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This paper reviews continuity theory as it applies to the field of ageing and reports the findings of a qualitative study aimed at understanding the personal meanings of ageing and well-being from the perspective of oldest-old women. Transcribed ethnographic interviews of 23 Caucasian and African-American community-dwelling women over the age of 85, who live in the midwestern United States, were analysed through the combined theoretical perspective of symbolic interactionism [1] and continuity theory [2, 3]. The women's communication about ageing and well-being leads the researchers to conclude that personal competence in the "feminine sphere" is key to understanding older women's health beliefs and behaviours in late life. Findings also point to the importance of occupational competence as a predictor of well-being in late life. This study underscores the importance of public communication of self and the role of occupational therapists in facilitating alternative visions of a meaningful occupational self. [ABSTRACT FROM AUTHOR]

The aim of this explorative study was to compare the prescription, frequency, costs, types, and impact of assistive devices (ADs) on different daily activities. The hypothesis was that the patients at a stroke unit (SU) would be better equipped with ADs, at a lower cost and with a higher impact than the patients on general wards (GW). Patients aged 70 years and older were randomized to the study and followed longitudinally during 12 months after acute stroke. The patients at the SU (n =116) and on the GW (n =57) were followed at an early (0 -3 months) and later stage (4 -12 months) of the rehabilitation process. There was a statistically significant difference in prescribing simple and inexpensive ADs between the SU and the GW within the first 3 months after acute stroke. However, there was no significant difference in cost of ADs at the different stages. It is concluded that different ADs were prescribed at different stages in the rehabilitation process, they were frequently prescribed, and they were used to a large extent in both groups. The ADs were prescribed at low cost and had a high impact on these elderly people's daily life after stroke. [ABSTRACT FROM AUTHOR]

The purposes of this study were to describe (1) perceived needs for occupational therapy, (2) the frequency of healthcare visits, (3) specific pain-related characteristics, and (4) to explore differences in these aspects between low (≤4 visits/year) and high consumers (> 4 visits/year) of healthcare among persons aged 18 -58 years with self-perceived activity limitations/participation restrictions due to long-term/recurrent pain. A sample of 443 individuals with long-term/recurrent pain completed questionnaires concerning these variables. The highest frequencies of perceived needs/problems were reported for ''temporal imbalance'', ''perform activities with greater effort'' and ''tense/stressed due to pain''. Principal component analysis (PCA) yielded four categories of needs/problems: (1) ''limitations in activity performance'', (2) ''need for education'', (3) ''need to regain activities'' and (4) ''adjustment difficulties''. Almost 40% of the respondents had more than four healthcare visits during the previous year. The highest frequencies of specific pain-related characteristics were reported for shoulder/low back pain of searing/aching/gnawing character, and depressive symptoms. The high healthcare consumers (HHC) perceived significantly more interference when performing daily occupations (e.g. stopped/interrupted performance of activity) than did the low healthcare consumers (LHC). The HHC group evidenced higher scores than the LHC group for all PCA-generated factors. The results suggest that persons with long-term/recurrent pain perceive needs/problems related to daily occupations and various depressive symptoms that are particularly frequent among those with high healthcare consumption. [ABSTRACT FROM AUTHOR]

Widowhood is a likely event for older women in Western society. As a result, occupational therapists working in gerontology are increasingly concerned with the health issues of older women, including those connected with the experience of widowhood. Although studies on widowhood are readily available, most of these studies are quantitative in nature, and little has been published from an occupational therapy perspective. This qualitative case study, through a series of three in-depth interviews, aimed to explore and interpret an understanding of how daily occupations are experienced in widowhood. The results of this study revealed the significance of occupational adaptation to widowhood. That is, active engagement in familiar, meaningful occupations facilitated an older woman to adapt to the death of her spouse(s). Results indicated that active engagement in meaningful occupations, particularly in the company of neighbours and friends, enabled this older woman to live a fulfilling and vital life in widowhood. The findings of this study suggest that occupational therapists working with older widows may consider encouraging their clients to engage in familiar, meaningful occupations, particularly in the company of others, to facilitate adaptation to the challenges of losing a spouse, and to support positive experiences in widowhood. [ABSTRACT FROM AUTHOR]

