Test-retest reliability of three life balance measures in people with neuromuscular disease: the activity card sort-NL, the activity calculator, and the occupational balance questionnaire

PURPOSE

Life balance is a new and important concept in occupational therapy. New measurements are needed to assess and evaluate life balance and interventions aimed to achieve this concept. This article describes the test-retest reliability of three life balance measures: the Activity Calculator (AC), Activity Card Sort (ACS-NL(18-64)) and Occupational Balance Questionnaire (OBQ11-NL).

METHOD

Data collection took place among 50 participants with neuromuscular diseases: facioscapulohumeral dystrophy (FSHD, n = 25) or mitochondrial myopathy (MM, n = 25). The AC, the ACS-NL(18-64) and the OBQ11-NL were assessed twice with an interval of one week. Intraclass correlation coefficients (ICC-agreement) were applied to examine test-retest reliability.

RESULTS

The ICC of the AC-average total day score was .95 (95% CI .91-.97), whereas the ICC of the weights allocated to each activity was 0.80 (95% CI .77-0.82). The ICC of the ACS-NL(18-64) percentage retained activities was 0.92 (95% CI 0.86 - 0.96) and the ICC of the importance score per activity was- .76 (95% CI . 0.68-0.89). The ICC of the OBQ11-NL total score was .76 (95% CI 0.62-0.86).

CONCLUSION

All three tools showed good to excellent test-retest reliability in a sample of patients with FSHD or MM, which is promising for its use in clinical practice and research.

Putting occupational balance on the radar: Content validity of the 11-item Danish Occupational Balance Questionnaire

Background

Assessment of occupational balance is of clinical relevance for occupational therapists working with patients with reduced occupational performance. Clinical practice lacks validated assessment tools to measure occupational balance.

Aim

To establish the content validity of the 11-item Danish version of the Occupational Balance Questionnaire (OBQ-DK) with a radar chart add-on for use in occupational therapy practice.

Materials and methods

A convergent mixed-methods study was performed investigating content validity. Three group interviews were conducted in 3 settings with 12 occupational therapists. A deductive content analysis covered face validity, relevance, comprehensiveness and comprehensibility. The relevance of the 11 items was further assessed using a content validity index.

Results

All items were found to be relevant to the construct of occupational balance. Even so, concerns were raised regarding content validity. The comprehensiveness was questioned regarding the coverage of the balance of meaningful occupations. Comprehensibility was questioned for 6 of the 11 items, and the response scale.

Conclusion

Content validity was investigated. The doubts raised in relation to comprehensiveness call for new wordings or elaborate instructions to enhance constructional clarity. The response scale levels should be adapted.

[Translation of the Occupational Balance Questionnaire in French and its Validation]

Background. Questionnaires measuring occupational balance have been created in recent years, but those available in French are limited. Purpose. This study aimed to translate and transculturally adapt the Occupational Balance Questionnaire and to examine the internal consistency, test-retest reliability and convergent validity of the French version. Methodology. A cross-cultural validation was conducted with adults in Quebec (n = 69) and in French-speaking Switzerland (n = 47). Results. Internal consistency was good in both regions (α > 0.85). Test-retest reliability was satisfactory in Quebec (ICC = 0.629; p < 0.001), but a significant difference was found between the two measurement times in French-speaking Switzerland. Significant associations were found between the results of the Occupational Balance Questionnaire and those of the Life Balance Inventory (Quebec, r = 0.47; French-speaking Switzerland, r = 0.52). Implications. These initial results support the use of the OBQ-French in the general population of two French-speaking regions.

Which Occupations Did People Engage in during Lockdown? A European Cross-Sectional Descriptive Survey by Generation

Objective

The primary objective was to describe the occupations people engaged in more frequently during lockdown than before the coronavirus disease 2019 pandemic as a function of generation. The secondary objectives were to (i) describe the levels of importance, performance, and satisfaction for these occupations and (ii) identify factors affecting the levels of importance, performance, and satisfaction.

