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Background The concept of an occupational pattern in occupational therapy and occupational science has evolved with varying definitions, ranging from activity patterns to patterns of daily occupation.Aims This study aimed to explore the concept of occupational pattern, develop an updated definition of the concept, and theoretically validate the concept’s definition.Method Walker and Avant’s concept analysis method was used, where both theoretical frameworks and peer-reviewed scientific literature were searched and synthesized to clarify and define the concept. Furthermore, seven occupational therapists theoretically validated the concept.Findings The analysis included forty-nine references from various research contexts and theoretical perspectives. The synthesis yielded a conceptualization of the concept of occupational pattern, outlining it into three overarching categories: ‘content in an individual’s occupational pattern’, ‘designing an occupational pattern’, and ‘balancing the occupational pattern’.Implications An updated operational definition of the multifaceted concept of an occupational pattern now exists, with practical implications for enhancing the education of occupational therapy students and guiding the utilization of the concept. Moreover, it holds significance for instrument development and outcome measurement in research; especially in lifestyle intervention studies within the field of occupational therapy.

Purpose The purpose of this study was to explore the employee and the managerial experience of reasons for sick leave due to CMDs in relation to work and private life, through the lens of a transactional perspective of everyday life occupation and gender norms. Methods Semi-structured interviews were conducted with 17 employees on sick leave due to CMDs and 11 managers. By using transactional and gender perspectives in a reflexive thematic analysis, themes were generated in a constant comparative process. Findings Four themes were identified: a) struggling to keep up with work pressure and worker norms; b) struggling with insecurity in an unsupportive work environment; c) managing private responsibilities through flexible work schedules, and d) managing emotions alongside unfavourable working conditions. Conclusion Sick leave due to CMDs was understood as related to experiences of accumulated events situated in different social, cultural, and societal contexts of everyday life. Practices and policies should encourage an open dialogue about work and private life and health between employees and managers. To build healthy and sustainable work environments practices should also aim for increased awareness of social norms. A better understanding may facilitate the identification of situations in work and private life that are problematic for the employee.

Background: The concept of an occupational pattern in occupational therapy and occupational science has evolved with varying definitions, ranging from activity patterns to patterns of daily occupation., Aims: This study aimed to explore the concept of occupational pattern, develop an updated definition of the concept, and theoretically validate the concept's definition., Method: Walker and Avant's concept analysis method was used, where both theoretical frameworks and peer-reviewed scientific literature were searched and synthesized to clarify and define the concept. Furthermore, seven occupational therapists theoretically validated the concept., Findings: The analysis included forty-nine references from various research contexts and theoretical perspectives. The synthesis yielded a conceptualization of the concept of occupational pattern, outlining it into three overarching categories: 'content in an individual's occupational pattern', 'designing an occupational pattern', and 'balancing the occupational pattern'., Implications: An updated operational definition of the multifaceted concept of an occupational pattern now exists, with practical implications for enhancing the education of occupational therapy students and guiding the utilization of the concept. Moreover, it holds significance for instrument development and outcome measurement in research; especially in lifestyle intervention studies within the field of occupational therapy.

Background: Phronesis is a way of knowing, implying wisdom, experiences, and reflections that guide our judgements. Phronesis, important for learning, is a neglected form of knowledge when applied to research., Aim: To examine how phronesis is conceptualised and practiced in three research projects., Method: Data from eight interviews with researchers involved in three research projects was generated. The interview material was analysed. A theoretical matrix of contemporary understanding of phronesis was applied to the material., Result: Examples of phronesis from three research projects in occupational therapy are presented according to categories of contemporary phronesis; acknowledging embodiment, embracing humility, using perceptiveness, and practicing reflexivity., Significance: This unique approach of analysing research projects contributes to the understanding of phronesis and its implications for research, providing valuable insights into the researchers' praxis in their respective projects., Conclusion: There is a need for a greater recognition of phronesis as a dimension of knowledge within all types of research, and within the discipline. By not recognising phronesis as a legitimate form of knowledge, the discipline perpetuates a superiority of knowledge from episteme that dominates our ways of learning about the world around us and where the type of knowledge gleaned from phronesis is consequently marginalised.

