Background To enable people with stroke to achieve an active everyday life under altered conditions, the development of self-management programs is essential to facilitate the process of change that individuals must undergo. To improve access to self-management, internet-based solutions have been proposed. The aim of this study was to evaluate the feasibility of a novel internet-based intervention, “Strategies for Empowering activities in Everyday Life” (SEE, version 1.0), for clients with stroke.

Methods This feasibility study had a preposttest design without a control group and utilized a mixed-method approach. Data were collected through study-specific forms, outcome assessments, interviews, and field notes. Descriptive statistics and content analysis were subsequently applied.

Results The study involved fifteen clients and staff at clinics in a hospital-based open-care rehabilitation setting. The results indicate that SEE is feasible for clients with stroke. When adopted as expected, SEE has the potential to empower self-management and enhance engagement, balance, and values in everyday activities. The study also indicates that SEE is feasible in terms of adherent delivery of dosage, acceptability, and value, as perceived by clients, occupational therapists, and clinic managers. However, adjustments are needed in the study design, in terms of recruitment strategies, the selection of assessor-based outcome assessment, and the evaluation of adherence. Additionally, the educational program for professionals should be enhanced to better support the implementation of SEE.

Conclusion After the study design, intervention, and educational program are refined, SEE can be prepared for a pilot randomized controlled trial.

Background: Digital work can be cognitively challenging especially for people with cognitive difficulties. New occupational therapy interventions are needed to empower these persons to self-manage challenges in digital work and everyday life. To address this need, the internet-based intervention ‘Strategies for Empowering Activities in Everyday Life’ (SEE 2.0) was tested.Aim: To explore and describe how SEE can support the development of self-management in people with cognitive difficulties who engage in digital work and other occupations in everyday life.Material and methods: A qualitative, descriptive case study included four participants with cognitive difficulties due to neurological disorders who participated in SEE. Data were collected through semi-structured interviews, self-reports and assessments then analysed using pattern matching.Results: Three cases were formed. Two cases (three people) adhered to SEE’s intervention process, resulting in increased work hours, improved occupational balance, and greater engagement in valued occupations. One case (one person) could not fully adhere to the process and struggled to adopt changes.Conclusions: SEE shows potential in supporting self-management, promoting sustainable digital work and everyday life.Significance: SEE can add to existing vocational rehabilitation programs by empowering persons to utilise their own resources to manage challenges in everyday life.

BACKGROUND: Digital work poses cognitive demands on all employees, but the impact is greater for employees with cognitive impairments. Digitalization also has significant implications for employer representatives as they are responsible for the work environment. However, knowledge is scarce concerning employer representatives’ perspectives on identifying needs and support for employees with cognitive impairments working in a digital work environment.

OBJECTIVE: To describe employer representatives’ experiences of work environment management with focus on employees with cognitive impairments working in a digital environment.METHODS:Focus group methodology was used. Six employer representatives with work environment responsibilities participated.

RESULTS: One overall theme “Mastering the interconnected processes in a transformative digital work environment” as well as three themes “Facilitating good digital work conditions”, “Identifying needs and difficulties in work tasks among employees’ with cognitive impairments” and “Pursuing knowledge and collaborations to support employees with cognitive impairments” with subthemes were identified. The themes describe employer representatives’ challenges and efforts to identify fluctuating needs in employees with cognitive impairments and, also, to organize and reduce cognitive demands in the work environment to support them.

CONCLUSIONS: Managing the challenges of an evolving digital work environment and matching individual work ability of employees with cognitive impairments in relation to cognitive demands is an ongoing process. The participants valued cooperation with employees with cognitive impairments but lacked support from expertise. The need to develop and implement a functioning support system for vocational rehabilitation to ensure a sustainable work in digital work environments is indicated.

Play for plays sake emphasises the significance of how children characterise play opposed to any secondary purposes or benefits it may generate. The concept of play value draws attention to how the space in which children play proffers the experiences that children want. Increasingly, digital play experiences are emerging as spaces for play. This inquiry aims to examine the play value of digital spaces, specifically how play is afforded by the digital space from the perspective of children. Eight children aged 11 years old participated in seven focus groups, creating comic strips which were used to elicit discussions. Focus group analysis generated three themes with associated sub-themes which were collectively explained by the overarching theme of endless possibilities in play in digital spaces. This study provides a new understanding of how digital spaces affords play value from the child's perspective.

Background: There is a need to enhance access to and support for self-management of activities in everyday life after a stroke. Internet-based solutions have the potential to contribute to this development. Consequently, an internet-based intervention called Strategies for Empowering Activities in Everyday Life (SEE) was developed. The intervention aims to assist clients in developing management strategies that promote a healthy distribution and balanced engagement in various activities performed in different places and with other people. To further support the development and feasibility of this intervention, more knowledge is needed about clients’ experiences during the intervention process.

Objective: This study aims to explore and describe how clients with stroke experienced the SEE intervention process and whether participation in SEE influenced their experience of everyday life.

Methods: Overall, 9 clients with stroke who received SEE participated in the study—4 (44%) women and 5 (56%) men aged 37 to 73 years. Qualitative interviews about experiences with SEE were conducted twice during the intervention process with each participant. The data were analyzed using the constant comparative method of grounded theory.

Results: The participants’ experiences with the intervention process of SEE formed the core category, conceptualized as The relevance of and readiness for entering a change process in activities of everyday life differ among clients, constituting of two main categories: (1) an eye-opener providing agency for a change process and (2) never beginning a change process in activities in everyday life. The results showed that the relevance of and readiness for SEE differed between the participants. The experiences of 78% (7/9) of the participants reflected that the intervention process provided them with an agency to drive their own change process for activities in everyday life to promote health. Overall, 22% (2/9) of the participants refrained from entering a change process during SEE as they did not recognize any need for changes in their activities. When SEE was relevant and adopted as expected, the participants described it as an eye-opener for how they can alter their health based on how they distribute and spend their time on various activities.

