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- Larsson, Ellinor, 1982-
(författare)
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Promoting social activities and participation among seniors : exploring and evaluating social and Internet-based occupational therapy interventions
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- IntroductionThe use of technology and Internet-based activities (IBAs) is increasing in society. However, seniors with limited experiences with the Internet can experience restricted participation in meaningful activities that are dependent on the Internet. Also, social transitions during aging might lead to reduced social activities and social contacts and to increased experiences of loneliness, all of which might have negative health implications. Therefore, there is a need to advance the knowledge of how occupational therapists can support seniors’ use of IBAs and create opportunities for social contacts and social activities during aging.AimThe overall aim of this thesis is to increase the knowledge of how Internet-based activities influence seniors’ participation in society, how seniors experience and are influenced by support from a social Internet-based occupational therapy intervention, and how different aspects of this intervention can contribute to healthy ageing.MethodsIn study I, seniors’ experiences of IBAs were explored and described through interviews with 10 seniors (66–82 years old) that were analyzed with the constant comparative method. In study II, a multiple case study with five seniors (65–85 years old) was used to explore the design of an Internet-based occupational therapy social intervention program and how it influenced social activities and social contacts among the participants. The qualitative and quantitative data from multiple sources were analyzed by pattern matching. In study III, an explorative randomized crossover study with an AB/BA design was conducted with 30 seniors (61–89 years old) who were vulnerable to loneliness and who participated in the intervention program. The quantitative data were analyzed with parametric and non-parametric statistics. In study IV, a qualitative interview study was conducted to collect the experiences of 15 seniors (66–87 years old) from the previous intervention process in study III. The interviews were analyzed with the constant comparative method. All participants in studies I–IV were community-dwelling, retired seniors without home-care services. ResultsComplex interactions of different aspects influence seniors’ possibilities and preferences for taking part in IBAs. The performance of IBAs yielded different experiences of participation in society (study I). The initial explorative results indicated that the client-centered and individually adapted intervention program supports participation in social IBAs (SIBAs) and other social contexts (study II). After participation in the intervention program, the experiences of loneliness significantly decreased, and satisfaction with social contacts on the Internet increased for one group (study III). If an individual’s requirements are met during the intervention process, experiences of habitual SIBA usage, increased self-reliance, and enriched social contacts and social activities both on and off the Internet might be facilitated (study IV).ConclusionThis thesis provides knowledge of how social support, experiences of and accessibility to technology, life-changing events, and identified meaningfulness with online activities influence the motivation to participate in social and Internet-based activities. The occupational therapist should address the individual’s perspective in the intervention program so as to adapt the intervention and to support experiences of satisfactory participation and enhanced social activities and social contacts for seniors. In addition, healthy aging might be supported by the intervention program due to the reduction in loneliness and increased participation in social activities and society. Further evaluation of the framework and content of the intervention program for seniors with restricted participation in IBAs and SIBAs and high levels of loneliness is suggested.
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- Wennberg, Birgitta, 1956-
(författare)
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Keeping track of time : Daily time management, participation, and time-related interventions for children, adolescents, and young adults with neurodevelopmental disorders
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to investigate daily time management (DTM) and time-related interventions aiming to enhance participation in everyday activities among school-age children and young adults with neurodevelopmental disorders.In study I, experiences of participation when using time assistive devices (TADs) in daily activities were investigated from the perspective of young adults (aged 17–37) with intellectual disabilities (ID) (n = 9), using semi structured interviews. In studies II and IV, a new multimodal time-related intervention consisting of psychoeducation, compensation with TADs and time-skills training, was investigated in children aged 9–15 with attention-deficit/hyperactivity disorder (ADHD). Study II was a randomized controlled trial (RCT) with an intervention group (n = 19) and a control group (n = 19). The aim of study III was to describe DTM, time processing ability (TPA) and self-rated autonomy in children aged 9–15 with ADHD (n = 47), compared to children with ID (n = 47) and typically developing (TD) children (n = 47). In study IV, occupational performance and satisfaction were evaluated (n = 27). In studies II, III and IV, a source for data collection included assessment, proxy report and self-reports.Using TADs (study I) increased participation in activities in all areas of daily life: self-care, activities at work or school and leisure time activities. A feeling of having more control led to health benefits. Participants described participation restrictions related to attitudes from their social network towards participation and attitudes towards the use of TADs from the individuals themselves. Study II showed that the children in the intervention group increased their TPA significantly more compared to the control group, mostly in terms of time orientation. The parents in the intervention group rated their children’s DTM as significantly more improved compared to the parents of the children in the control group. However, according to the children themselves, there was no statistically significant improvement in their DTM. The psychoeducation for parents and school staff did not increase children’s TPA and DTM on its own. The majority of parents and children (study IV) rated the children’s occupational performance and satisfaction significantly higher at follow-up than at baseline. In general, children rated their occupational performance and satisfaction higher than their parents did. Most goals decided by the children and their parents involved daily routines and time orientation. Study III showed that children with ADHD and children with ID had significantly lower TPA, DTM and autonomy compared to TD children. Children with ADHD showed higher levels of self-rated autonomy compared to children with ID, but the reverse was found in DTM. However, there was significant diversity among children with ADHD and children with ID, which was not explained by age. Some children had difficulties at every level of TPA, while others were skilled at every level. The level of self-rated autonomy followed the level of TPA.In conclusion, this thesis revealed that children with ADHD and ID have the same overall pattern of TPA but may have a delayed TPA, which affects their DTM and autonomy, and thereby also influences their participation in daily activities. The results show that a multimodal time-related intervention using TADs and time-skills training could increase TPA and DTM in children with ADHD aged 9–15 years with time deficits. Experiences from young adults with ID also show increased participation in daily activities and health benefits using TADs. It is recommended that TPA and DTM should be measured to identify difficulties in TPA and DTM in children with ADHD and to offer tailored time-related interventions in addition to medication.
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