentarily capturing well-being' and four categories were identified: 'Photographing moments of well-being visualizes well-being', 'Using photographs could either facilitate or complicate the narrative', 'Changing perspective in everyday life' and 'Creating recollections of well-being'. CONCLUSIONS AND SIGNIFICANCE: Introducing a focus on well-being in everyday life despite living with a stress-related disorder might contribute a valuable complement to stress rehabilitation for occupational therapists and other health professionals. Using photographs as a basis for reflections about everyday life and health/well-being also seems positive for this group.

6.
Scand J Occup Ther ; 28(6): 415-425, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32027526

RESUMO

BACKGROUND: Support has been found for using garden therapy as form of intervention for clients with common mental disorders, but no consensus has been found for what contributes to perceived meaningfulness of garden therapy. AIMS: To investigate whether participants perceived garden therapy as meaningful, and if so, what contributed to the meaningfulness. MATERIAL AND METHODS: Narrative individual interviews were conducted twice with six participants who participated in garden therapy and once with two participants. Data was analysed using narrative methodology. RESULTS: Perceived meanings in garden therapy were associated to the participants' individual needs and prerequisites: to land, just be, relax, go back to basics, understand, verbalise, enhance energy, and socialise. The group leaders had an important role to create safety and trust, and to adapt the activities and use of the environment. The activities, the garden environment and social group contributed to perceived meaning in garden therapy. CONCLUSIONS: Garden therapy offered the participants possibilities to meet their different needs and thereby perceived meaning. To achieve this, the group leaders need to adapt the gardening individually to each participant. SIGNIFICANCE: Various components were perceived as meaningful. The group leaders therefore have to adapt the garden therapy to each participant's needs.


Assuntos
Horticultura Terapêutica , Transtornos Mentais , Jardinagem , Humanos , Transtornos Mentais/terapia , Pacientes Ambulatoriais , Suécia
7.
Issues Ment Health Nurs ; 41(11): 1038-1046, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32605419

RESUMO

The aim was to explore informal carers' perceptions of supporting the everyday life of a relative who has a psychiatric disability and resides in supported housing (SH). A qualitative study based on interviews with 12 informal carers was performed, and the data was analyzed with qualitative content analysis. The theme "Navigating in a misty landscape when striving to support a relative with a psychiatric disability" was identified, encompassing four categories pertaining to residents' needs, collaboration, environmental issues and the carer's situation. SH services can be enhanced by addressing informal carers' experiences and developing greater collaboration involving informal carers, residents and staff.


Assuntos
Cuidadores , Habitação , Humanos , Percepção , Pesquisa Qualitativa
8.
Scand J Occup Ther ; : 1-7, 2019 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-31838931

RESUMO

Background: Anxiety and depressive disorders are associated with problems with everyday occupations, including difficulties achieving occupational balance. The aim of this cross-sectional study was to describe occupational balance in people suffering from anxiety and/or depression and the factors that are associated with better self-rated occupational balance.Material: One hundred and eighteen participants were recruited from outpatient mental health care and primary health care. The participants were 18-65 years, had a diagnosis of anxiety and/or depression, and had problems in everyday occupations. They answered questionnaires on occupational balance, psychological symptoms, quality of life and everyday occupations.Results: A generally low rating of occupational balance was found; however, the scores differed depending on the participants' degree of anxiety and depression, their quality of life, their occupational performance and satisfaction with their occupational performance. Logistic regression analyses revealed that high quality of life, high satisfaction with occupational performance and low level of depression were associated to occupational balance.Conclusion: The results indicate that enhanced satisfaction with life and with performance of everyday occupations are relevant factors for achieving occupational balance in clients diagnosed with anxiety and/or depression.Significance: The results will be valuable for professionals working to support their clients in enhancing their occupational balance.