Background: Within and beyond occupation-based scholarship, concerns abound regarding the pervasiveness of discourses that promote a negative, deficit-based view of intellectual disability and associated consequences for disabled people's lives. Such representations risk reducing the complexities of human doing and being and can limit the occupational possibilities of this group. Yet, there is a lack of critically reflexive research exploring how disability is discursively constructed in occupation-based literature., Aims/objectives: This paper critically analyses representations of intellectual disability within occupation-based literature. It considers the influence of such representations on the occupational possibilities of people labelled intellectually disabled., Methods: This review employed a critical interpretive synthesis of 21 peer-reviewed articles from occupational therapy and occupational science that focused on intellectual disability., Results: Three analytic threads were identified as contributing to how intellectual disability was represented across the reviewed literature: habilitating expected doings , becoming productive citizens , and activated, but insufficient ., Conclusion & Significance: Occupation-based discourses have powerful influence within society, particularly within occupational therapy, regarding understandings of intellectual disability and how these shape occupational possibilities for persons labelled intellectually disabled. Drawing attention to taken-for-granted representations of intellectual disability is essential to promote transformative occupational therapy practice and enhance occupational possibilities for this population.

Background: A survey showed European occupational scientists cover a broad range in occupational science (OS) research, however, no contemporary overviews of European OS research exists, and current research may provide valuable information for OS and occupational therapy., Aim: The aim was to provide an overview of contemporary European OS research., Materials and Method: A scoping review was performed, including studies conducted in Europe and published in the British Journal of Occupational Therapy (BJOT), the Scandinavian Journal of Occupational Therapy (SJOT) or the Journal of Occupational Science (JOS) between 2015 and 2020. The journals were systematically searched, and quality assessment and thematic analysis were undertaken., Results: Findings from 93 articles identified many studies from the Nordic countries. Most studies applied qualitative research methods. Theoretical concepts from OS were used in data generating and discussions. A wide range of demographics, and living conditions were explored. Recent articles took a reflexive stance on the positionality of the researcher/s., Conclusions: This review highlights the diversity of OS research, suggesting a solid theoretical knowledge base within European OS research., Significance: The results contribute to further development and maturation of the discipline of OS in Europe and internationally.

Background: People's perceptions of events like a pandemic are shaped by individual experiences within their socio-cultural context. Attributing negative or positive meanings to an experience may influence the sense of Being, Belonging and Becoming., Aim and Objectives: To investigate the impact of the isolation/social distancing measures on people's sense of Being, Belonging, Becoming and overall sense of Occupational Wholeness compared to the time before the Covid-19 Pandemic as it is perceived by an Iranian population., Methods: The Model of Occupational Wholeness used to inform the theoretical basis of this study and development of the survey questions. An internet-based survey using a convenient and snowball sampling method was conducted. A self-administered questionnaire was published using a software named Porsline. A sample of 1624 members of the general population in Iran (67% response rate) completed the questionnaire within the first four weeks of the isolation/social distancing period starting on 18 March 2020. The Data was analysed by the SPSS 22., Results: The participants showed a more positive perceived level of Being and Belonging as well as an overall sense of Occupational Wholeness, and no difference in the perceived sense of Becoming during the isolation/social distancing period compared to the time before the Covid 19 pandemic., Conclusions: The findings show that the isolation/social distancing measures were perceived by participants as an opportunity to meet some of their Being, and Belonging needs that contribute to an overall sense of OccupationalWholeness.This highlights the role that Occupational science and Occupational therapy may have in helping people in situations when they need to rethink and replan for what they Do and the way they attribute meaning to their experiences.

