Re‐imagining occupational wellbeing: Development of an evidence‐based framework

Abstract

Background/aim Occupational therapists concern themselves with understanding engagement in everyday activity as a mode of facilitating wellbeing. However, there appears to be little consensus within the literature as to how engagement in meaningful activities contributes to wellbeing. Currently, there are no published evidence‐based frameworks for wellbeing to support occupational therapy practitioners to address wellbeing with clients. The purpose of the study was to establish an evidence‐based contemporary framework, domains and descriptive statements defining occupational wellbeing. Methods A multiphase, exploratory sequential mixed methods design, using both qualitative and quantitative approaches was used. Two phases were identified for data collection. The first phase involved exploration of the domains of occupational wellbeing, through conducting a literature review and two focus groups. The Delphi technique was employed in the second phase to refine and corroborate the domains of occupational wellbeing with an expert panel. Results Six new domains of occupational wellbeing were generated in the first phase of the study, namely: Competence, autonomy, contentment and pleasure, identity, hope and belonging. In the second phase, five out of the six domains reached a consensus level of 70% or more. Hope was the only domain not to reach consensus. Conclusion The framework for occupational wellbeing produced by this study was created using evidence‐based, replicable methodology and garnered support from a highly regarded expert key informant group of occupational therapy and occupational science academics. Further exploration to determine whether there is widespread support and applicability for these domains with normative and vulnerable population groups is required.

“Just one of the guys” An application of the Occupational Wellbeing framework to graduates of a Men’s Shed Program for young unemployed adult males with intellectual disability

“…Seven participants made 12 references to the domain of autonomy. The domain of autonomy refers to an individual's sense of control over their actions and personal choices (Saraswati et al, ). Opportunities to exercise this control and make their own decisions can promote a sense of autonomy, and contribute to occupational wellbeing (Saraswati et al, ).…”

“…Eight participants made 16 references to the domain of identity, referring to an individual's sense of self, fostered through activities that align with personal values and provide a purpose (Saraswati et al, ). Two of the parents reported how mentees sense of identity increased through engagement in activities at the Men's Shed and interaction with other members:

To go to this place and experience these activities in an environment where they can socialize and grow as a person (Wendy, mother)

…”

“…Saraswati et al () refined the framework through consultation with a group of occupational therapy and occupational science academics. The redefined domains move away from the notion of “occupational needs,” instead comprising individual descriptors to define occupational wellbeing: (a) competence (when individuals feel effective); (b) autonomy (when individuals feel they are the originator of their own personal choices and exert control over their actions); (c) contentment and pleasure (an individual's experience of enjoyment and fun); (d) belonging (when individuals have an emotional connection to place, person, past traditions or social network) and (e) identity (a strong sense of self identity through validation from others, engagement in activities that give purpose, are congruent with personal values and are supported by society; Saraswati et al, ). This newly developed framework requires further validation and may help understand the importance of meaningful occupations and their contribution to occupational wellbeing for people who experience ID.…”

“…In recognition of the importance of holistic wellbeing and occupation, the occupational wellbeing framework was recently refined (Saraswati, Milbourn, & Buchanan, 2018). This framework facilitates an understanding of the subjective meaning of a person's occupational life rather than focusing on performance (Saraswati et al, 2018). The framework builds upon the work of Doble and Santha (2009), who theorised that occupational wellbeing has several prerequisites, referred to as occupational needs.…”

“…These needs include the experiences of agency, accomplishment, affirmation, pleasure, renewal, coherence and companionship (Doble & Santha, 2009). Saraswati et al (2018) refined the framework through consultation with a group of occupational therapy and occupational science academics. The redefined domains move away from the notion of "occupational needs," instead comprising individual descriptors to define occupational wellbeing: (a) competence (when individuals feel effective); (b) autonomy (when individuals feel they are the originator of their own personal choices and exert control over their actions); (c) contentment and pleasure (an individual's experience of enjoyment and fun); (d) belonging (when individuals have an emotional connection to place, person, past traditions or social network) and (e) be considered when attempting to understand the quality of life and function for people with disabilities.…”