9.
Work ; 59(4): 585-598, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29733044

RESUMO

BACKGROUND: Mental health problems (MHP) are common in working life and can be hard to respond to for employers. Therefore, knowledge of employers' perceptions of employees with MHP is important to support coping efforts of persons and their work environments. OBJECTIVE: Identify and characterise employers' perceptions of the impact of MHP on work ability. METHODS: Twelve employers with experience of employees with MHP were interviewed. Data were analysed with a phenomenographic method. RESULTS: The first main category, "Experiences of employees with MHP", included experiences of diffuse and unexpressed signs of the onset of MHP and frustration among employers and work-mates which was difficult to verbalise. MHP could also be turned off, thus having no impact on work ability. The second main category, "Strategies to handle effects of MHP in the workplace", included the importance of continual responsiveness and communication, and of fluctuating adaptations. The informants expressed diversity in the workplace as a strategy. CONCLUSIONS: Employers have experiences of, as well as strategies for, how to handle MHP at times when they impact with the ability to work. However, neither experiences nor strategies were explicitly pronounced and verbalised which makes it a challenge to develop strategies and guidelines in workplaces.


Assuntos
Transtornos Mentais/complicações , Organização e Administração , Percepção , Desempenho Profissional/normas , Adulto , Idoso , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Aprendizagem , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Saúde do Trabalhador/normas , Pesquisa Qualitativa , Local de Trabalho/psicologia , Local de Trabalho/normas
10.
Scand J Occup Ther ; 24(3): 167-177, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-27141968

RESUMO

Young people with psychiatric disabilities may require support in structuring their everyday life. To learn more about the relevance of day centres in this respect, this study aimed to examine the experiences of young people with psychiatric disabilities. A particular focus was on the perceptions of meaningful occupation when visiting day centres, their reasons for not choosing this option when given it and what they desired instead. A qualitative design based on individual interviews was used. Twelve women and eight men between 18 and 35 years, with a need for organized daily occupations, participated as informants. Qualitative content analysis revealed three categories: 'Being in a context', 'Balancing between developing and stagnating', and 'Longing for something more'. The findings indicated that the occupations were inherently age neutral, as were the possibilities for socializing. There was a desire for more activities in the community and more support for engaging in occupations that other young people did. A major issue in the accomplishment of this was the need to earn money, and the lack of opportunities for doing that in the day centre context was a considerable drawback. The findings highlight the importance of identifying young people's views when designing day centres.


Assuntos
Hospital Dia , Pessoas com Deficiência/psicologia , Transtornos Mentais/reabilitação , Adolescente , Adulto , Serviços Comunitários de Saúde Mental , Pessoas com Deficiência/reabilitação , Feminino , Humanos , Entrevistas como Assunto , Masculino , Terapia Ocupacional , Pesquisa Qualitativa , Apoio Social
11.
Lakartidningen ; 1132016 09 06.
Artigo em Sueco | MEDLINE | ID: mdl-27622759

RESUMO

Patients' experiences of orgasm changes and loss of ejaculation after radical prostatectomy   In this study we report on men's experiences of orgasm changes and loss of ejaculation after radical prostatectomy. Ten men, all recruited through a Swedish hospital, were interviewed and data was analyzed using qualitative content analysis. The results showed that the experience of orgasm has weakened but that the loss of ejaculation was not perceived as a loss per se. However, the risk of urine release during orgasm was troublesome and inhibiting. These challenges were framed within an existential narrative about sexuality, as expressed in preoperative sexual farewell rituals and postoperative feelings of ambivalence and regret. These findings can be used in the design of patient information and for sexual rehabilitation treatment.


Assuntos
Ejaculação/fisiologia , Orgasmo/fisiologia , Prostatectomia/efeitos adversos , Disfunções Sexuais Fisiológicas , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Pesquisa Qualitativa , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Fisiológicas/psicologia , Disfunções Sexuais Psicogênicas , Inquéritos e Questionários , Suécia , Incontinência Urinária/etiologia , Incontinência Urinária/psicologia
12.
BMC Psychol ; 3: 40, 2015 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-26552426