Background: As social and health inequalities deepen around the world, scholarship in occupational therapy and occupational science has increasingly emphasised the role of occupation as a powerful tool in transformative processes., Objective: To explore how opportunities for everyday doing together may contribute to processes of social transformation by identifying ways occupation is being taken up in socially-transformative practice., Material and Methods: A generic descriptive qualitative case study design was utilised in order to describe current practice examples and identify ways occupation was being taken up in five initiatives working towards social transformation located in Canada, Germany, South Africa and the United Kingdom., Results: Focussing on the positioning of occupation within the initiatives, three themes were developed: The intentionality of the process, the nature of occupation within the initiatives, and the role of occupation within the processes of social transformation., Conclusions and Significance: Providing examples of agency on the micro level and of engagement with socioeconomic, political and cultural power structures at the societal level, this analysis raises important considerations in addressing how occupational therapy practice can move in socially responsive and transformative directions.

Background: Heat waves impact the health of older adults, and occupations are important for health. An overview of research focussed on older adults' occupations in heat waves can be useful for occupational therapy practice., Objective: To identify what the literature shows about older adults' experience and performance of, and participation in, occupations in heat waves., Material and Method: This scoping review included a literature search in five academic databases, four databases for grey literature, and a manual search. Literature in English regarding older adults 60+ and their occupations in heat waves were eligible., Findings: Twelve studies were included. Findings showed that older adults adapt their occupations using bodily, environmental, and social interaction strategies and by changing their daily routines. Personal, environmental, social, and economic factors facilitate and maintain occupations in heat waves., Conclusion: Older adults adapt their occupations in heat waves and different factors impact how they can be adapted. Future research is needed to explore how older adults experience their occupations in heat waves, and to deepen the knowledge about their heat-adaptive strategies., Significance: The findings support the role of occupational therapists in the design and practice of interventions managing the impact of heat waves in daily life.

Background: People with psychiatric disabilities often find it difficult to maintain a satisfactory occupational balance., Aims/objectives: This study aimed to investigate the validity and reliability of the Turkish version of the Occupational Balance Questionnaire (OBQ11-T) in mental health., Material and Methods: OBQ11-T was applied to 149 people for construct validity analysis and to 61 of them for reliability analysis. Validity was determined using factor analyses. The reliability of the OBQ between the first and second evaluations was assessed using the intraclass correlation coefficient (ICC) for each item and the total OBQ11-T score. Internal consistency was assessed using Cronbach's alpha., Results: The results of factor analysis revealed one factor that explains 35.94% of the total variance in the model. OBQ11-T item 1 had the lowest and OBQ11-T item 4 had the highest factor loadings. The model fits the data according to the indices of relative fit (RMSEA = 0.087, CMIN/DF = 2.129, CFI = 0.901). There was an excellent correlation between test and retest OBQ11-T total scores (ICC = 0.905). All items of the OBQ11-T showed good reliability. Cronbach's alpha for the OBQ11-T total score was 0.839, indicating acceptable internal consistency., Conclusions and Significance: The current study showed that OBQ11-T is a valid and reliable tool for measuring the self-rated occupational balance of people with mental illness.

Background: The police profession is a high-strain and high-risk profession, sometimes resulting in poor physical, mental and social health. This systematic review aims to identify and describe crucial areas for a healthy and sustainable lifestyle among patrolling police officers in Europe, an area not previously studied., Methods: The review was conducted according to the PRISMA guidelines. A protocol was published and registered with PROSPERO beforehand. Searches were carried out in eight databases. Two independent authors screened articles and critically appraised the included studies. A narrative synthesis was conducted to analyse the results. The review's total body of evidence was assessed with GRADE-CERQaul., Results: A total of 16 articles were located, representing 13 studies. Barriers and resources for a healthy and sustainable lifestyle were linked to a theoretical framework of life balance. Subsequently, a linkage model was created to explain different aspects of patrolling police officers' life balance and its relation to health (physical, social and mental)., Conclusions: Several crucial areas for a healthy and sustainable lifestyle were found and described, indicating that patrolling officers' working life affects their possibilities of living a balanced lifestyle, which might disturb different aspects of health, depending on which aspect is compromised.