This article describes the experience of using focus group discussions as a tool for developing an occupation-based health education programme for elderly persons with age-related macular degeneration (AMD). Focus group methodology is one way to learn how a particular target group describes and perceives their disease, including how the disease has changed their daily occupations. This focus group study gave us an understanding of the problems in daily occupations faced by people who suffer from AMD and important indications and ideas for further planning and evaluation of the health education programme. To further develop and improve the programme and to maximize the success of the programme, focus group methodology was also used as a tool for process evaluation. The group turned their attention to the programme itself, their reaction to it, and whether it was successful or not. The results indicated that the participants were, on the whole, pleased with the content of the programme, but they did not understand all the information provided. Several suggestions for improving the programme were put forward. Finally, focus group discussions were used to develop an evaluative instrument. Focus group discussions were thus found to be a versatile and invaluable tool for developing a health education programme. [ABSTRACT FROM AUTHOR]

Juvenile chronic arthritis (JCA) is one cause of chronic illness and disability in childhood. Traditional clinical assessment of clients with JCA include objective measures of joint deformity, joint swelling, range of motion, duration of morning stiffness, pain, walking speed, running speed and muscle strength. In many instances, these traditional measures have little or no significance or relevance to paediatric clients and their parents whereas functional skills used in everyday living are more likely to be meaningful. Measures of physical, social, and psychological functioning ensure a comprehensive health assessment. Responsible occupational therapy assessment and management of paediatric clients diagnosed with JCA requires the use of reliable, valid and sensitive measures of function. Several instruments are now available which measure a child's or adolescent's functional abilities. In this paper, JCA and the impact of JCA on functional development are reviewed. As well, seven functional assessment tools designed for use with paediatric clients with JCA which occupational therapists can use in their clinical practice will be appraised. The various characteristics of these tools are discussed in order to assist practitioners and researchers in selecting thefunctional instrument which best meets their needs. [ABSTRACT FROM AUTHOR]

The importance of patterns of daily occupations to health has been emphasised ever since occupational therapy was founded, but little is known about this relationship. The aim of this study was to describe in detail one woman's pattern of daily occupations as an initial step in developing strategies for further studies of patterns of daily occupations. Four different methods were used, one on each of four days. Three types of occupations were discerned; main occupations, hidden occupations, and unexpected occupations, which intertwined and formed an occupational pattern. The occupations were, in turn, composed of actions. Using the diary method gave an overall picture of main occupations during a whole day. Direct observation and video-recorded observation added additional information about the actions that were the building blocks of the occupations, as well as about hidden and unexpected occupations. The fourth method, a variant of the experience sampling method, gave deeper knowledge about the informant's reflections when performing an occupation. It was assumed that a detailed description of patterns of occupation is needed to understand its relationship to health. Therefore, if the diary method is used, it has to be combined with a subsequent interview. Direct observation was the single method that best captured the complexity of the pattern of daily occupations as captured in this study. [ABSTRACT FROM AUTHOR]

By focusing on the everyday life of persons suffering from chronic illness who have been re-employed, this article reflects on how it is possible for these persons to maintain identity and attain health through employment. As a consequence of governmental efforts to encourage employment in Norway, increasing numbers of the chronically ill are joining the ranks of the employed. In order to study their active adaptations in an inductive manner, this study is based on in-depth interviews with 13 persons who had returned to their previous jobs. By studying their adaptations and the ''space'' within which the identity process develops, this space is found to vary as a result of their flexibility at work, illness experience, and adaptations at home. The results pose how daily life is influenced when a person is affected by illness. In order to maintain their self-esteem through employment, this study visualizes how these re-employed with chronic illness experience limited possibilities for adaptations and restitution at work. Their need for rest was therefore first and foremost affecting family life and the leisure activities. [ABSTRACT FROM AUTHOR]

Within the framework of the gerontological and geriatric population studies in Göteborg, Sweden, H70, 617 85-year-old people were studied in a cross-sectional study. The purpose was to describe disability in activities of daily living (ADL) and how it is related to visual impairment, focusing on age-related macular degeneration (AMD). People with visual impairment, especially those with AMD, were found to be more dependent on help in both personal activities of daily living and instrumental activities of daily living compared with elderly persons with normal vision. The proportion of participants with disability in ADL and the relative risk of developing ADL dependence increased with the decrease in visual acuity (VA). However, the relationship between ADL and VA was weak, implying that people adapt to the consequences of the disease, although to different degrees. The results indicate that early detection and intervention might be essential to improve the odds for successful rehabilitation. [ABSTRACT FROM AUTHOR]