Method

We conducted an online, cross-sectional survey of young adults (YAs, aged 18-39), middle-aged adults (MAs, aged 40-59), and older adults (OAs, aged 60 or over).

Results

2534 participants (YAs: 47%, MAs: 33%, and OAs: 20%) cited 4500 occupations. The occupations in which people most engaged were leisure occupations (67%), followed by productive occupations (31%) and then self-care (2%) occupations. YAs gave a median (interquartile range) importance score of 8 (6; 9) to leisure, 8 (7; 10) to productivity, and 8 (7; 10) to self-care. MAs gave a median importance score of 8 (6; 10) to leisure, 8 (7; 10) to productivity, and 8 (7; 10) to self-care. OAs gave a median importance score of 8 (7; 10) to leisure, 8 (7; 9) to productivity, and 9 (8; 10) to self-care. In a pre-/postlockdown comparison, the changes in performance scores among YAs were +5 (3; 6) for leisure, +4 (2; 5) for productivity, and +4 (3; 6) for self-care. Among MAs, these changes were, respectively, +4 (3; 6), +3 (2; 5), and +4.5 (3; 6). Among OAs, these changes were, respectively, +3 (1; 5) for leisure, +3 (2; 5) for productivity, and +2 (0; 4) for self-care. The changes in satisfaction scores among YAs were +3 (0; 5) for leisure, +3 (0; 5) for productivity, and +3 (1; 6) for self-care. Among MAs, these changes were, respectively, +3 (0; 5), +2 (0; 4), and +5 (0; 6). Among OAs, these changes were, respectively, +2 (0; 4), +2 (0; 4), and +2 (0; 4).

Conclusions

Lockdown led to stronger engagements in quiet leisure and alternative forms of socialization. Occupational therapists may have a role in helping community-dwelling people to balance and structure their new daily routine.

Translation, Psychometric and Concept Analysis of the Occupational Balance-Questionnaire Based on a Turkish Population

Occupational balance is a crucial concept in occupational therapy, accepted as a key component of health and well-being. The Occupational Balance-Questionnaire (OB-Quest) is designed as a standardized instrument to assess occupational balance. This study investigated the validity and reliability of the OB-Quest Turkish, which consisted of translation, cross-cultural adaptation, and analysis psychometric properties phases. The factor structure of the OB-Quest indicated a good model fit. The criterion-related validity showed a positive correlation with Beck Depression Inventory and a negative correlation with the 12-item Short Form Survey. The OB-Quest-Turkish showed questionable internal consistency and an excellent correlation between test-retest.Supplemental data for this article is available online at https://doi.org/10.1080/07380577.2021.2010160 .

The Spanish version of Occupational Balance Questionnaire: psychometric properties and normative data in a representative sample of adults

BACKGROUND

The Occupational Balance Questionnaire (OBQ) is an instrument that assesses occupational balance (OB). It has been transculturality adapted and validated in different countries, showing adequate psychometric properties. To date, no general population-based cut-off points for OB have been developed.

OBJECTIVE

To assess the psychometric proprieties of the Spanish version OBQ (OBQ-E) and to estimate reference norms and the cut-off for OBQ-E in a representative sample of Spanish adults.

MATERIALS AND METHODS

A total of 797 adults were included in this validity study. Internal consistency, intra and test-retest reliability of OBQ-E were examined. To obtain the convergent validity and the divergent validity, the Satisfaction with Life Scale (SLS) and the Hospital Anxiety and Depression Scale (HAD) were used respectively, compared with OBQ-E. To determine extreme and moderate disturbed OB stratified by age, sex, and educational level were used the 5 and 15% percentiles of OBQ-E.

RESULTS

The OBQ-E showed good internal consistency (α-Cronbach = 0.87), intraclass reliability (ICC = 0.87), and test-retest reliability (rho = 0.83). Convergent (SLS) and divergent (HAD) validity were moderate (rho = 0.39 and rho = -0.46, respectively). The lowest extreme disturbed OB cut-off point in men (17.2) and in women (24) appeared at the primary education level, under 40 years of age (men) and 40-65 years of age (women).