Background: Increasing numbers of people are delaying retirement. Studies of their motives are scarce and biased to Western contexts., Aims: The aim was to explore internal and external motives of older Slovenians who continue to work after becoming eligible for retirement., Methods: Nine workers, aged 59-72, were interviewed. The interviews were analysed using thematic analysis., Findings: Three main themes were extracted. The 'Foundations' described the prerequisites for continued work engagement that were often non-negotiable. The 'Rewards' included the benefits of working and suggested a strong pull towards the non-material aspects of work. 'Negotiating occupational challenges' summarized an internal crisis that was experienced when faced with a potential occupational void of retirement., Conclusions: Although the participants' motivations were not homogenous, we identified a pattern in the way they constructed their motives in relation to the occupational life trajectories and contextual factors. Based on our findings and multidisciplinary theories, we proposed a hierarchy of motives for prolonged work activity., Significance: The study offers an occupational perspective of the phenomenon of delayed retirement and argues that the efforts of the discipline of occupational therapy should be directed at different levels of motives, including empowering people to nurture higher level occupational motives.

Background: Occupational balance is a key concept in occupational science and occupational therapy. However, it is not well operationalized and instruments to evaluate occupational balance are scarce., Aim: To translate and validate a Danish version of the 10-item Occupational Balance Questionnaire (OB-Quest)., Material and Methods: Translation was conducted using the dual-panel approach. Thereafter, data from 262 healthy Danish students were analyzed regarding fit to the Rasch model., Results: The translation of the questionnaire to Danish required only minor cultural adaptations. Ninety percent of the participants were female. The mean age (±SD) was 26.10 (7.05) years. The reliability (person separation index) was questionable (0.63), and the scale showed multidimensionality. Two items (1 and 9) showed misfit to the Rasch model. Differential item function by gender was detected in one item (item 4). After deleting items 1 and 9 and splitting item 4 into two gender-specific items, the new 9-item scale showed good overall and individual item fit. However, reliability remained low (0.59) and some elements of the latent variable (occupational balance) were not sufficiently represented., Conclusions and Significance: Further development and testing of the Danish OB-Quest is needed before implementation in clinical practice or research involving healthy subjects.

Background: It is important to understand how healthy lifestyle habits can be developed as they are essential in cardiovascular disease (CVD) prevention. There is limited knowledge regarding whether, and how, engaging occupations (things that people do and occupy themselves with) can promote and help sustain healthy lifestyle habits for persons at risk for CVDs, including stroke., Aim: The aim was to develop knowledge of how engaging in occupations can contribute to changes in lifestyle habits among persons at risk for stroke., Methods: Six adults presenting with stroke risk factors were interviewed on several occasions after participating in an occupation-focused stroke prevention programme. Grounded theory was utilised, and constant comparative methods guided the analysis., Findings: Changing lifestyle habits was perceived as a complex process, much like weaving a fabric with many parallel and interlacing threads. Literacy of both health and occupations and participation in engaging occupations were important facilitators for promoting healthy lifestyle habits, yet engagement in health-promoting occupations was described as conditioned behaviour., Conclusions: CVD prevention programmes can benefit from incorporating engaging occupations to promote healthy lifestyle habits and literacy of health and occupations. However, contextual factors conditioning health and occupations should be considered when developing and implementing sustainable interventions.

Background: An occupational perspective in stroke prevention could support sustainable changes in habits and routines that could contribute to reduce modifiable risk factors., Aim: To explore engaging occupation in relation to risk for stroke by drawing on experiences from everyday life among persons with a heightened risk for stroke., Material and Methods: Interviews from 14 persons with an increased risk for stroke were analysed by a constant comparative approach., Findings: The analysis resulted in the core category; the paradox of engaging occupations and health. The paradox involved aspects of engaging occupations that could provide well-being and at the same time were compromising considering stroke health., Conclusions and Significance: The paradox conceptually challenges some of the core values inherent in occupational therapy regarding the relationship between engaging occupations, health and well-being. Gaining a deeper understanding of experiences of occupations and studying this in relation to health promoting or compromising characteristics of occupations, can facilitate lifestyle programs that support changes in everyday life. Moreover, programs need to be designed to offer personal relevance and to facilitate a positive balance between health compromising occupations and health promoting occupations in everyday life.

