Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-19T02:17:57.122Z Has data issue: false hasContentIssue false
  • English
  • Français

Making meaning around experiences in interventions: identifying meaningfulness in a group-based occupational therapy intervention targeting older people

Published online by Cambridge University Press:  12 April 2017

INGEBORG NILSSON  and
ANNA SOFIA LUNDGREN
INGEBORG NILSSON*
Affiliation:
Department of Community Medicine and Rehabilitation, Occupational Therapy, Umeå University, Sweden. Center for Demographic and Aging Research (CEDAR), Umeå University, Sweden.
ANNA SOFIA LUNDGREN
Affiliation:
Center for Demographic and Aging Research (CEDAR), Umeå University, Sweden. Department of Culture and Media Studies, Umeå University, Sweden.
*
Address for correspondence: Ingeborg Nilsson, Umeå University, Vårdvetarhuset, Occupational Therapy, SE-901 87 Umeå, Sweden. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

There is a need to understand the underlying mechanisms at work within health promotion and occupational therapy interventions. The aim of this article was, therefore, to explore and describe how the participants of a group-based occupational therapy intervention with positive health outcomes created meaning of and around their experiences of the intervention. The studied intervention was part of the evaluation of a single-blinded, exploratory randomised controlled trial of three different interventions. A total of 19 participants between 77 and 82 years of age with experiences from the group-based intervention were interviewed, and the transcribed interviews were analysed from a constructivist approach. The results showed five different perspectives of meaning, including enjoyment, usefulness, togetherness, respect for individuality and self-reflection. Based on our findings, we argue that the possibility of getting information, sharing with others and having fun, and the ability to adjust the activities in the intervention so that they met the individual's needs, created meaning for the participants. Moreover, meeting with others supported the participants’ perspectives of themselves. The results are discussed in relation to the pervasive discourse of successful ageing, including how it was present but also challenged within the participants’ accounts of the intervention.

Keywords

meaninginterventionsoccupational therapyidentitysuccessful ageingold age
Type
Article
Information
Ageing & Society , Volume 38 , Issue 9 , September 2018 , pp. 1887 - 1911
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anderson, K. and Jack, D. C. 2013. Learning to listen: interview techniques and analyses. In Berger Gluck, S. (ed.), Women's Words: The Feminist Practices of Oral History. Routledge, Florence, Kentucky, 11–17.Google Scholar
Behm, L., Dahlin Ivanoff, S. and Zidén, L. 2013. Preventive home visits and health – experiences among very old people. BMC Public Health, 13, 1, 378–87.Google Scholar
Bennett, J. A. 2013. Troubled interventions: public policy, vectors of disease and the rhetoric of diabetes management. Journal of Medical Humantities, 34, 1, 15–32.Google Scholar
Beswick, A. D., Rees, K., Dieppe, P., Ayis, S., Gooberman-Hill, R., Horwood, J. and Ebrahim, S. 2008. Complex interventions to improve physical function and maintain independent living in elderly people: a systematic review and meta-analysis. Lancet, 371, 9614, 725–35.Google Scholar
Blackwood, B., O'Halloran, P. and Porter, S. 2010. On the problems of mixing RCTs with qualitative research: the case of the MRC framework for the evaluation of complex healthcare interventions. Journal of Research in Nursing, 15, 6, 511–21.Google Scholar
Blomqvist, P. 2004. The choice of revolution: privatization of Swedish welfare services in the 1990s. Social Policy & Administration, 38, 2, 139–55.Google Scholar