CONCLUSIONS

The OBQ-E presents adequate psychometric properties, and its normative data can be used as a reference to assess and monitor the occupational balance in the general Spanish population.KEY MESSAGESThe 'Occupational Balance Questionnaire' (OBQ), stands out as a specific measure of the concept of Occupational Balance, considered as satisfaction with the number and variation of occupations in which the person participates.The OBQ is a short and simple instrument that can be a useful tool for use in population-based and epidemiological studies to monitor OB and explore the associated factors or implications of disturbed OB.The Spanish version of the OBQ (OBQ-E) seems to be a reliable and valid questionnaire to assess the perception of balance between occupations, related to health and well-being in the Spanish adult population.

Occupational disruptions during lockdown, by generation: A European descriptive cross-sectional survey

Introduction

The periods of lockdown during 2020 led to changes in daily occupations. As participation relies on dynamic interactions between the person, his/her occupations and his/her environment, we wondered whether people from different generations shared the same perception of occupational disruptions during the lockdown.

Methods

We performed an online survey based on the Canadian Occupational Performance Measure (COPM) of adults in 27 European Union countries, the United Kingdom and Switzerland. Three groups were compared: young adults (YAs, aged 18-39), middle-aged adults (MAs, aged 40-59) and older adults (OAs, aged 60 and over).

Results

2865 participants (YAs: 47%; MAs: 33%; OAs: 20%) reported a total of 6549 disrupted occupations. The most frequently disrupted domain was leisure (83%), followed by productivity (16%) and self-care (2%); there were no significant intergroup differences (p = 0.18). In a multivariate analysis, socializing disruptions were more likely to be associated with younger age (adjusted odds ratio (OR) [95% confidence interval (CI)] = 0.62 [0.50-0.76] for YAs versus MAs and 0.46 [0.30-0.71] for YAs versus OAs.

Conclusion

With the exception of socializing, the main disrupted occupations were similar from one generation to another. Our findings might enable the more accurate assessment of the risk of occupational disruption in a restrictive environment.

Occupational Balance and Depressive Symptoms During the COVID-19 Pandemic: A Four-Wave Panel Study on the Role of Daily Activities in Austria

OBJECTIVE

The aim of this study was to investigate the relationship among daily activities (paid work, childcare, caregiving, voluntary work, sports, and social contact), occupational balance, and depressive symptoms during the COVID-19 pandemic.

METHODS

We analyzed data from the Austrian Corona Panel Project (four time points, 6-month period) using regression models with logarithmically transformed data and nonparametric repeated-measures tests (N = 871).

RESULTS

Results showed higher depressive symptoms among women. Family caregivers (either parents or those caring for other relatives) were at the highest risk for occupational imbalance and depressive symptoms. Sports and social contact were initially associated with better outcomes, but the effects waned. There was a main effect for time point driven by the last wave (amidst the second lockdown), but no significant interaction effects between predictors and time point were found.

CONCLUSION

The results provide a nuanced depiction of the relationship between different daily activities and health-related outcomes during the pandemic, highlighting groups at risk.

Associations Between Parental Occupational Balance, Subjective Health, and Clinical Characteristics of VLBW Infants

Objective

Very low birthweight (VLBW) infants have an increased risk of mortality and frequently suffer from complications, which affects parental occupational balance. Occupational balance is the satisfaction with one's meaningful activities, which include everyday activities that people need to, want to, and are expected to do. In contrast to work-life balance, the construct of occupational balance addresses different activities equally and it applies to all persons, regardless of whether they are working or not. Parental occupational balance might be related to parents' and VLBW infants' health. Therefore, the objective of this study was to investigate associations between parental occupational balance, subjective health, and clinical characteristics of VLBW infants.