Background: Digital technology is closely intertwined with and influences people's everyday lives. Within occupational science and occupational therapy, research is therefore warranted into situationally oriented analysis of the use of digital technology for engagement in occupation., Objective: To contribute with an analytic framework facilitating a situationally oriented analysis of the use of digital technology for engagement in occupation., Material and Methods: An operationalisation of Dewey's theory of transaction and inquiry in conjunction with an occupational science approach served as the analytical framework for exploring how underprivileged adults use digital technology for engaging in health-related occupation., Findings: The analytical framework proved useful for a situationally oriented analysis of digital technology use for engagement in occupation: by fostering identification and registration of digital technology artefacts used for engagement in occupation, by making transparent the complexity that the situation creates for the participant, by identifying problems with and needs for inquiries in relation to engagement in occupation and, finally, by facilitating a situation-oriented analytical language., Conclusion: The analytical framework presented is useful for conducting a situationally oriented analysis of digital technology use for engagement in occupation. Future research and validation of the analytical framework are needed.

Background: Understanding the dynamics and aspects of how activity choices impact health and well-being in people living with chronic obstructive pulmonary disease (COPD) is important to inform rehabilitation., Aim: To describe, firstly, how much time people living with COPD spend on work, daily living tasks, recreation and rest; secondly, how this population perceived competence, importance and enjoyment related to these activities; thirdly, if differences in such perceptions and time use were associated with the living situation and COPD severity., Material and Methods: This cross-sectional study involved 76 participants (+45 years, COPD, living in ordinary homes), who completed the Occupational Questionnaire (OQ). Descriptive statistics and group comparisons were performed., Results: Most of the participants' time were spent on daily living activities and recreational activities. Participants spent approx. 80% of their recorded time in OQ on activities they valued, enjoyed and in which they felt competent. Participants living alone scored significantly lower on enjoyment in restful activities than those living in couples ( p  < 0.05). No statistically significant difference in perceived competence, importance or enjoyment was found in relation to COPD severity., Conclusions and Significance: Findings underscore the importance of targeting overall daily activity repertoires including compositions of activity types, time use and perceived competence, importance and enjoyment.

Background: This paper is in line with the on-going discussion of a theoretical re-orientation towards acknowledging the socio-cultural dimensions of occupation. Aim: To define enacted togetherness as a concept and share our understandings of how this concept can add to the understanding of occupation as socio-culturally situated. Method and material: The concept enacted togetherness emerged from empirical findings of a larger research project with older adults living with late-life depression. Informed by a transactional understanding of occupation and a narrative approach, the concept emerged as a contextually situated process holding qualities and potential as a source of meaning-making. Findings: Enacted togetherness as described herein has a clear association to occupation in terms of doing activities together. We reflect on enacted togetherness as a process of meaning-making, connecting people and places through unfolding stories; as an arena where togetherness and belonging can be created; and as a space for interpretation, providing opportunities to negotiate issues of meaning that can lead to possibilities for change. Conclusion: The concept of enacted togetherness can contribute to the ongoing discussion of a theoretical reorientation towards understanding socio-cultural dimensions of occupation. Significance: Enacted togetherness is a concept that can contribute to occupational therapy and occupational science as it adds to an understanding of the qualities and potentials inherent in engagement in occupations with others.