RESUMO

BACKGROUND: Depression and anxiety disorders are increasing among the general population in the Western world. Individuals may need several kinds of treatment in order to maintain health, such as cognitive behavioural therapy (CBT) and drug treatment. However, having an everyday life that "works" is also important, suggesting a need for interventions based on activities that facilitate a satisfying everyday life. There is still lack of such evidence-based interventions. The Tree Theme Method(®) (TTM) is an occupational therapy intervention designed for a client-centred context in which an individual develops strategies to become an actor in his or her everyday life. Previous studies of the TTM have focused on process evaluation; therefore, further studies are needed to evaluate the method's effects. The aim of this paper is to outline an intervention that can evaluate the effects of the TTM in terms of psychological symptoms, as well as everyday occupations and well-being, in patients suffering from depression and anxiety. METHODS/DESIGN: This randomized clinical trial includes patients from three Swedish counties randomized to either intervention or treatment as usual. Men and women aged 18-65 years who have been diagnosed with either depression or anxiety are eligible for inclusion. Data collection is carried out at baseline, and outcomes are assessed at the end of intervention, as well as at 3 months and 12 months after intervention ends. The outcomes measured are psychological symptoms, everyday activities, and health-related factors. DISCUSSION: Depression and anxiety may create difficulties for individuals in the activities of their everyday lives to the extent that they require diagnosis and intervention. Despite this reality, evidence-based interventions that focus on everyday activities are lacking. Therefore, it would be useful to design a specific method for occupational therapy intervention that does precisely that. This study provides insight into the effects of the TTM, comparing it to occupational therapy treatment as usual. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01980381; registered November 2013.


Assuntos
Transtornos de Ansiedade/terapia , Transtorno Depressivo/terapia , Terapia Ocupacional/métodos , Adolescente , Adulto , Idoso , Protocolos Clínicos , Terapia Cognitivo-Comportamental/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Adulto Jovem
13.
Work ; 52(1): 153-67, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26410230

RESUMO

BACKGROUND: Since work ability is manifested in working life and ``bought'' by employers, employers perceptions of the concept are important to understand. Studies have shown that people with health problems want to take part in the labour market, but experience difficulties in gaining access. Additionally, studies have demonstrated the doubt felt by employers when they consider hiring a person with a disability. OBJECTIVE: The aim was to identify and characterise employers' conceptions of work ability. METHODS: The study design was qualitative with a phenomenographic approach. Six male and six female employers from various workplaces and geographical areas in Sweden were interviewed. RESULTS: Three domains were identified: employees' contributions to work ability, employers' contributions to work ability and circumstances with limited work ability. Work ability was regarded as a tool in production and its output, production, was the main issue. The employees' commitment and interest could bridge other shortcomings. CONCLUSIONS: The employers highlighted their own contributions in shaping work ability in order to fit with work circumstances. Health problems were not the only limiting issues; other circumstances, such as individual characteristics and contextual factors, could limit work ability too. Knowing the importance of commitment and interest is valuable in work rehabilitation.


Assuntos
Seleção de Pessoal/organização & administração , Avaliação da Capacidade de Trabalho , Adulto , Idoso , Caráter , Eficiência , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Motivação , Pesquisa Qualitativa , Habilidades Sociais , Local de Trabalho/organização & administração
14.
J Occup Rehabil ; 25(1): 127-40, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24972663

RESUMO

PURPOSE: To evaluate the interventional capacity of problem based method groups (PBM) regarding mental health and work ability compared to cognitive behavioural therapy (CBT) for persons on sick leave due to common mental disorders. METHODS: In a randomised controlled design the experimental group received PBM and the control group received CBT. Outcomes were measured by the Hospital Anxiety and Depression Scale (HADS), the Stress and Crisis Inventory 93 (SCI-93) and the Dialogue about Working Ability instrument (DOA). RESULTS: Twenty-two participants in the PBM group and 28 in the CBT group completed intervention. Both groups showed significant lower scores on the two HADS subscales. Regarding stress the PBM group showed significant decrease in one (out of three) subscales of SCI-93. The CBT group showed significant decrease on all subscales of SCI-93. Regarding work ability the PBM group showed significant higher scores on one of five subscales of DOA. The CBT group showed significant higher scores on four of five subscales of DOA. Between groups there were significant differences to the favour of CBT on one of two subscales of HADS, all three subscales of SCI-93 and on two of the five subscales of DOA. CONCLUSION: PBM seem to be able to reduce anxiety- and depression symptoms. CBT showed to be superior to PBM in reducing symptoms in all aspects of mental health, except for anxiety, in which they seem equally effective. Regarding work ability CBT showed to be superior, with significant effect on more aspects compared to PBM.