Methods

A cross-sectional multicenter study was conducted in six Austrian neonatal intensive care units. Occupational balance and subjective health of parents of VLBW infants were assessed with six self-reported questionnaires. The following clinical characteristics of VLBW infants were extracted from medical records: gestational age, birthweight, Apgar scores, Clinical Risk for Babies II Score, and complications of prematurity. Spearman's rank coefficients were calculated.

Results

In total, 270 parents, 168 (62%) female and their VLBW infants, 120 (44%) female, were included in this study. Parents' mean age was 33.7 (±6.0) years, mean gestational age of VLBW infants was 27 + 3 (±2) weeks. Associations between parental occupational balance, subjective health, and clinical characteristics of VLBW infants were identified (r s = 0.13 - 0.56; p ≤ 0.05), such as the correlation between occupational areas (r s = 0.22, p ≤ 0.01), occupational characteristics (r s = 0.17, p = 0.01), and occupational resilience (r s = 0.18, p ≤ 0.01) with bronchopulmonary dysplasia of VLBW infants.

Conclusion

Occupational balance is associated with parents' and VLBW infants' health. Interventions to strengthen parental occupational balance might increase parental health and thereby also improve health and developmental outcomes of their VLBW infants.

Examination of validity, reliability, and interpretability of a self-reported questionnaire on Occupational Balance in Informal Caregivers (OBI-Care) - A Rasch analysis

Objectives

Informal caregivers often experience a restriction in occupational balance. The self-reported questionnaire on Occupational Balance in Informal Caregivers (OBI-Care) is a measurement instrument to assess occupational balance in informal caregivers. Measurement properties of the German version of the OBI-Care had previously been assessed in parents of preterm infants exclusively. Thus, the aim of this study was to examine the measurement properties of the questionnaire in a mixed population of informal caregivers.

Methods

A psychometric study was conducted, applying a multicenter cross-sectional design. Measurement properties (construct validity, internal consistency, and interpretability) of each subscale of the German version of the OBI-Care were examined. Construct validity was explored by assessing dimensionality, item fit and overall fit to the Rasch model, and threshold ordering. Internal consistency was examined with inter-item correlations, item-total correlations, Cronbach’s alpha, and person separation index. Interpretability was assessed by inspecting floor and ceiling effects.

Results

A total of 196 informal caregivers, 171 (87.2%) female and 25 (12.8%) male participated in this study. Mean age of participants was 52.27 (±12.6) years. Subscale 1 was multidimensional, subscale 2 and subscale 3 were unidimensional. All items demonstrated item fit and overall fit to the Rasch model and displayed ordered thresholds. Cronbach’s Alpha and person separation index values were excellent for each subscale. There was no evidence of ceiling or floor effects.

Conclusions

We identified satisfying construct validity, internal consistency, and interpretability. Thus, the findings of this study support the application of the German version of the OBI-Care to assess occupational balance in informal caregivers.

Development and validation of a self-reported questionnaire to assess occupational balance in parents of preterm infants

Background

Parents’ meaningful activities (occupations) and occupational balance are relevant to neonatal care. Valid and reliable self-reported measurement instruments are needed to assess parents’ occupational balance and to evaluate occupational balance interventions in neonatal care. The aims of this study were to develop a self-reported questionnaire on occupational balance in informal caregivers (OBI-Care) and to examine its measurement properties including construct validity and internal consistency.

Methods and findings

A mixed method multicenter study design was employed. Items of the OBI-Care were created with parents of preterm infants based on qualitative research methods. Measurement properties were analyzed with quantitative data of parents of preterm infants. Construct validity was assessed by determining dimensionality, overall and item fit to a Rasch model, differential item functioning and threshold ordering. Internal consistency was examined by determining inter-item and item-total correlations, Cronbach’s alpha and Rasch’s person separation index. Fourteen parents participated in item creation. Measurement properties were explored in data of 304 parents. Twenty-two items, summarized in three subscales were compiled to the OBI-Care. Items showed an overall fit and except one item, an item fit to the Rasch model. There was no evidence of differential item functioning and all items displayed ordered thresholds. Each subscale had good values of person separation indices and Cronbach’s alpha.