Conclusions:SEE has the potential to support clients’ development of self-management and to take an active role in influencing their engagement in activities in everyday life and health. This study identified necessary improvements in the educational program for professionals to enhance delivery and strengthen the therapeutic mechanisms of SEE for future research. To effectively implement internet-based interventions such as SEE, it is crucial to identify clients who express a need for self-management in activities and are ready to invest the effort required to adopt a change process. Furthermore, it is indicated that participants’ self-analysis of their everyday activities empowers them to adopt new self-management strategies, which can also benefit other interventions.

Background: Everyday lives of adolescents reflects a pattern and balance of occupations across the awake-sleep continuum. Despite ongoing discussions regarding overconsumption, play in digital spaces is an occupation of choice for many adolescents.Aim: To explore and identify how the meaning of playing video games is situated in adolescents’ everyday life.Material and Method: Five participants aged 16–17 years were recruited. Data was generated through interviews and encounters using recorded clips of their play in digital spaces. Narrative analysis was utilised to explore the stories of adolescent’s digital play in everyday life.Results: The overall plot of ‘bridging the divide’ represents and symbolises how play in the digital space is integrated in adolescents’ everyday life as they negotiate and balance the habits and routines of everyday life. Four storylines help demonstrate the stories told.Conclusion: Playing in digital spaces enabled the participants to be part of an ongoing story where meaning could be negotiated and created. Play was interwoven in the complexity of routines reflecting the importance of examining the integrated whole of adolescents’ everyday life.Significance: These findings are significant in shifting current assumptions and discourses of how digital play is situated in everyday life.

Introduction: Internet-based interventions are called for within rehabilitation to meet the limited access to support for self-management after stroke. Therefore, a new intervention program, “Strategies for Empowering activities in Everyday life” (SEE) was developed. The aim of this study was to explore and describe how clients with stroke and their occupational therapists experienced the SEE intervention process and whether SEE has the potential to promote an active everyday life.

Methods: A qualitative descriptive case study was designed. Four people with stroke (two of each sex, mean age 66,5 years) and their two occupational therapists (one of each sex) were included. A mix of data collection methods as interviews, assessments, registration forms and fieldnotes was used to uncover the participants’ experiences and potential changes. Data were analysed with pattern matching.

Findings: The analysed data formed three categories: “Not being able to take on the internet-based intervention”, “Being facilitated in the change process of everyday life through the internet-based intervention”, and “Providing a new internet-based intervention is a transition from ordinary practice”. These categories included two to four subcategories that reflected aspects of SEE feasibility and acceptability with a focus on content and delivery.

Conclusion: The first test of the intervention indicates that the content and delivery of SEE can be feasible and acceptable both for clients and occupational therapists. The findings suggest that SEE has the potential to support clients’ self-reflections and their adoption of strategies that influence engagement in daily activities and satisfaction with life in various ways. Further research with large-scale studies is needed.

Background: Sustainability is an important issue in implementation processes in health care, and more knowledge is needed to facilitate improvement work in occupational therapy practice.

Aim: The aim of this study was to explore how occupational therapists experienced continuous quality improvement work based on the Occupational Therapy Intervention Process Model after 17 years.

Method: Two focus group interviews were conducted with a total of 12 occupational therapists. The data were analysed using qualitative content analysis.

Results: The analysis resulted in three themes with related subthemes describing the occupational therapists’ experiences of their model-based long-term improvement work. The themes were labelled as follows: ‘sharing a safe and well-known professional reasoning’, ‘reaching normality and empowerment’ and ‘questioning and reshaping the too safe and too well-known normality’. The model functioned as a sustainable framework both for ordinary clinical practice and for continuous improvement work.

Conclusion: By using the model, the occupational therapists had established a safe and well-known professional reasoning in which continual quality improvement work had become sustainable.

Background:

Digital spaces are rapidly emerging as a space for children to engage in autotelic play.

Aim:

To explore and describe children’s experiences of choice-making in their play in digital spaces from the perspective of children themselves.

Methods:

Focus groups were conducted with a total of eight children aged six years of age within their school, in a large city in Ireland. A Mosaic Approach with drawing, cutting, and colouring in was used to elicit the children’s voices to ensure their active engagement throughout the data collection. Data was analyzed using focus group analysis.

Results:

Data analysis revealed three main themes; children enjoy the ability to make choices in their play, that they are often constrained in their ability to make choices, and that they negotiate ways in which they can select options for play in digital spaces.

Conclusions:

Findings indicate that children are agentic individuals who are capable of making decisions in their play in digital spaces. This knowledge provides implications for Occupational Therapists to enhance play as an occupation in digital spaces.

Background

Research is limited about how the introduction of new ways of delivering and conducting occupational therapy, in accordance with expected changes in health care, is experienced by occupational therapists (OTs).

Aim

To explore how OTs experienced use of a new internet-based intervention, ‘Strategies for Empowering activities in Everyday life’ (SEE), focusing on supporting client resources to manage an active everyday life after stroke.

Material and methods

A focus group study with periodical repeated discussion was designed. Four sessions during a period of 22 months were conducted with a total of four OTs.

Result

Overall, the results reflected that the OTs experienced that the use of SEE for persons with stroke was a valuable complement to existing rehabilitation. The process of introducing SEE included a multifaceted transition involving context, intervention process and delivery that renewed occupational therapy.

Conclusion

These results indicate how the use of new internet-based interventions such as SEE can influence and support renewal of occupational therapy that extends beyond the particular intervention. Continued research is needed to explore more aspects of SEE feasibility.