Background: Occupational balance is fundamental to occupational therapy and occupational science. Therefore, the Occupational Balance Questionnaire (OBQ) was developed and has previously been found psychometrically valid according to classical test theory. Aim: To investigate the internal construct validity of the OBQ using Rasch measurement theory. Material and methods: Data from two general population samples were used to investigate the psychometric properties of the OBQ according to Rasch measurement theory. Results: The analyses identified problems with the current response scale and multidimensionality of two items. As a result, a revised version, the OBQ11, was suggested and exhibited response categories that worked properly, good reliability (0.92), model fit and measurement invariance across age and gender groups. The hierarchical item ordering was in agreement with previous research. Conclusion: The new OBQ11 satisfies the measurement criteria defined by the Rasch model. However, further studies of additional samples are needed to validate its generic properties. Significance: The purpose of the OBQ11 is to measure occupational balance of individuals or groups, and to identify aspects of occupational balance in need of improvement. Our observations suggest that the OBQ11 is a valid and promising complement to other instruments.

Background: Occupational therapy has long emphasized the concepts doing, being, becoming and belonging, and a notion of balance between them. Measures of these concepts are in a developing stage. Aim: This study aimed to develop and examine the properties of the Norwegian version of the Occupational Wholeness Questionnaire (N-OWQ), which is proposed to measure being, becoming, and belonging, in addition to occupational wholeness as a higher-order concept. Methods: An anonymous sample of 248 persons over the age of 18 years completed the N-OWQ along with sociodemographic information. Principal Components Analysis (PCA) was performed on the scale items when examining factor structure. Item reduction was based on considerations of communalities, factor loadings, scale consistency if item deleted, and conceptual issues. Internal consistency was assessed with Cronbach's α. Results: Following the PCA, the 'Being' and 'Becoming' scales merged into one five-item 'Self' scale (Cronbach's α 0.77). The 'Belonging' scale items were split into two scales comprised by three items each: 'Closeness' (Cronbach's α 0.70) and 'Relatedness' (Cronbach's α 0.73). Conclusions: The revised N-OWQ merged the 'Being' and 'Becoming' items into one factor, whereas the 'Belonging' items were split into two distinct factors. Internal consistency for all scales were satisfactory.

Background: A growing number of adults experience chronic conditions and related disability. However, a limited understanding of the activities and occupations of this population reduces the capacity of occupational therapists to deliver person-centred, occupation-based care. Aims: To investigate the activities and occupations of adults living with chronic conditions. Methods: Sixteen adults with multiple chronic conditions participated in two semi-structured interviews at their home or health center. Grounded theory methods were used to analyze data and construct a conceptual understanding of human occupation. Findings: Human occupation was conceptualized as doing activities and actions with meaning, in the context of one's life, health condition(s), and world. Three, two-dimensional categories of meaning were developed from the data: (i) connecting/reconnecting and disconnecting; (ii) caring and harming; and (iii) contributing and detracting. Conclusions: The findings present a complex, dynamic and multifaceted understanding of the activities and occupations of adults living with chronic conditions. Significance: This study demonstrates the value of exploring the experiences of actual or potential occupational therapy clients to refine the concept of human occupation. An in-depth knowledge of what people do is an essential foundation for person-centred, occupation-based practice.

Background: Occupational therapists' are increasingly working with communities and providing services at the community level. There is, however, a lack of conceptual frameworks to guide this work., Aim: The aim of this article is to present a new conceptual framework for community-centered practice in occupational therapy., Material and Method: The conceptual framework was developed from qualitative multi-case research on exemplars of community participation. The first was, a network of Canadian food security programs, and the second, a rural Australian community banking initiative. Key themes were identified from across the case studies, and cross-case findings interpreted using occupational therapy and occupational science knowledge, and relevant social theory. The outcome is a four-stage, occupation-focused, community-centered practice framework., Findings: The Community-Centred Practice Framework can be used by occupational therapists to understand and apply a community-centered practice approach. The four stages are: (1) Community Identity, (2) Community Occupations, (3) Community Resources and Barriers, and (4) Participation Enablement., Conclusions: Further research is needed to trial and critically evaluate the framework, to assess its usefulness as a robust, occupation-focused, frame of reference to guide community-centered practice in occupational therapy., Significance: The proposed framework should assist occupational therapists to conceptualize community-centered practice, and to utilize and apply theory.