Conclusions

The OBI-Care demonstrates construct validity and internal consistency and is thus a suitable measurement instrument to assess occupational balance of parents of preterm infants in neonatal care. OBI-Care is generic and can be applied in various health care settings.

The impact of COVID-19 restrictions on occupational balance: A mixed method study of the experience of Australian occupational therapists

Introduction

COVID‐19 has seen unprecedented changes to the daily occupational lives of citizens across the globe as a result social and physical restrictions. Frontline healthcare workers health and wellbeing have been impacted but what of occupational balance? The aim of this study was to investigate if there was a change in the occupational balance of occupational therapists working in a metropolitan hospital during a COVID‐19 lockdown.

Methods

All occupational therapists working in a metropolitan hospital were invited to participate in an online survey. Occupational Balance was measured using the Occupational Balance Questionnaire‐11 (OBQ11). Participants retrospectively rated their occupational balance before COVID‐19 restrictions were in place and again rated their current status during the restrictions. Participants were also asked to comment on strategies used to help them during the COVID‐19 restrictions.

Results

Forty‐two occupational therapists completed the survey. The mean total score prior to the COVID‐19 restrictions was 19.4 and during restrictions was 19.0 (Z = −0.4, p = 0.68). There was a significant decrease in having sufficient to do during the COVID‐19 restrictions (Z = −3.6, p < 0.001). Satisfaction with how time was spent in rest, recovery and sleep significantly increased during the restrictions (Z = −3.3, p = 0.001). Strategies used included engaging in valued activities, finding alternate ways of doing and showing gratitude.

Conclusion

Occupational balance of occupational therapists remained high and satisfaction in how time was spent improved during COVID‐19 restrictions. Occupational therapists implemented their own theoretical approach of adaptation to cope with the COVID‐19 restrictions.

Cultural Adaptation and Psychometric Properties of the Spanish Version of the Occupational Balance Questionnaire: An Instrument for Occupation-Based Research

Occupational balance (OB) may be a major determinant of health outcomes due to its role in bringing a sense of purpose in the occupations that are personally experienced as a process of getting health and wellness. The Occupational Balance Questionnaire (OBQ) is a reliable instrument for measuring OB, although it has not been adapted and validated in Spain so far; therefore, this study had a double aim: (1) to translate and cross-culturally adapt the original OBQ version into Spanish (OBQ-E); (2) to analyze the psychometric properties for its use in the Spanish population. Standard procedures were used for the cross-adaptation process and pilot testing was carried out using three different samples to extend the applicability of the OBQ-E. Validation measures of the final version of the OBQ-E were conducted in a sample of 219 participants. The OBQ-E showed that items and instructions were culturally appropriate and written clearly. Psychometric testing showed excellent internal consistency (Cronbach’s alpha = 0.87; Guttman split-half coefficient = 0.85), good test–retest reliability (r_s (Spearman rho) = 0.73), and acceptable convergent validity (overall status, r_s = 0.37; Related Quality of Life, r_s = 0.42; Satisfaction with Life Scale, r_s = 0.54). The findings suggest that the OBQ-E may be a suitable instrument for assessing OB in the Spanish population; hence, it is a promising tool for epidemiological research that will significantly contribute to the understanding of OB as a health-related factor. Nevertheless, further investigation is also warranted to explore the potentiality of this instrument for clinical purposes.

