The impact of within and between role experiences on role balance outcomes for working Sandwich Generation Women.

Women combining paid employment with dual caring responsibilities for children and aging parents, otherwise known as the sandwich generation, experience both benefits and costs related to role participation and quality of life. However, previous literature is inconclusive regarding the impact of this role combination on role balance. In the context of these mixed findings on role balance for working sandwich generation women, this study aimed to explore how within role characteristics and between role interactions are related to role balance for these women. This aim was achieved through the use of a questionnaire administered to 18 Australian working sandwich generation women. Data were analyzed using descriptive statistics and correlation coefficients, with findings suggesting the women studied tended to experience neither role balance or role imbalance. Within-role characteristics, particularly within the mother and family member roles, were related to role balance. In addition, between-role conflict and role interactions involving either the home maintainer or family member roles had the greatest impact on role balance.

The Role of Adult Day Services in Supporting the Occupational Participation of People with Dementia and Their Carers: An Integrative Review.

The increasing numbers of people with dementia places considerable stress on health and aged care services and has resulted in the development of community adult day services. Aim: The aim of this integrative review is to determine the extent to which these services support the occupational participation of people with dementia, and how they impact their primary carers. Method: The mixed-methods appraisal tool (MMAT) was used to identify relevant studies in the period 2011⁻2016. Results: Nine databases were searched and yielded 16 articles with a variety of research designs for inclusion in the review. Conclusions: Findings indicate that adult day services use a range of approaches to support attendees and their carers. In spite of these efforts, there appears to be a lack of interest in utilizing these services while a person is in the early stages of dementia. This suggests that policies in aged care, such as aging-in-place, need to consider the pressure and stress they exert on carer’s quality of life. Another consideration is to better promote the benefits of participating in adult day services in the early stages of dementia for both the attendees and their carers, thereby delaying the tendency towards early institutionalization.

Learning management by self-employed occupational therapists in private practice.

BACKGROUND/AIM: This study explored how occupational therapists in private practice developed the business skills needed to operate a successful private practice. The literature shows that many small-business owner-managers have poorly developed business skills, and some experience high rates of failure. This indicates that to be successful in private practice, occupational therapists need to gain mastery of management competencies in addition to their professional clinical competencies. METHODS: A qualitative study, using in-depth interviews, collected data from twenty-six self-employed occupational therapists on their experiences of becoming a small-business owner-manager. A narrative analysis built an understanding about how these therapists developed their business competencies. RESULTS: Analysis revealed the factors affecting the development of business competencies were interactions between the initial motivations for start-up, growth aspirations and engagement with external business environments. Business competencies developed through a combination of formal learning prior to starting their businesses, and informal learning once their businesses were in operation. Lower level learning occurred in the routine and operational processes, with higher level learning through discontinuous events resulting in a transformation in the therapists' understanding about themselves as business owner-managers. CONCLUSIONS: Findings led to a proposition that occupational therapists make the transition to becoming successful small-business owner-manager through management learning that includes elements of self-reflection, identifying environmental opportunities and risks, developing capabilities, and strategic planning for growth and development. It provides insights on what occupational therapists need to consider to become successful small-business owner-managers.

Viewpoints of working sandwich generation women and occupational therapists on role balance strategies.

Occupational therapists need to be cognizant of evidence-based role balance advice and strategies that women with multigenerational caring responsibilities can implement independently or with minimal assistance, as role balance may not be the primary goal during many encounters with this population. Hence, this study aimed to identify the viewpoints on the most helpful role balance strategies for working sandwich generation women, both from their own perspectives and from the perspective of occupational therapists. This was achieved through a Q methodology study, where 54 statements were based on findings from interviews, sandwich generation literature and occupational therapy literature. In total, 31 working sandwich generation women and 42 occupational therapists completed the Q sort through either online or paper administration. The data were analysed using factor analysis with varimax rotation and were interpreted through collaboration with experts in the field. The findings revealed similarities between working sandwich generation women and occupational therapists, particularly in terms of advocating strategies related to sleep, rest and seeking practical assistance from support networks. Differences were also present, with working sandwich generation women viewpoints tending to emphasize strategies related to coping with a busy lifestyle attending to multiple responsibilities. In contrast, occupational therapy viewpoints prioritized strategies related to the occupational therapy process, such as goal setting, activity focused interventions, monitoring progress and facilitating sustainable outcomes.