Bowling, A. and Dieppe, P. 2005. What is successful ageing and who should define it? British Medical Journal, 331, 7531, 1548–51.Google Scholar
Bryant, L. R. 2011. The Democracy of Objects. Open Humanities Press, University of Michigan Library, Ann Arbor, Michigan.Google Scholar
Bülow, M. H. and Söderqvist, T. 2014. Successful ageing: a historical overview and critical anaysis of a successful concept. Journal of Aging Studies, 31, 139–49.Google Scholar
Butler, J. 1990. Gender Trouble. Feminism and the Subversion of Identity. Routledge, London.Google Scholar
Butler, J. 1993. Bodies That Matter. On the Discursive Limits of ‘Sex’. Routledge, London.Google Scholar
Christiansen, C. H. 1999. Defining lives: occupation as identity: an essay on competence, coherence, and the creation of meaning. American Journal of Occupational Therapy, 53, 6, 547–58.Google Scholar
Christiansen, C. H., Backman, C., Little, B. R. and Nguyen, A. 1999. Occupations and well-being: a study of personal projects. American Journal of Occupational Therapy, 53, 1, 91–100.Google Scholar
Clark, A. M., MacIntyre, P. D. and Cruicksbank, J. 2007. A critical realistic approach to understanding and evaluating heart health programmes. Health: An Interdisciplinary Journal for the Study of Health, Illness and Medicine, 11, 4, 513–39.Google Scholar
Clark, F., Jackson, J., Carlson, M., Chou, C. P., Cherry, B., Jordan-Marsh, M., Knight, B. G., Mandel, D., Blanchard, J., Granger, D. A., Wilcox, R. R., Lai, M. Y., White, B., Hay, J., Lam, C., Marterella, A. and Azen, S. P. 2012. Effectiveness of a lifestyle intervention in promoting the well-being of independently living older people: results of the Well Elderly 2 Randomised Controlled Trial. Journal of Epidemiology and Community Health, 66, 9, 782–90.Google Scholar
Clark, F., Stanley, P. A., Zemke, R., Jackson, J., Carlson, M., Mandel, D., Hay, J., Josephson, K., Cherry, B., Hessel, C., Palmer, J. and Lipson, L. 1997. Occupational therapy for independent-living older adults: a randomized controlled trial. Journal of the American Medical Association, 278, 16, 1321–6.Google Scholar
Connely, J. B. 2007. Evaluating complex public health interventions: theory, methods and scope of realist enquiry. Journal of Evaluation in Clinical Practice, 13, 6, 935–41.Google Scholar
Cruikshank, B. 1993. Revolutions within: self-government and self-esteem. Economy and Society, 22, 3, 327–43.Google Scholar
Daniels, R., van Rossum, E., de Witte, L., Kempen, G. I. J. M. and van den Heuvel, W. 2008. Interventions to prevent disability in frail community-dwelling elderly – a systematic review. BMC Health Service Research, 8, 278.Google Scholar
DeSalvo, K. B., Bloser, N., Reynolds, K., He, J. and Muntner, P. 2006. Mortality prediction with a single general self-rated health question: a meta-analysis. Journal of Genetic Internal Medicine, 21, 3, 267–75.Google Scholar
Easton, K. L., McComish, J. F. and Greenberg, R. 2000. Avoiding common pitfalls in qualitative data collection and transcription. Qualitative Health Research, 10, 5, 703–7.Google Scholar
Fisher, A. G., Atler, K. and Potts, A. 2007. Effectiveness of occupational therapy with frail community living older adults. Scandinavian Journal Occupational Therapy, 14, 4, 240–9.Google Scholar
Fivush, R. 2010. Speaking silence: the social construction of silence in autobiographical and cultural narratives. Memory, 18, 2, 88–98.Google Scholar
Gubrium, J. F. and Holstein, J. A. (eds) 2003. Ways of Aging. Blackwell, Malden, Massachusetts.Google Scholar
Gustafsson, S., Wilhelmson, K., Eklund, K., Gosman-Hedström, G., Zidén, L., Häggblom Kronlöf, G., Hojgaard, B., Slinde, F., Rothenberg, E., Landahl, S. and Dahlin Ivanoff, S. 2012. Health-promoting interventions for persons aged 80 and older are successful in the short term: results from the randomized and three-armed Elderly Persons in the Risk Zone study. Journal of American Geriatric Society, 60, 3, 447–54.Google Scholar
