Photovoice provides a useful framework to apply a participant-centred research approach on occupational participation. It is important to consider and further examine ethical and methodological issues related to stigma, physical and cognitive capacities, mobility and technical accessibility related to using this method.

Introduction: Affecting 5-6% of children, developmental coordination disorder is a neurodevelopmental disorder characterized by poor motor coordination and difficulty learning motor skills. Although quantitative studies have suggested that children with developmental coordination disorder experience reduced quality of life, no known qualitative studies have reported what daily life is like from their perspective. Method: Guided by an inductive realistic approach and using semi-structured, individual interviews, 13 children (8-12 years) were asked to describe what life is like in their own words. Three researchers coded interviews manually to identify relevant content. An experienced qualitative researcher conducted a second, in-depth thematic analysis using NVivo to identify patterns and themes. Findings: Two themes-milestones as millstones and the perils of printing-illuminated participants' challenges in completing everyday activities at home and at school. The third theme-more than a motor problem-revealed the social and emotional impact of these struggles and from being excluded from play. The fourth theme-coping strategies-described their efforts to be resilient. Conclusion: Parents, educators, physicians, and therapists working with children with developmental coordination disorder must recognize how their quality of life is affected by the physical and emotional toll of their efforts to participate successfully in daily activities.

Loneliness and depression are serious mental health concerns across the spectrum of residential care, from nursing homes to assisted and retirement living. Psychosocial care provided to residents to address these concerns is typically based on a long-standing tradition of 'light' social events, such as games, trips, and social gatherings, planned and implemented by staff. Although these activities provide enjoyment for some, loneliness and depression persist and the lack of resident input perpetuates the stereotype of residents as passive recipients of care. Residents continue to report lack of meaning in their lives, limited opportunities for contribution and frustration with paternalistic communication with staff. Those living with dementia face additional discrimination resulting in a range of unmet needs including lack of autonomy and belonging-both of which are linked with interpersonal violence. Research suggests, however, that programs fostering engagement and peer support provide opportunities for residents to be socially productive and to develop a valued social identity. The purpose of this paper is to offer a re-conceptualization of current practices. We argue that residents represent a largely untapped resource in our attempts to advance the quality of psychosocial care. We propose overturning practices that focus on entertainment and distraction by introducing a new approach that centers on resident contributions and peer support. We offer a model-Resident Engagement and Peer Support (REAP)-for designing interventions that advance residents' social identity, enhance reciprocal relationships and increase social productivity. This model has the potential to revolutionize current psychosocial practice by moving from resident care to resident engagement.

The strategies adopted by a sample of people coping well with their BD show remarkable overlap with the targets of existing adjunctive psychosocial interventions for BD. The clinician can use this information to motivate clients to engage with such strategies. The present findings also serve to remind the clinician of significant individual differences in the personal meaning and concrete application of superficially similar strategies.

Objective. To describe the impact of chronic, inflammatory arthritis on parenting and to develop a conceptual framework for subsequent study of mothering. Methods. A qualitative, grounded theory design guided data collection and analysis. In-depth interviews were conducted with a purposive sample of 12 women with either rheumatoid arthritis, ankylosing spondylitis, juvenile idiopathic arthritis, or systemic lupus erythematosus who were mothers of at least 1 child living at home. Transcripts were analyzed using a systematic approach of coding and forming concepts and key categories to construct an explanatory framework. Peer checking and member checking enhanced analytical rigor. Results. Analysis of participants' experiences resulted in 4 interrelated categories describing the impact of arthritis on their role as mothers: participation in mothering tasks, best described as "sometimes I can, sometimes I can't"; different types and levels of support from others; the influence of the mother's arthritis on the family; and the challenge of balancing energy and fatigue. Individuals' arthritis story, life stage, their children's developmental stage, and daily routine described the context in which mothers experienced elements of each of the 4 main categories. Conclusion. Inflammatory arthritis has a dramatic impact on the experience of motherhood, with both positive and negative influences. The perspectives shared by study participants may inform practice regarding problem identification and adaptive strategies, and the explanatory model generated from the data proposes hypotheses for further study.

Despite leisure's central position within occupational therapy models of practice, theoretical development from within occupational therapy remains limited. Historically occupational therapy has viewed leisure as an occupational performance area, quantifiable and discretionary time, and as activity used to achieve clients' targeted outcomes. Using social sciences literature and Primeau's (1996) ideas about the relationship between work and leisure, an argument is made for further theoretical development of leisure concepts and their application to occupational therapy. A brief review of standardized leisure assessments reveals their emphasis on leisure as time or activity. In contrast, interdisciplinary advances in leisure studies pertinent to occupational therapy focus on understanding leisure as a subjective experience. Acknowledgement of the importance of leisure as a state of mind underscores the importance of creating meaning within occupations. Finally, the stages of the Occupational Performance Process (CAOT, 1997; Fearing, Law & Clark, 1997) provide a framework for demonstrating how leisure concepts and assessments guide occupational therapy practice.

Bipolar disorder (BD) is a complex chronic condition associated with substantial costs, both at a personal and societal level. Growing research indicates that experiences with stigma may play a significant role in contributing to the distress, disability, and poor quality of life (QoL) often experienced in people with BD. Here, we present a sub-set of findings from a qualitative study of self-management strategies utilized by high functioning Canadian individuals with BD. Specifically, we describe a theme relating to participants' experiences and understandings of internalized stigma. Descriptive qualitative methods were used including purposeful sampling and thematic analysis. High functioning individuals with BD type I or II (N = 32) completed quantitative scales to assess symptoms, functioning and QoL, and participated in an individual interview or focus group to discuss the self-management strategies that they use to maintain or regain wellness. Thematic analysis identified several themes, including one relating to internalized stigma. Within this, four additional themes were identified: stigma expectations and experiences, sense of self/identity, judicious disclosure, and moving beyond internalised stigma. One of the more unique aspects of the study is that it involves a participant sample that is managing well with their illness, which differs from the norm in biomedical research that typically focuses on pathology, problems and dysfunction.

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