The leisure satisfaction of people with psychiatric disabilities

Contribution of travel participation to social integration and life satisfaction after spinal cord injury

BACKGROUND

Research has found that participation in travel declines for people after spinal cord injury (SCI) because the traumatic injury usually results in impaired physical mobility and sensation, and barriers in the environment make travel more challenging. While travel participation can offer numerous physical, psychological, and emotional benefits, empirical evidence on positive outcomes of travel for people after SCI is scarce in the literature.

OBJECTIVE

To empirically examine the effects of travel participation on social integration and life satisfaction for people with SCI, along with other personal characteristics including income, self-perceived health status, levels of physical independence, occupational activities, and travel barriers.

METHODS

Cross sectional data are collected from 250 patients enrolled in a SCI Model System. Hierarchical regression analyses, followed by mediation analyses, are conducted to assess the effects of travel participation on social integration and life satisfaction.

RESULTS

Travel participation along with occupational activities is shown to significantly impact social integration, with participation in occupational activities partially mediating the relation from travel participation to social integration. The significant effect of travel participation on life satisfaction is fully mediated by social integration. Income and self-perceived health status both significantly contribute to social integration and life satisfaction.

CONCLUSIONS

Travel participation should be considered as an independent domain that directly impacts the social integration of people with SCI, which in turn enhances their life satisfaction. Systematic interventions with standard protocols for travel-related skill training and assessments procedures are needed for people after SCI.

Acting Out: Enabling Meaningful Participation Among People With Long-Term Mental Health Problems in a Music and Theater Workshop

In this article, we explore what enables meaningful participation in a music and theater workshop from a first person's perspective of people with mental health problems. The study uses a hermeneutical-phenomenological approach. Data were collected from qualitative in-depth interviews with 12 participants in a music and theater workshop located in a Norwegian mental health hospital. Data were analyzed through thematic analysis. Two overarching themes were identified: (a) room for dignity and (b) a creative arena. This study indicates that to enable participation for people with long-term mental health problems, it is important to facilitate activities that are flexible, person centered, and resource oriented, in which participants have the possibility to participate regardless of symptoms, functional ability, or whether they are hospitalized. In addition, having professionals who believe in creative growth and offer an illness-free zone that belongs to the participants in a hospital setting is of great importance.

The Active Advice Pilot Project: Leisure Enhancement and Social Inclusion for People with Severe Mental Health Problems

The social and occupational consequences of mental illness have a considerable impact on quality of life. In addition to high levels of unemployment, many users of mental health services experience significant barriers to satisfying leisure participation.

The Active Advice project is a systematic client-centred approach to leisure enhancement for adults with severe mental health problems, which involves identifying latent interests, facilitating leisure participation and helping to bring together isolated individuals through a shared interest.

This paper reports the findings from the pilot study, which suggest that adults with enduring mental health problems can participate successfully in leisure occupations and achieve greater social inclusion when individualised support is provided to enable the barriers to be overcome. However, it is essential that subsequent programmes devise strategies to maintain participants' initial enthusiasm and motivation since 53% of participants did not carry through their action plan.

Occupational Therapy and Clinical Research in Mental Health Rehabilitation

Practitioners working in Australian mental health services are faced with the challenge of providing appropriate evidence-based interventions that lead to measurable improvement and good outcomes. Current government policy is committed to the development of strategic mental health research. One focus has been on under-researched practice areas, which include the development of psychosocial rehabilitation systems and models that facilitate recovery.

To meet this challenge, an Australian rehabilitation service formed a collaborative partnership with a university. The purposes of the collaboration were to implement new forms of service delivery based on consumer need and evidence and to design research projects to evaluate components of the rehabilitation programme. This article examines the process of developing the collaboration and provides examples of how research projects have been used to inform practice and improve the effectiveness of service delivery. Challenges to the sustainability of this kind of collaboration are considered.

Leisure as a context for active living, recovery, health and life quality for persons with mental illness in a global context

Globally, the mental health system is being transformed into a strengths-based, recovery-oriented system of care, to which the concept of active living is central. Based on an integrative review of the literature, this paper presents a heuristic conceptual framework of the potential contribution that enjoyable and meaningful leisure experiences can have in active living, recovery, health and life quality among persons with mental illness. This framework is holistic and reflects the humanistic approach to mental illness endorsed by the United Nations and the World Health Organization. It also includes ecological factors such as health care systems and environmental factors as well as cultural influences that can facilitate and/or hamper recovery, active living and health/life quality. Unique to this framework is our conceptualization of active living from a broad-based and meaning-oriented perspective rather than the traditional, narrower conceptualization which focuses on physical activity and exercise. Conceptualizing active living in this manner suggests a unique and culturally sensitive potential for leisure experiences to contribute to recovery, health and life quality. In particular, this paper highlights the potential of leisure engagements as a positive, strengths-based and potentially cost-effective means for helping people better deal with the challenges of living with mental illness.

Patient opinions on the helpfulness of external rehabilitative activities in residential psychiatric care: a pilot study

INTRODUCTION

This study explores the patient opinions about the helpfulness of the External Rehabilitative Activities (ERA) delivered in two residential facilities for psychiatric rehabilitation.

METHODS

We administered a Questionnaire developed to assess general helpfulness, helpfulness of specific therapeutic processes and satisfaction with the ERA to a sample of 46 psychiatric patients participating in at least three external activities.

RESULTS

The External Rehabilitative Activities, tested by the ERA-Questionnaire, were considered helpful or very helpful by most of the patients. The therapeutic process with the highest score was "relaxation", followed by "general helpfulness", "socialization", "knowledge of social context", "community integration". The least-valued process was "autonomy".

CONCLUSION

This pilot study has shown that psychiatric patients consider ERA helpful and rate more helpful the specific therapeutic processes, such as relaxation and socialization, that assure symptomatic relief and interaction with the outside world.

Evidence-based practice and rehabilitation: occupational therapy in Australia and New Zealand experiences

Evidence-based practice has become the dominant paradigm in the delivery of rehabilitation programme. However, occupational therapists in Australia and New Zealand have been slow in making the transition to become evidence-based practitioners. Collaboration between the university/tertiary institute and clinical setting is one way that clinicians can be assisted with incorporating research into their practice. Two case examples are presented outlining how collaborative practice can result in improved outcomes for all concerned.

Towards an integrated, structural model of psychiatric rehabilitation

In the past two decades, the number of principles and approaches that have been touted as psychiatric rehabilitation have overwhelmed the service provider. As a result, the field seems to be bombarded by contradictory ideas. In this paper, I seek to resolve this problem by providing an overview of psychiatric rehabilitation in terms of four key structures: goals (the reasons why people with psychiatric disabilities seek rehabilitation), strategies (the tools which service providers might use to help consumers reach their goals), settings (the places in which providers and consumers use these tools), and roles (the variety of professional and personal backgrounds which influence providers in carrying out their duties). In this paper, I review the research literature that has identified relevant examples of each of these structural dimensions. This description of psychiatric rehabilitation is based on a two-factor model of the life challenges that arise from mental illness: the disabilities produced by the disease and the loss of opportunity that result from stigma and discrimination. The paper also includes a brief discussion of the two-factor model.