Assuntos
Terapia Cognitivo-Comportamental , Transtornos Mentais/terapia , Resolução de Problemas , Psicoterapia de Grupo/métodos , Autocuidado , Licença Médica , Adulto , Feminino , Humanos , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Autocuidado/métodos , Autocuidado/psicologia , Avaliação da Capacidade de Trabalho
15.
Aust Occup Ther J ; 61(4): 268-75, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24571494

RESUMO

BACKGROUND/AIM: Day centres for people with psychiatric disabilities need to be evaluated for effectiveness in order to provide the best possible support. This study aimed at investigating the effectiveness of a tailor-made intervention to improve day centre services for people with psychiatric disabilities. METHODS: The intervention was devised to bridge identified gaps in the services and lasted for 14 months. Eight centres were allotted to the intervention (55 attendees) or comparison condition (51 attendees). Fidelity to the intervention and major events in the day centres were assessed. The outcomes were degree of meaningfulness found in the day centre occupations, satisfaction with the rehabilitation received, satisfaction with everyday occupations and quality of life. RESULTS: The fidelity to the intervention was good, but more positive events, such as new occupational opportunities, had taken place in the comparison units. No differences were identified between the intervention and the comparison group regarding changes from baseline to the 14-month follow-up in perceived meaningfulness among day centre occupations, satisfaction with everyday occupations or quality of life. CONCLUSIONS: The intervention seemed ineffective, but the positive events in the comparison group resembled the measures included in the tailor-made interventions. This first intervention study in the day centre context has hopefully helped to generate hypotheses and methods for future research.


Assuntos
Centros Comunitários de Saúde Mental/organização & administração , Hospital Dia/organização & administração , Transtornos Mentais/reabilitação , Terapia Ocupacional/organização & administração , Qualidade de Vida , Adulto , Idoso , Pessoas com Deficiência/reabilitação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação Pessoal , Fatores Socioeconômicos
16.
Aust Occup Ther J ; 60(3): 154-60, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23730780

RESUMO

BACKGROUND/AIM: The Tree Theme Method(®) is an intervention based on creative activities and occupational storytelling. The Tree Theme Method(®) implies that the clients draw and paint trees symbolising various periods in their life. The pictures are then used as a starting point to tell their life story to enhance their wellbeing and management of their everyday life. This study aimed to evaluate if changes observed among clients regarding their wellbeing and everyday occupations, between baseline and the end of their term of the Tree Theme Method(®) therapy, persisted three years after the completion of the intervention. METHODS: This study had a quantitative design. Thirty-one former clients were recruited to a follow-up three years after completing the intervention. Self-rating questionnaires were used regarding psychological symptoms, self-mastery, sense of coherence, activity level, occupational performance and satisfaction with occupational performance. Non-parametric methods were used for the data analysis. RESULTS: The findings revealed positive significant changes regarding sense of coherence and occupational performance and satisfaction with occupational performance, measured between the end of the intervention and at the time of the three-year follow-up. Furthermore, the respondents' ratings regarding psychological symptoms, self-mastery, activity level and the extent of satisfaction with performed occupations were found to be stable. CONCLUSIONS: The Tree Theme Method(®) appeared to function well as an intervention in psychosocial occupational therapy, where the aim was that a client would enhance their wellbeing and management of their everyday life. However, there is need for further evaluation to assess the effects of the Tree Theme Method(®) intervention.