Working Sandwich Generation Women Utilize Strategies within and between Roles to Achieve Role Balance.

Increasingly, women simultaneously balance the roles of mother, parental carer and worker. However, individual role balance strategies among these working 'sandwich' generation women have not been thoroughly explored. Eighteen women combining these three roles were interviewed about their individual role balance strategies. Findings were identified through the framework analysis technique, underpinned by the Model of Juggling Occupations. Achieving and maintaining role balance was explained as a complex process accomplished through a range of strategies. Findings revealed the women used six within-role balance strategies: living with integrity, being the best you can, doing what you love, loving what you do, remembering why and searching for signs of success. The women also described six between-role balance strategies: maintaining health and wellbeing, repressing perfectionism, managing time and energy, releasing responsibility, nurturing social connection and reciprocating. These findings provide a basis for health care providers to understand and potentially support working 'sandwich' generation women.

The complexity of role balance: support for the Model of Juggling Occupations.

OBJECTIVE: This pilot study aimed to establish the appropriateness of the Model of Juggling Occupations in exploring the complex experience of role balance amongst working women with family responsibilities living in Perth, Australia. METHODS: In meeting this aim, an evaluation was conducted of a case study design, where data were collected through a questionnaire, time diary, and interview. RESULTS: Overall role balance varied over time and across participants. Positive indicators of role balance occurred frequently in the questionnaires and time diaries, despite the interviews revealing a predominance of negative evaluations of role balance. Between-role balance was achieved through compatible role overlap, buffering, and renewal. An exploration of within-role balance factors demonstrated that occupational participation, values, interests, personal causation, and habits were related to role balance. CONCLUSIONS: This pilot study concluded that the Model of Juggling Occupations is an appropriate conceptual framework to explore the complex and dynamic experience of role balance amongst working women with family responsibilities. It was also confirmed that the case study design, including the questionnaire, time diary, and interview methods, is suitable for researching role balance from this perspective.

The experience of being a motorised mobility scooter user.

PURPOSE: To explore the individual experience of being a scooter user and the ways in which scooters impact the individual's community and social engagement, daily activities and enhances mobility. METHODS: A qualitative, constructive framework utilising purposive sampling and a semi structured interview was used with 14 individuals. Questions were categorised according to the International Classification of Functioning, Disability and Health framework into the three areas of activities, participation and environmental factors. RESULTS: The three main themes identified through the research were knowledge, engagement and environments. Knowledge included a lack of concise information, and adequate trialling and training prior to purchase. Engagement consisted of participation and interaction demonstrating scooter use resulted in increased participation, role maintenance, choice, freedom and social interaction. Environments highlighted discrimination from the wider population and building design and barriers. CONCLUSIONS: The research demonstrated a strong positive impact on individual's engagement from using a scooter, while highlighting a lack of adequate knowledge about scooters, batteries, skill ability and design along with environmental challenges of discriminatory attitudes and physical barriers. The research indicates the need for pre-purchase assessments and trials along with improvements in community attitudes and environments. IMPLICATIONS FOR REHABILITATION: Development of a pre-purchase assessment including specific core skills for scooter use is of great importance to minimise accidents and death as a consequence of scooter driving. Education and training of prescribers and suppliers of scooters is important to match needs and skills to enable a better fit of scooter to user. Incorporation of adjustability of features within the standard design of scooters, including type of driving controls, seat height, and adjustment of distance to controls, will enable greater fit of scooter to the user s needs.

