Background Purposive sampling has a long developmental history and there are as many views that it is simple and straightforward as there are about its complexity. The reason for purposive sampling is the better matching of the sample to the aims and objectives of the research, thus improving the rigour of the study and trustworthiness of the data and results. Four aspects to this concept have previously been described: credibility, transferability, dependability and confirmability. Aims The aim of this paper is to outline the nature and intent of purposive sampling, presenting three different case studies as examples of its application in different contexts. Results Presenting individual case studies has highlighted how purposive sampling can be integrated into varying contexts dependent on study design. The sampling strategies clearly situate each study in terms of trustworthiness for data collection and analysis. The selected approach to purposive sampling used in each case aligns to the research methodology, aims and objectives, thus addressing each of the aspects of rigour. Conclusions Making explicit the approach used for participant sampling provides improved methodological rigour as judged by the four aspects of trustworthiness. The cases presented provide a guide for novice researchers of how rigour may be addressed in qualitative research.

The findings may encourage professionals working in health and rehabilitation settings to assist clients in identifying meaningful, creative occupations that are feasible within the limits imposed by illness or injury.

This study explored women's strategies for living with multiple sclerosis (MS).Twenty-seven women were interviewed, most of whom had lived with MS for more than five years. Analysis of the semi-structured interviews followed the interpretative phenomenological approach. The women portrayed living with MS as an ongoing process of negotiation, and described gaining quality of life through looking after their health; maintaining a familiar self-image, particularly through meaningful occupations, and adapting pre-illness skills and interests to their changing levels of physical functioning; actively valuing positive life experiences, including finding benefits in adversity; clarifying values, priorities and philosophy of life; and maintaining mutual, caring relationships. Some regarded MS as presenting opportunities for personal growth. Without minimizing the very substantial difficulties that MS presents, the findings suggest that well-being derives from both managing the illness and also embracing life's wider experiences, including change and growth. Implications for rehabilitation and counseling professionals are considered.1 "Sticking jewels in your life": Exploring women's strategies for negotiating life with multiple sclerosis.

The aim of this qualitative research was to understand why some people with cancer take up art as a leisure activity, and how visual art-making in daily life might support identity maintenance/ reconstruction. The study forms part of a larger project with people who view art-making as a resource for living with chronic illness. In order to provide a detailed, holistic analysis, the paper focuses on the accounts and artwork of three participants, two women (aged 47 and 59) each with breast cancer, and a man (aged 51) with stomach and lung cancer. The participants turned to art after a process of reflection but did not necessarily reject their pre-illness lifestyles or selves. Rather, art-making afforded many opportunities to retain familiar personal and social identities, and to resist being dominated by labels related to their illness. A practical implication is that people coping with cancer may need not only cognitive and emotional support, but opportunities to find meaningful activities. Such activities can be understood to have a powerful role in maintaining a familiar, positive identity in cancer, and providing a resource for coping.

This qualitative study invited women living with cancer who engaged in visual art-making to reflect on their experiences of the creative process. The study sought to explore whether the participants described experiences of flow during art-making and, if so, how such experiences helped them to cope with cancer. Ten women took part in semi-structured interviews. They described a range of difficulties associated with their illness. The interview data were analysed using a template approach, based on the theory of Csikszentmihalyi.The participants described a number of experiences that have been associated with flow in previous work. However, one aspect of flow, namely having clear goals, was not present clearly in the participants' accounts. The participants also described other facets of art-making that seemed part of the flow experience, including sensuous vitality, responsiveness to art materials and evolving imagery, and creative adventures. The flow experiences during art-making helped to banish intrusive thoughts about cancer, provided valued experiences of mastery and control and encouraged the participants to engage in positive journeys into the unknown, thereby alleviating some of the stress of cancer.The study offers a detailed analysis of the experience of creative occupation and has relevance to occupational therapists working with clients who have life-threatening illnesses.

Background: Online electronic records such as patient portals and personally controlled electronic health records (PEHRs) have been widely viewed as a key component to modernising the delivery of healthcare but the uptake of such systems has been slow. Objective: The purpose of this literature review was to determine what influences consumers to engage and interact with their clinical data online. Method: A scoping literature review following PRISMA guidelines was completed. Electronic patient record research published between January 2009 and December 2018 was included. Following screening and full-text reviews, a total of 64 records were included in this review. Results: Three key areas of influence on consumer engagement with their clinical data online emerged: demographic factors affecting consumer interaction with PEHRs; consumers’ perceived benefits and detriments of PEHR use; and the influence of PEHR use on consumer empowerment and responsibility. Discussion: Consumer motivation and readiness for engaging with their clinical data online and their long-term ongoing use of these systems requires further exploration. Conclusion: As worldwide rates of consumer interactions with individual online clinical data remain low, what influences consumer engagement with a PEHR remains unknown. Further research into the consumer perspective of, and interaction with, a PEHR, needs to be undertaken to determine if factors such as frequent usage of the system by consumers leads to improved clinical outcomes.

Group projects are an established but debated pedagogical technique in higher education. The purpose of this study was to assess the appropriateness of combining individual and group marks in assessment. A mixed method design involving correlational and comparative elements was used. The sample included one cohort of students who completed a group project at Level one (n=127) and Level three (n=103) of an undergraduate occupational therapy BSc degree. Key findings included no statistically significant correlation between group and individual assessment marks; a significant proportion of students failing the individual written assignment passed the module overall; and neither academic ability nor demographic factors predicted group performance. This suggests that group assessment measures factors other than individual academic performance. The implications are that group assessment should be clearly linked to module learning outcomes; should explicitly grade relevant non-academic skills; and should be used with caution as a Level one assessment.

Purpose: To understand the meanings of art-making among a group of women living with the occupational constraints and stigma of CFS/ME. The study explored their initial motives for art-making, and then examined how art-making had subsequently influenced their subjective well-being.Method: Ten women with CFS/ME were interviewed; three provided lengthy written accounts to the interview questions.Findings: Illness had resulted in devastating occupational and role loss. Participants took many years to make positive lifestyle changes. Art-making was typically discovered once participants had accepted the long-term nature of CFS/ME, accommodated to illness, and reprioritised occupations. Several factors then attracted participants specifically to art-making. It was perceived as manageable within the constraints of ill-health. Participants also tended to be familiar with craft skills; had family members interested in arts and crafts, and some desired a means to express grief and loss. Once established as a leisure activity, art-making increased subjective well-being mainly through providing increased satisfaction in daily life, positive selfimage, hope, and contact with the outside world. Participants recommended provision of occupational/ recreational counselling earlier in the illness trajectory.Conclusions: Creative art-making occurred as part of a broader acceptance and adjustment process to CFS/ME, and allowed some psychological escape from a circumscribed lifeworld.