Role of Rehabilitation in Promoting Engagement in Daily Life in Multiple Sclerosis: Facing the Challenges of the 21st Century

The purpose of this narrative review is to define the theoretical constructs of engagement, participation, and balance. The implementation of these constructs in multiple sclerosis (MS) rehabilitation are described because MS symptoms such as fatigue and cognitive decline may affect engagement in daily life. The constructs of engagement and participation can be considered to be different when they are studied. The constructs related to balance are of interest when targeting engagement. Multidisciplinary rehabilitation programs may have beneficial effects in optimizing engagement. Therefore, the measurement of these constructs is primordial because they give us a deeper understanding of the meaning of activity performance that reflects engagement in daily life. Future research may focus on describing engagement in both men and women at all stages of MS and may explore variables that influence engagement in daily life to integrate engagement optimization in MS rehabilitation. Engagement may have beneficial effects as part of multidisciplinary rehabilitation in MS.

Occupational balance from a clinical perspective

BACKGROUND

Occupational balance is a central concept in occupational therapy and is commonly defined as an individual's perception of having the right amount and variety of occupations in daily life. This individualistic and subjective nature of occupational balance brings with it certain challenges when applied in practice. The aim of this discussion paper is to highlight the challenges associated with the lone application of individualistic occupational balance in practice situations, and propose some way forward.

METHODS

The Meleis' Theory to Practice to Theory strategy was used. Practice-based vignettes were used as a point of departure to discuss these challenges. This was followed by theorising the importance of including the others' perceptions of a person's pattern of daily occupations.

CONCLUSION

Besides a goal of increasing a person's occupational balance in clinical practice, striving towards creating a suitable pattern of daily occupations from a community perspective also seems to be a relevant goal.

Exploring perceived occupational balance in women with fibromyalgia. A descriptive study

BACKGROUND

People with chronic pain conditions such as fibromyalgia may experience occupational limitations and imbalances in their basic and instrumental occupations of daily living, leisure, work, and social participation.

OBJECTIVE

To describe occupational balance in persons with fibromyalgia and to analyze whether it is associated with self-reported disability and self-efficacy to manage symptoms.

METHODS

A cross-sectional study was carried out. Individuals with fibromyalgia were invited to participate. Occupational balance was assessed with the Occupational Balance Questionnaire; self-reported disability was assessed with the World Health Organization Disability Assessment Schedule, WHODAS 2.0-12; and self-efficacy was evaluated with the 8-item version of the Arthritis Self-Efficacy Scale. Data were analyzed using multiple linear regression with a forward stepwise procedure.

RESULTS

One hundred women with fibromyalgia were included. Occupational balance was 26.96 ± 12.09; however, scores differed between the mild disability group and the moderate disability group (33.11 ± 9.99 vs. 20.29 ± 10.61, p < 0.001). Multiple linear regression analyses revealed that self-reported disability and self-reported pain management explained 58.1% of the variance in occupational balance.

CONCLUSION

Women with fibromyalgia showed low occupational balance. Self-reported disability and self-reported pain management were associated with occupational balance.

SIGNIFICANCE

Occupational therapy practitioners can design intervention programs focussing on occupational balance and self-efficacy to manage symptoms.

Measuring the occupational balance of people with insomnia in a Chinese population: Preliminary psychometric evidence on the Chinese version of the Occupational Balance Questionnaire

BACKGROUND

Occupational balance, a fundamental concept in occupational therapy, is the arrangement of right amount and variety of occupations contributes to a person's health and well-being. This study was aimed to investigate the reliability and validity of the Chinese version of the Occupational Balance Questionnaire (OB-Quest) for people with insomnia.

METHODS

The OB-Quest was translated into traditional Chinese and reviewed by an expert panel for content validity, cultural relevance and translation accuracy. Internal consistency, factor analysis and convergent validity, as well as test-retest reliability, were explored.

RESULTS

The participants (n = 205), 115 adults with insomnia and 90 adults without insomnia, completed a survey of demographic background, the Chinese version of OB-Quest and the Chinese Insomnia Severity Index (C-ISI). The Chinese version of OB-Quest demonstrated excellent test-retest reliability (ICC= 0.98) and good internal consistency (Cronbach's α  =  0.80). Factor analysis indicated that a single-factor solution explained 42% of the variance, and 9 out of 10 items had a factor loading of 0.4 or above. The Chinese version of OB-Quest had significant correlations with C-ISI (r = -0.88; p < 0.001). A significant difference was found in occupational balance between groups with different levels of insomnia severity and without insomnia (F = 169.72; p < 0.001). As in a previous study, age, living environment and life role had no significant relationship with occupational balance.