Hannam, D. 1997. More than a cup of tea: meaning construction in an everyday occupation. Journal of Occupational Science, 4, 2, 69–74.Google Scholar
Hart, T. 2009. Treatment definition in complex rehabilitation interventions. Neuropsychological Rehabilitation, 19, 6, 824–40.Google Scholar
Houston, S. 2010. Prising open the black box: critical realism, action research and social work. Qualitative Social Work, 9, 1, 73–91.Google Scholar
Hull Garci, T. C. and Mandich, A. 2005. Going for gold: understanding occupational engagement in elite-level wheelchair basketball athletes. Journal of Occupational Science, 12, 3, 170–5.Google Scholar
Isaac, V., McLachlan, C. S., Baune, B. T., Huang, C.-T. and Wu, C.-Y. 2015. Poor self-rated health influences hospital service use in hospitalized inpatients with chronic conditions in Taiwan. Medicine (Baltimore), 94, 36, e1477.Google Scholar
Johnston, M. V. and Case-Smith, J. 2009. Development and testing of interventions in occupational therapy: toward a new generation of research in occupational therapy. OTJR: Occupation, Participation and Health, 29, 1, 4–13.Google Scholar
Katz, S. 2000. Busy bodies: activity, aging and the management of everyday life. Journal of Aging Studies, 14, 2, 135–52.Google Scholar
Knight, T. and Ricciardelli, L. A. 2003. Successful aging: perceptions of adults aged between 70 and 101 years. International Journal of Aging and Human Development, 56, 3, 223–45.Google Scholar
Kvale, S. 1996. Inter Views: An Introduction to Qualitative Research Interviewing. Sage, Thousand Oaks, California.Google Scholar
Laclau, E. and Mouffe, C. 1985. Hegemony and Socialist Strategy: Towards a Radical Democratic Politics. Verso, London.Google Scholar
Laliberte Rudman, D. 2006. Shaping the active, autonomous and responsible modern retiree: an analysis of discursive technologies and their links with neo-liberal political rationality. Ageing & Society, 26, 2, 181–201.Google Scholar
Law, M. 2002. Distinguished Scholar Lecture: participation in the occupations of everyday life. American Journal of Occupational Therapy, 56, 6, 640–9.Google Scholar
Martinson, M. and Minkler, M. 2006. Civic engagement and older adults: a critical perspective. The Gerontologist, 46, 3, 318–29.Google Scholar
McEvoy, P. and Richards, D. 2003. Critical realism: a way forward for evaluation research in nursing? Journal of Advanced Nursing, 43, 4, 411–20.Google Scholar
Metzelthin, S. F., van Rossum, E., de Witte, L. P., Ambergen, A. W., Hobma, S. O., Sipers, W. and Kempen, G. I. J. M. 2013. Effectiveness of interdisciplinary primary care approach to reduce disability in community dwelling frail older people: cluster randomised controlled trial. British Medical Journal, 347, f5264.Google Scholar
Minkler, M. and Fadem, P. 2002. ‘Successful aging’: a disability perspective. Journal of Disability Policy Studies, 12, 4, 229–36.Google Scholar
Mol, A. 2008. The Logic of Care: Health and the Problem of Patient Choice. Routledge, Abingdon, UK.Google Scholar
Nelson, T. D. 2011. Ageism: the strange case of prejudice against the older you. In Wiener, R. L. and Wilborn, S. L. (eds), Disability and Aging Discrimination. Springer, New York, 37–48.Google Scholar
Nairn, S. 2012. A critical realist approach to knowledge: implications for evidence-based practice in and beyond nursing. Nursing Inquiry, 19, 1, 6–17.Google Scholar
Oliver, D. G., Serovich, J. M. and Mason, T. L. 2005. Constraints and opportunities with interview transcription: towards reflection in qualitative research. Social Forces, 84, 2, 1273–89.Google Scholar
Phelan, E. A., Anderson, L. A., Lacroix, A. Z. and Larson, E. B. 2004. Older adults’ views of ‘successful aging’ – how do they compare with researchers’ definitions? Journal of the American Geriatric Society, 52, 2, 211–6.Google Scholar