Background: Reforms are changing pension systems in many European countries, in order to both restrict early retirement and force people to extend their working life. From occupational therapy and occupational science perspectives, studies focusing on aspects of working life that motivate the older worker is urgent., Aim: The aim was to describe incentives behind an extended working life among people over age 65., Method: Focus group methodology was used, with participants ages 66-71, from varying work fields: construction and technical companies and the municipal elderly care sector., Findings: Work was considered important and valuable to the degree of how challenging work was, the possibilities for inclusion in a team of colleagues and the chances for better personal finances. Amongst all, the participants expressed a feeling of a strengthened identity by being challenged and having the opportunity to manage working tasks., Conclusion: The finding showed the actual reasons behind an extended working life among older workers. However, a risk of rising social inequity may appear with increased working life if older people are forced to extend their working life due to a difficult financial situation as a pensioner. A variety of retirement options and initiatives in order to support older workers are justified.

People with rare diseases are a minority group that faces risks for healthcare and work inequities because knowledge and resources on how to systematically support health or working life are limited. Integrating voices of persons living with rare diseases are an important aspect in inclusive and relevant healthcare practices. This study sought to actively involve persons with autoimmune Addison's disease (AAD), a rare condition, in exploring challenges and possibilities situated in everyday life. Photovoice methods were utilized to incorporate experiences through photographic documentation and group discussions with five persons over seven weeks. Data generated from group sessions were visually analyzed or transcribed and analyzed with thematic analysis. Five themes emerged: Individual and fine tuning in everyday life; It is not how it was; The power of knowledge and support; Becoming the expert in an uncertain context; and, Finding balance and paving new ways. The findings showed that everyday life with AAD was more complex than earlier portrayed; entailing several barriers and negotiations. In order to meet the needs of persons with AAD, more extensive and relevant information, support and self-management education is needed. Moreover, a complementary focus on everyday life to promote their health and wellbeing is also important.

Background: Perspectives that individualize occupation are poorly aligned with socially responsive and transformative occupation-focused research, education, and practice. Their predominant use in occupational therapy risks the perpetuation, rather than resolution, of occupational inequities., Aim: In this paper, we problematize taken-for-granted individualistic analyses of occupation and illustrate how critical theoretical perspectives can reveal the ways in which structural factors beyond an individual's immediate control and environment shape occupational possibilities and occupational engagement., Method: Using a critically reflexive approach, we draw on three distinct qualitative research studies to examine the potential of critical theorizing for expanding beyond a reliance on individualistic analyses and practices., Results: Our studies highlight the importance of addressing the socio-historical and political contexts of occupation and demonstrate the contribution of critical perspectives to socially responsive occupational therapy., Conclusion and Significance: In expanding beyond individualistic analyses of occupation, critical perspectives advance research and practices towards addressing socio-political mediators of occupational engagement and equity.

Background/aim: People with severe mental illness (SMI) do not receive adequate attention in research or clinical practice. They are considered hard to reach and difficult to engage. Information is needed to help provide support for this vulnerable population. This paper aims to investigate the well-being of adults diagnosed with SMI and receiving Assertive Community Treatment (ACT) by applying the occupational well-being framework to the everyday activities of this vulnerable group of people., Materials and Methods: Eleven adults diagnosed with an SMI, living in the community, participated in semi-structured interviews over a 12-month period. A longitudinal design was used to collect data through using field notes and audio recordings. For this paper, secondary analysis was conducted by coding the data deductively thereby investigating the participants' experiences in relation to the seven Occupational Well-being framework descriptors (accomplishment, affirmation, agency, coherence, companionship, pleasure and renewal)., Results: Participants' everyday activities and occupational well-being appeared severely restricted and largely determined by the type of care they received. There was minimal evidence of the well-being descriptors, though all the participants reported experiencing some form of pleasure, even though some of the pleasurable experiences negatively impacted their health., Conclusion/significance: The episodic nature of SMI means that people living with an SMI require continuity in key relationships and support to achieve Occupational Well-being. Occupational therapists working with mental health consumers need to facilitate the types of activities that foster well-being through accomplishment, affirmation, agency and companionship, and that derive pleasure in healthy and positive ways.