CONCLUSION

The Chinese version of OB-Quest is a short, easy to understand and culturally relevant assessment for Chinese. It demonstrates satisfactory psychometric properties and had significant correlations with insomnia.

Occupational balance in people with type-2 diabetes: A comparative cross-sectional study

Introduction

Diabetes mellitus may negatively impact individuals’ occupational balance. This study seeks to compare occupational balance in people with and without diabetes and also explore the biological and psychological factors associated with occupational balance in people with diabetes.

Method

This comparative cross-sectional study was conducted using simple non-probability sampling. Participants’ occupational balance was evaluated by the Life Balance Inventory. Blood samples were taken from those with diabetes and analyzed. Psychological distress was also evaluated in the people with diabetes using the Diabetes Distress Scale.

Results

A total of 160 individuals, including 80 people with diabetes and 80 people without diabetes, participated in this study. The mean occupational balance scores for people with and without diabetes were 2.56 and 2.61, respectively. There was no significant difference between the groups in occupational balance. Distress was the only significant factor related to occupational balance in people with diabetes ( p < 0.05).

Conclusion

Distress was the only bio-psychological factor associated with occupational balance in people with diabetes. A higher level of distress is associated with lower occupational balance and also poor glycemic control in this population.

Measuring occupational balance and its relationship to perceived stress and health: Mesurer l'équilibre occupationnel et sa relation avec le stress perçus et la santé

BACKGROUND

There is an assumption that occupational balance is integrally related to health and well-being.

PURPOSE

This study aimed to investigate test-retest reliability of the English-translated Occupational Balance Questionnaire (OBQ), its relationship to measures of health (Short Form Health Survey-36 Version 2.0 [SF-36v2]) and stress (Perceived Stress Scale-10; PSS-10), and demographic differences in OBQ scores in Canadian adults.

METHOD

Test-retest reliability (2 weeks) was assessed using intraclass correlation (ICC) coefficients. Online surveys from 86 adults were analyzed using descriptive, correlational, and t test statistics.

FINDINGS

OBQ test-retest reliability was ICC = 0.74 (95% CI [0.34, 0.90]; p = .003) when excluding an influential case ( n = 20). OBQ correlations with PSS-10 were r = -.72; with SF-36v2 Mental Component Score, r = .65; and with Physical Component Score, r = .31; all p < .001. Age and gender had no impact on OBQ scores.

IMPLICATIONS

Findings help elucidate relationships among health, stress, and occupational balance; however, further psychometric testing is warranted before using OBQ for clinical purposes.

Occupational therapists' perception of the concept of occupational balance

INTRODUCTION

Occupational balance is one of the concepts used by occupational therapists with no consensus on its definition. Literature demonstrates different perspectives when this concept is applied in practice and in its link to other concepts such as health and well-being. This study aims to explore how the concept of occupational balance is perceived and practised by occupational therapy practitioners.

METHOD

A qualitative methodology was employed. Fourteen occupational therapists volunteered for the study. Nine occupational therapy practitioners were interviewed individually and five attended a focus group. Thematic analysis was applied to analyze the data.

RESULTS

Six themes were identified as follows: (1) occupational balance: what it is; (2) how occupational balance is formed; (3) occupational balance and well-being (4); subjective and objective representations of occupational balance (5); what disrupts/affects occupational balance; and (6) occupational balance/imbalance and occupational therapy practice.

CONCLUSIONS

Both objective and subjective experiences of occupational balance need to be considered in order to make an informed decision in practice. The right occupational balance for each individual should be based on his/her values but with consideration of the principal of no harm to others.