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Predictors of clinically important improvements in occupational and quality of life outcomes among mental health service users after completion and follow-up of a lifestyle intervention : multiple regression modelling based on longitudinal data

Hultqvist, Jenny LU ; Lund, Kristine LU ; Argentzell, Elisabeth LU and Eklund, Mona LU orcid (2019) In BMC psychology 7(1).
Abstract

BACKGROUND: Balancing Everyday Life (BEL) is a new activity-based lifestyle intervention for mental health service users. An earlier study found BEL to be effective in increasing occupational engagement, occupational balance, activity level, and quality of life scores when compared with a care-as-usual group. However, it is unclear whether care context and socio-demographic, clinical and self-related factors at baseline also influence the results. Thus, the aim of the current study was to explore whether such factors could predict clinically important improvements in occupational and quality of life aspects. METHODS: Participants were interviewed and filled out self-report questionnaires before starting the 16-week intervention (n =... (More)

BACKGROUND: Balancing Everyday Life (BEL) is a new activity-based lifestyle intervention for mental health service users. An earlier study found BEL to be effective in increasing occupational engagement, occupational balance, activity level, and quality of life scores when compared with a care-as-usual group. However, it is unclear whether care context and socio-demographic, clinical and self-related factors at baseline also influence the results. Thus, the aim of the current study was to explore whether such factors could predict clinically important improvements in occupational and quality of life aspects. METHODS: Participants were interviewed and filled out self-report questionnaires before starting the 16-week intervention (n = 133), upon completion (n = 100), and 6 months following (n = 89). Bi-variate and multi-variate statistical analyses were performed. RESULTS: Several baseline factors were associated with clinically important improvements, but few predictors were found in the multivariate analyses. Having children was found to be a predictor of improvement in occupational engagement at BEL completion, but reduced the chance of belonging to the group with clinically important improvement in activity level at follow-up. Regarding occupational balance, having a close friend predicted belonging to the group with clinically important improvement in the leisure domain. At BEL completion, other predictors for improvements were female gender for the self-care domain, and self-esteem for the home chores domain. At follow-up, psychosocial functioning and lower education level predicted general balance. None of the factors explored in this study were found to be predictors for improvements in quality of life. CONCLUSIONS: Few of the studied care context, socio-demographic, clinical and self-related factors were found to predict clinically important improvements in occupational engagement, activity level, occupational balance, or QOL. This study, together with previous studies showing positive results, suggests that BEL can be an appropriate intervention in both community and clinical settings, and can support improvement in occupational aspects and QOL for participants with diverse socio-demographic, clinical, and self-related characteristics. TRIAL REGISTRATION: This study is part of a larger research project that is registered at ClinicalTrials.gov. Reg. No. NCT02619318.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Mental illness, Occupational balance, Occupational engagement, Occupational therapy, Psychiatric rehabilitation, Quality of life
in
BMC psychology
volume
7
issue
1
article number
83
publisher
BioMed Central (BMC)
external identifiers
  • pmid:31847910
  • scopus:85076838456
ISSN
2050-7283
DOI
10.1186/s40359-019-0359-z
language
English
LU publication?
yes
id
35bb28ab-78b3-4272-b55e-14ab0f335e89
date added to LUP
2020-01-03 12:33:49
date last changed
2024-03-04 10:56:20
@article{35bb28ab-78b3-4272-b55e-14ab0f335e89,
  abstract     = {{<p>BACKGROUND: Balancing Everyday Life (BEL) is a new activity-based lifestyle intervention for mental health service users. An earlier study found BEL to be effective in increasing occupational engagement, occupational balance, activity level, and quality of life scores when compared with a care-as-usual group. However, it is unclear whether care context and socio-demographic, clinical and self-related factors at baseline also influence the results. Thus, the aim of the current study was to explore whether such factors could predict clinically important improvements in occupational and quality of life aspects. METHODS: Participants were interviewed and filled out self-report questionnaires before starting the 16-week intervention (n = 133), upon completion (n = 100), and 6 months following (n = 89). Bi-variate and multi-variate statistical analyses were performed. RESULTS: Several baseline factors were associated with clinically important improvements, but few predictors were found in the multivariate analyses. Having children was found to be a predictor of improvement in occupational engagement at BEL completion, but reduced the chance of belonging to the group with clinically important improvement in activity level at follow-up. Regarding occupational balance, having a close friend predicted belonging to the group with clinically important improvement in the leisure domain. At BEL completion, other predictors for improvements were female gender for the self-care domain, and self-esteem for the home chores domain. At follow-up, psychosocial functioning and lower education level predicted general balance. None of the factors explored in this study were found to be predictors for improvements in quality of life. CONCLUSIONS: Few of the studied care context, socio-demographic, clinical and self-related factors were found to predict clinically important improvements in occupational engagement, activity level, occupational balance, or QOL. This study, together with previous studies showing positive results, suggests that BEL can be an appropriate intervention in both community and clinical settings, and can support improvement in occupational aspects and QOL for participants with diverse socio-demographic, clinical, and self-related characteristics. TRIAL REGISTRATION: This study is part of a larger research project that is registered at ClinicalTrials.gov. Reg. No. NCT02619318.</p>}},
  author       = {{Hultqvist, Jenny and Lund, Kristine and Argentzell, Elisabeth and Eklund, Mona}},
  issn         = {{2050-7283}},
  keywords     = {{Mental illness; Occupational balance; Occupational engagement; Occupational therapy; Psychiatric rehabilitation; Quality of life}},
  language     = {{eng}},
  month        = {{12}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC psychology}},
  title        = {{Predictors of clinically important improvements in occupational and quality of life outcomes among mental health service users after completion and follow-up of a lifestyle intervention : multiple regression modelling based on longitudinal data}},
  url          = {{http://dx.doi.org/10.1186/s40359-019-0359-z}},
  doi          = {{10.1186/s40359-019-0359-z}},
  volume       = {{7}},
  year         = {{2019}},
}