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Balancing Everyday Life. Exploring change following an activity-based lifestyle intervention for mental health service users.

Lund, Kristine LU (2019)
Abstract

There is limited
research that evaluates occupational therapy and lifestyle interventions,
especially for mental health service users. This thesis provides increased
knowledge and understanding of the processes and factors that led to better
quality of everyday life, engagement in meaningful activities, and balance for
participants who took part in the Balancing Everyday Life (BEL) intervention.
BEL was implemented in 2012-2015 as part of a larger research project, of which
this dissertation is part. BEL is a group-based occupational therapy
intervention that aims to support overall well-being and recovery through
finding a personalized balance of meaningful activities and... (More)

There is limited
research that evaluates occupational therapy and lifestyle interventions,
especially for mental health service users. This thesis provides increased
knowledge and understanding of the processes and factors that led to better
quality of everyday life, engagement in meaningful activities, and balance for
participants who took part in the Balancing Everyday Life (BEL) intervention.
BEL was implemented in 2012-2015 as part of a larger research project, of which
this dissertation is part. BEL is a group-based occupational therapy
intervention that aims to support overall well-being and recovery through
finding a personalized balance of meaningful activities and relationships.



Study I investigated
whether socio-demographic, care context, clinical and self-related factors
could predict clinically important improvements in the outcomes mentioned
above. Data collection took place with 133 participants at baseline, and then
again at BEL end and six months following. Bi-variate analyses and then
multivariate regression analyses were performed. Though many associations were
found, few factors were identified as predictors in the regression analyses.
The strongest predictors of belonging to the improved groups for occupational
balance included having a friend for the leisure domain of occupational balance
and female gender for the self-care domain. Having children was found to be a
predictor for improved occupational engagement.



Studies II-IV used a
qualitative Grounded Theory approach. Nineteen participants were interviewed
after BEL, and some were interviewed mid-intervention and 1.5-2 years after
BEL. Study II focused on the meaning of the group for the BEL participants, and
a process of meaning-making through group participation was constructed of
three categories: Joining with others, Sense of belonging, and Re-valuing Self.
Those who experienced the most meaning reported feeling less lonely, more
connected, as well as respected and worthy.



Study III focused on
the processes at work that supported making lifestyle changes. A process of
making changes was constructed, consisting of five categories: Going at it
gently: change is an on-going process; Support for progress, permission to
fail; Prioritizing and setting boundaries; Adjusting for a sustainable balance;
and Caring for a valued Self. Each category included a strategy for change as
well as a related inner change. A more self-compassionate approach seemed to be
a key for caring for Self and making sustainable changes.



Study IV focused on
perceptions of the BEL format and content and included focus group and/or
individual interviews with 12 group leaders and 19 participants. Both parties
felt that they had benefited from BEL’s structure and manual, yet flexibility
was desired. BEL appeared to create bridges - to other people, to society at
large, and to a future version of everyday life. BEL’s occupation- and
person-focused approach was appreciated. Group leaders experienced BEL as easy
to implement and some felt it strengthened their professional role.
Participants appreciated feeling respected and listened to by the group
leaders, and appreciated them maintaining structure in the group. Regarding
hindering factors, group leaders mentioned mainly material obstacles, such as
the lack of suitable group rooms or projector. Participants felt that too
different functional levels between the group participants could be an
obstacle.



As similar research
and interventions are lacking, this dissertation provides an important
contribution to the knowledge base for occupational therapeutic interventions
in the psychiatric field.

