Purpose: This study describe and compare the ability of professionals working in municipality stroke rehabilitation services to facilitate learning and change in the daily living of stroke survivors in two regions: one in northern Norway, the other central Denmark. Materials and Methods: Semi-structured individual interviews were conducted with survivors 3 and 9 months after discharge from in-patient care. By contrast, field observations and focus group interviews were completed with professionals on multidisciplinary teams in the two regions. A sociocultural perspective on learning was applied during data analysis. Results: Altogether, the ability of municipal health services to facilitate learning and change for stroke survivors during the first year generally depended upon developing comprehensive integrated rehabilitation plans and ensuring access to coordinated, qualified multidisciplinary teams with professional knowledge and skills to support the survivors and their families during processes of adjustment, learning and change. However, Danish stroke survivors seemed positioned to be more active, proactive and empowered, and their processes of learning and change seemed more closely co-constructed with professional support. Conclusion: Findings reveal considerable differences in municipal stroke rehabilitation services in northern Norway and central Denmark and their ability to support stroke survivors in performing self-management.
Procedures for paradigmatic analysis were followed, and brought forward three themes: doing crafts in a group facilitated stability and routines, skills and abilities, and peer support. The discussion reflected knowledge and experiences of crafts as an activity with a low-risk threshold for participation and its healing value. How the doing of craft activities in a group offered transactional space to gain experiences to manage everyday occupations was further discussed.
Background: People with dementia in institutional settings lack engagement in meaningful occupations, which may cause decreased quality of life. Although many researchers and professionals have proposed approaches to engage people with dementia in these occupations, an overview seems to be missing.
Aim:This scoping review provides an overview by categorizing and describing the characteristics of the approaches.
Material and method:A thorough literature search in nine databases identified the studies on approaches. We included 54 studies and extracted bibliometric data. A content analysis revealed the characteristics of the approaches.Results: Four categories of approaches were uncovered. First, the literature defined the concept of meaningful occupation in various ways. Second, a category of approaches provided theoretical knowledge of meaningful occupations. The third category focused on specific themes, such as certain methods. The final described comprehensive multilevel approaches.
Conclusion:This review contributes to knowledge of the diversity of approaches to engage people with dementia in meaningful occupation within institutional settings.Significance: We suggest that occupational therapy researchers and practitioners consider how the concept of meaningful occupation is embedded in the theoretical landscape. Furthermore, activity programming requires reflexive decision-making at the policy and practice level, as engagement in meaningful occupations is complex.
Acknowledgements:The authors would like to thank Easyfact AS for technical support with the electronic questionnaire development, the seven occupational therapists who piloted the electronic draft, and all the therapists who responded the questionnaire. We also acknowledge Ergoterapeutene (the Norwegian Occupational Therapy Association) who have contributed with funds and practical assistance.
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