Yerxa's [1] model of an integrated profession depicts a circular scholarly process whereby ideas formed in practice are subjected to research and then returned to practice through education. This knowledge-generating cycle supports occupational science and the development of our professional identity. The aim of this article is to demonstrate how Yerxa's model was used to evaluate if three developmental cycles of the ADL-Focused Occupation-Based Neurobehavioral Evaluation (A-ONE) sufficiently represented all necessary model components required for implementation into practice. The three cycles were historical, educational and measurement. The necessary components included: (a) dilemmas in practice, (b) new ideas that emerged from those practice issues, (c) research to test those ideas and (d) education designed to integrate new knowledge into practice. The results of this analysis of the A-ONE supported adequate research related to ideas from practice being implemented back into practice. Through using the model of an integrated profession to reflect on ideas ignited within practice, and then implementing research to explore the potential contribution of those ideas to knowledge generation, we gain the power to influence the future development of occupational science and the profession.

Background: In this article constructions of identity, occupation, and performance are explored with a particular focus on the interrelatedness of these concepts. Insights were derived from a study in which the influences that impact on the work-lives of people with a psychiatric disability were explored., Method: An interpretive biography design was utilised. Data construction took the form of narrative interviews and a combination of paradigmatic narrative analysis and narrative analysis was used. Participants, selected by means of purposive maximum variation sampling, had been diagnosed with psychiatric impairment and lived in the Western Cape, South Africa., Findings and Discussion: Identity construction processes were explored, with a particular focus on how these impacted on decisions regarding participation in work., Conclusions: Performance elements of identity, called forth by occupational demands, occurring within work environments were found to be shaped through, and expressed as, doing. The notion of Punctualized Identity was shown to provide a lens that is able to capture the dynamic interplay of identity constructs and provide a synthesised perspective on participation.

Objective: This qualitative, longitudinal, descriptive study aimed to understand the lived experience of enacting agency, and to describe the phenomenon of agency and the meaning structure of the phenomenon during the year after a stroke. Agency is defined as making things happen in everyday life through one's actions., Methods: This study followed six persons (three men and three women, ages 63 to 89), interviewed on four separate occasions. Interview data were analysed using the Empirical Phenomenological Psychological method., Results: The main findings showed that the participants experienced enacting agency in their everyday lives after stroke as negotiating different characteristics over a span of time, a range of difficulty, and in a number of activities, making these negotiations complex. The four characteristics described how the participants made things happen in their everyday lives through managing their disrupted bodies, taking into account their past and envisioning their futures, dealing with the world outside themselves, and negotiating through internal dialogues., Conclusions: This empirical evidence regarding negotiations challenges traditional definitions of agency and a new definition of agency is proposed. Understanding clients' complex negotiations and offering innovative solutions to train in real-life situations may help in the process of enabling occupations after a stroke.

Background: Since the beginning of the occupational therapy profession, engagement in occupation has been valued as the primary therapeutic agent as well as the goal of intervention. While there are few today who would not support this idea, occupational therapists continue to struggle with implementing their beliefs through "what we do" and "how we do it". Contributing to this problem is their failure to use terminology in a manner that clearly defines what and how occupational therapists do what they do in occupational therapy research, education, and practice., Methods: The author will, therefore, first discuss some key occupational therapy terms and propose that they represent an occupation-related taxonomy that can be used to more clearly define and describe for occupational therapists and others what they do and how they do what they do as occupational therapists. Then, with a goal of fostering critical self-reflection among occupational scientists and occupational therapy researchers, educators, and practitioners, the author will go through the stages of the occupational therapy process outlined in the Occupational Therapy Intervention Process Model (OTIPM) and demonstrate how a more precise use of this occupation-related taxonomy can facilitate maximizing the power of occupation in practice.