Radomski, M. V. 2011. More than good intentions: advancing adherence to therapy recommendations. American Journal of Occupational Therapy, 65, 4, 471–7.Google Scholar
Reed, K., Hocking, C. and Smythe, L. 2010. The interconnected meanings of occupation: the call, being-with, possibilities. Journal of Occupational Science, 17, 3, 140–9.Google Scholar
Rose, N. 2007. The Politics of Life Itself. Princeton University Press, Princeton, New Jersey.Google Scholar
Rowe, J. W. and Kahn, R. L. 1997. Successful aging. Gerontologist, 37, 4, 433–40.Google Scholar
Rowe, J. W. and Kahn, R. L. 2015. Successful aging 2.0: conceptual expansions for the 21st century. Journals of Gerontology: Psychological Sciences and Social Sciences, 70B, 4, 593–96.Google Scholar
Rozanova, J. 2010. Discourse of successful aging in The Globe & Mail: insights from critical geronotology. Journal of Aging Studies, 24, 4, 213–22.Google Scholar
Ryan-Flood, R. and Gill, R. (eds) 2013. Secrecy and Silence in the Research Process. Taylor & Francis, London.Google Scholar
Shordike, A. and Pierce, D. 2005. Cooking up Christmas in Kentucky: occupation and tradition in the stream of time. Journal of Occupational Science, 12, 3, 140–8.Google Scholar
Sinding, C. and Gray, R. 2005. Active aging – spunky survivorship? Discourses and experiences of the years beyond breast cancer. Journal of Aging Studies, 19, 2, 147–61.Google Scholar
Spitzer, S. L. 2003. With and without words: exploring occupation in relation to young children with autism. Journal of Occupational Science, 10, 2, 67–9.Google Scholar
Stenner, P., McFarquhar, T. and Bowling, A. 2011. Older people and ‘active ageing’: subjective aspects of ageing actively and becoming old. Journal of Health and Psychology, 16, 3, 467–77.Google Scholar
Sue, C. A. 2015. Hegemony and silence: confronting state-sponsored silences in the field. Journal of Contemporary Ethnography, 44, 1, 113–40.Google Scholar
Swedish National Institute of Public Health 2007. Healthy Ageing – A Challenge for Europe. 2006:29, Huskvarna, Sweden. Available online at http://www.healthyageing.nu/upload/Rome/Healthy_web.pdf [Accessed 3 April 2009].Google Scholar
Villar, F. 2012. Successful ageing and development: the contribution of generativity in older age. Ageing & Society, 32, 7, 1087–105.Google Scholar
Wallin, M., Talvitie, U., Cattan, M. and Karppi, S.-L. 2007. The meanings older people give to their rehabilitation experience. Ageing & Society, 27, 1, 147–64.Google Scholar
West, K. 2013. The grip of personalisation in adult social care: between managerial domination and fantasy. Critical Social Policy, 33, 4, 638–57.Google Scholar
West, K. and Lundgren, A. S. 2015. Välfärdsfantasier. Personalisering av offentlig service i Storbritannien. Kulturella Perspektiv, 23, 2, 24–33.Google Scholar
Whyte, J. and Hart, T. 2003. It's more than a black box: it's a Russian doll. American Journal of Physical and Medical Rehabilitation, 82, 8, 639–52.Google Scholar
World Health Organization 2002. Towards a Common Language for Functioning, Disability and Health: ICF. International Classification of Functioning, Disability and Health. World Health Organization, Geneva.Google Scholar
Wurm, S., Warner, L. M., Ziegelmann, J. P., Wolff, J. K. and Schüz, B. 2013. How do negative self-perceptions of aging become a self-fulfilling prophecy? Psychology and Aging, 28, 4, 1088–97.Google Scholar
Zingmark, M., Fisher, A. G., Rocklöv, J. and Nilsson, I. 2014. Occupation-focused interventions for well older people: an exploratory randomized controlled trial. Scandinavian Journal Occupational Therapy, 21, 6, 447–57.Google Scholar
Zingmark, M., Nilsson, I., Fisher, A. G. and Lindholm, L. 2016. Occupation-focused health promotion for well older people - a cost effectiveness analysis. British Journal of Occupational Therapy, 79, 3, 153–62.Google Scholar