Assuntos
Terapia pela Arte , Transtornos Mentais/reabilitação , Terapia Ocupacional/métodos , Adolescente , Adulto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Narração , Escalas de Graduação Psiquiátrica , Inquéritos e Questionários , Adulto Jovem
17.
Scand J Occup Ther ; 17(3): 200-8, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19562625

RESUMO

The Tree Theme Method (TTM) is an intervention based on sessions involving creative activities and life storytelling/story-making, in which the client paints trees representing various periods of his/her life. The aim of this study was to investigate clients' experiences of participating in a TTM intervention and their perceptions of the therapeutic relationship. Thematic interviews were undertaken. Twenty clients attending general outpatient mental healthcare units were recruited after having participated in the intervention. A qualitative content analysis resulted in six categories: "From feeling a pressure to perform to becoming focused and expressive", "Expressing oneself and one's life situation led to awakening of memories and feelings", "New perspectives of self-image, everyday life and relations to others", "Story-making led to shaping and reconstructing one's life story", "Interaction was of importance when reconstructing one's life story" and, finally, "The attitude of the occupational therapist was of importance for the development of the therapeutic relationship". There seemed to be a close association between the intervention and the therapeutic relationship in starting a process of opening up new perspectives on everyday life, but there is a need for further studies including therapists' experience of using the TTM and their perception of the client­therapist relationship.


Assuntos
Terapia pela Arte/métodos , Criatividade , Narração , Terapia Ocupacional/métodos , Pinturas/psicologia , Percepção Social , Adolescente , Adulto , Feminino , Humanos , Entrevista Psicológica , Masculino , Saúde Mental , Pessoa de Meia-Idade , Projetos Piloto , Avaliação de Programas e Projetos de Saúde , Pesquisa Qualitativa , Confiança , Adulto Jovem
18.
Aust Occup Ther J ; 56(3): 167-76, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20854510

RESUMO

BACKGROUND/AIM: The Tree Theme Method (TTM) is an intervention in which the client paints trees representing certain periods in his/her life. The intervention comprises five sessions, using trees as a starting point to tell one's life story. This study, which is part of an implementation project, aimed to examine the therapeutic alliance and client satisfaction, in relation to perceptions of everyday occupations and health-related factors, with clients going through a TTM intervention. METHODS: Nine occupational therapists recruited 35 clients, at general outpatient mental health care units, for the TTM intervention. Self-rating instruments, targeting therapeutic alliance (HAq-II), different aspects of daily occupations (Canadian Occupational Performance Measure, Satisfaction with Daily Occupations), health-related factors (Sense of Coherence measure, Mastery Scale, Symptom Checklist-90-R) and client satisfaction (Client Satisfaction Questionnaire), were administrated before and after the intervention. RESULTS: A good initial therapeutic alliance, experienced by both therapists and clients, was correlated to increased changes regarding occupational performance and self-mastery. According to the therapists' ratings, a good initial therapeutic alliance was correlated to increased sense of coherence and a decreased level of psychiatric symptoms. The results showed positive significant changes in occupational performance and health-related factors. High ratings of the therapeutic alliance by the therapists were also related to high client satisfaction. CONCLUSIONS: The TTM seemed to function well in psychosocial occupational therapy, but there is a need for further implementation studies to deepen our understanding of the treatment process, comprising both technique and formation of the therapeutic alliance.


Assuntos
Terapia pela Arte/métodos , Terapia Ocupacional/métodos , Satisfação do Paciente , Relações Profissional-Paciente , Atividades Cotidianas , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
19.
Scand J Occup Ther ; 13(4): 229-40, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17203673

RESUMO

This study aimed to describe the Tree Theme Method (TTM) as a method for intervention in psychosocial occupational therapy. The TTM is based on theories concerning creative activities and occupational storytelling and story making. In order to exemplify the method a case study of a treatment process with follow up was undertaken. The participant was a female client suffering from anxiety and depression. During an interview the client painted symbolic trees on five different occasions with specific variations of the tree theme: a tree symbolizing her present life, her childhood, adolescence, adulthood, and, finally, a tree representing her future. The trees were used as starting points for the client to tell her life story. The intention was that she would find new strategies for how to change her daily life. Three years later there was a follow up stage where the client painted new trees and told her story. Some life themes were identified. The TTM appears suitable for intervention in psychosocial occupational therapy. In future studies the TTM should be subjected to evaluation research based on several clients in order to develop a deeper understanding of the process and what kind of results changes in the TTM intervention may provide.


Assuntos
Ansiedade/reabilitação , Arte , Depressão/reabilitação , Terapia Ocupacional/métodos , Adulto , Feminino , Humanos , Árvores
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