The impact of switching on family caregivers of children with cerebral palsy.

PURPOSE: This study aimed to enhance our knowledge and understanding of switching, as assistive technology, and how it impacts on family caregivers of children with cerebral palsy with GMFCS levels four or five. METHODS: A qualitative method using a constructivist approach was adopted. Purposive sampling was used to recruit five caregivers to participants in this study. Framework analysis was applied to the data collection of semistructured interviews conducted with each caregiver. FINDINGS: The three main themes identified were an investment in the future, resulting in joy and hope. The learning process of switching is resource intensive, time consuming and effortful for caregivers. If caregivers do not perceive this as an investment, then they may not experience the joy switching can bring to their child, and in turn the joy, hope, and caregiver satisfaction it can offer for the future. CONCLUSION: This research indicates that caregivers often have the greatest impact on whether switching will be adopted in the home. The greatest impact on caregivers is related to their perception on the competence of therapists and coordination of services provided.

Impact of assistive technology on family caregivers of children with physical disabilities: a systematic review.

PURPOSE: To systematically review the literature on the effects of assistive technology (AT) on family caregivers of children with physical disabilities. METHOD: Electronic searches of Medline, CINAHL Plus, PubMed, and PsychInfo were conducted. The main search terms were AT, caregiver, physical disability, cerebral palsy and quality of life. Studies were included if they related to the impact of AT on the family caregiver of children with physical impairment. Data extraction and quality assessments were conducted by three reviewers. RESULTS: Five articles were eligible for inclusion. Two studies rated weak quality of evidence (level 5), two studies rated moderate quality of evidence (level 3), and one article was a systematic review, rating high level of quality (level 1). A paucity of literature, small sample sizes, descriptive study designs and weak methodological quality meant a narrative review was possible. Three articles reported that AT lightened caregiver assistance in the areas of mobility, self- care and social function. CONCLUSIONS: Evidence suggests that AT has a positive impact on children with physical impairments and their caregivers. Future studies in this area could include valid and reliable outcome measures of AT use and the psychological impacts of AT on caring for a child with physical impairments.

In search of wellness: allied health professionals' understandings of wellness in childhood disability services.

PURPOSE: Wellness approaches are not routine in childhood disability services, despite theoretical and empirical support and an increasing demand for them from health consumers and disability activists. We aimed to investigate how health professionals define or understand wellness and its practice in the context of childhood disability. METHOD: A qualitative, interpretive approach was taken. Semi-structured interviews were conducted with 23 health professionals (allied health therapists and managers) providing early intervention and ongoing therapy within four Australian childhood health and disability services. Years of experience providing services to children with disabilities and their families ranged from 6 months to 30 years (M=9.41, SD=9.04). RESULTS: The data revealed a noteworthy impediment to incorporating wellness into practice - the difficulties in the allied health professionals reaching consensus in defining wellness. There appeared to be distinct differences between the four services, while there appeared to be no appreciable difference based on the individual professional's years of experience or allied health discipline. CONCLUSIONS: The effect of organisational culture should be considered in efforts to embed wellness in childhood health and disability services in order to address client well-being, empowerment, choice, independence and rights to meaningful and productive lives.

Factors affecting the retention of occupational therapists in rural services.

Failure to retain health professionals in rural areas contributes to the poor health status of these communities through an inability to deliver reliable and consistent services. Considerable attention has focused on factors affecting recruitment of health professionals. Far less is known about factors affecting the retention of occupational therapists. In this study ethnographic interviews were conducted with 10 occupational therapists to explore their experiences related to leaving rural practice. Six themes emerged from the participants' experiences and gave rise to a framework that suggests retention can be improved by addressing the imbalance between incentives to leave and to stay in rural practice. The findings can be used by occupational therapists contemplating rural practice, as well as by health services managers responsible for service delivery in rural areas.