(Less)
Please use this url to cite or link to this publication:
author
supervisor
opponent
  • professor Killapsy, Helen, University College London (UCL)
organization
publishing date
type
Thesis
publication status
published
keywords
Lifestyle, Lifestyle intervention, Mental Health, Mental illness, Occupational Therapy, Quality of life, Change Process, meaning, Grounded theory, Recovery
pages
95 pages
publisher
Lund University, Faculty of Medicine
defense location
Health Science Centre, Baravägen 3 i Lund
defense date
2019-03-22 13:00
ISBN
978-91-7619-754-7
language
English
LU publication?
yes
id
00e10026-aa0b-488a-8f0a-fd6c97f295d9
date added to LUP
2019-02-21 17:02:59
date last changed
2019-03-01 09:28:46
@phdthesis{00e10026-aa0b-488a-8f0a-fd6c97f295d9,
  abstract     = {<p class="MsoNormal">There is limited<br>
research that evaluates occupational therapy and lifestyle interventions,<br>
especially for mental health service users. This thesis provides increased<br>
knowledge and understanding of the processes and factors that led to better<br>
quality of everyday life, engagement in meaningful activities, and balance for<br>
participants who took part in the Balancing Everyday Life (BEL) intervention.<br>
BEL was implemented in 2012-2015 as part of a larger research project, of which<br>
this dissertation is part. BEL is a group-based occupational therapy<br>
intervention that aims to support overall well-being and recovery through<br>
finding a personalized balance of meaningful activities and relationships.</p><br>
<br>
<p class="MsoNormal">Study I investigated<br>
whether socio-demographic, care context, clinical and self-related factors<br>
could predict clinically important improvements in the outcomes mentioned<br>
above. Data collection took place with 133 participants at baseline, and then<br>
again at BEL end and six months following. Bi-variate analyses and then<br>
multivariate regression analyses were performed. Though many associations were<br>
found, few factors were identified as predictors in the regression analyses.<br>
The strongest predictors of belonging to the improved groups for occupational<br>
balance included having a friend for the leisure domain of occupational balance<br>
and female gender for the self-care domain. Having children was found to be a<br>
predictor for improved occupational engagement.</p><br>
<br>
<p class="MsoNormal">Studies II-IV used a<br>
qualitative Grounded Theory approach. Nineteen participants were interviewed<br>
after BEL, and some were interviewed mid-intervention and 1.5-2 years after<br>
BEL. Study II focused on the meaning of the group for the BEL participants, and<br>
a process of meaning-making through group participation was constructed of<br>
three categories: Joining with others, Sense of belonging, and Re-valuing Self.<br>
Those who experienced the most meaning reported feeling less lonely, more<br>
connected, as well as respected and worthy.</p><br>
<br>
<p class="MsoNormal">Study III focused on<br>
the processes at work that supported making lifestyle changes. A process of<br>
making changes was constructed, consisting of five categories: Going at it<br>
gently: change is an on-going process; Support for progress, permission to<br>
fail; Prioritizing and setting boundaries; Adjusting for a sustainable balance;<br>
and Caring for a valued Self. Each category included a strategy for change as<br>
well as a related inner change. A more self-compassionate approach seemed to be<br>
a key for caring for Self and making sustainable changes.</p><br>
<br>
<p class="MsoNormal">Study IV focused on<br>
perceptions of the BEL format and content and included focus group and/or<br>
individual interviews with 12 group leaders and 19 participants. Both parties<br>
felt that they had benefited from BEL’s structure and manual, yet flexibility<br>
was desired. BEL appeared to create bridges - to other people, to society at<br>
large, and to a future version of everyday life. BEL’s occupation- and<br>
person-focused approach was appreciated. Group leaders experienced BEL as easy<br>
to implement and some felt it strengthened their professional role.<br>
Participants appreciated feeling respected and listened to by the group<br>
leaders, and appreciated them maintaining structure in the group. Regarding<br>
hindering factors, group leaders mentioned mainly material obstacles, such as<br>
the lack of suitable group rooms or projector. Participants felt that too<br>
different functional levels between the group participants could be an<br>
obstacle.</p><br>
<br>
<p class="MsoNormal">As similar research<br>
and interventions are lacking, this dissertation provides an important<br>
contribution to the knowledge base for occupational therapeutic interventions<br>
in the psychiatric field.</p>},
  author       = {Lund, Kristine},
  isbn         = {978-91-7619-754-7},
  keyword      = {Lifestyle,Lifestyle intervention,Mental Health,Mental illness,Occupational Therapy,Quality of life,Change Process,meaning,Grounded theory,Recovery},
  language     = {eng},
  pages        = {95},
  publisher    = {Lund University, Faculty of Medicine},
  school       = {Lund University},
  title        = {Balancing Everyday Life. Exploring change following an activity-based lifestyle intervention for mental health service users.},
  year         = {2019},
}