Work-, lifestyle-, and health-related factors among women and men working in the emergency medical services.

Objectives. This study aimed to describe work-, lifestyle-, and health-related factors among ambulance personnel, and to analyse differences between women and men. Methods. The cross-sectional study (N = 106) included self-reported and objective measures of work, lifestyle, and health in 10 Swedish ambulance stations. The data collection comprised clinical health examination, blood samples, tests of physical capacity, and questionnaires. Results. A high proportion of the ambulance personnel reported heavy lifting, risk of accidents, threats and violence at work. A low level of smoking and alcohol use, and a high level of leisure-time physical activity were reported. The ambulance personnel had, on average, good self-rated health, high work ability and high physical capacity. However, the results also showed high proportions with risk factors for cardiovascular disease (CVD), e.g., high blood pressure, and high levels of blood lipids. More women than men reported high work demands. Furthermore, women performed better in tests of physical capacity and had a lower level of CVD risk factors. Conclusions. Exposure to work-related factors that might affect health was common among ambulance personnel. Lifestyle- and health-related factors were somewhat contradictory, with a low proportion reporting lifestyle-related risk factors, but a high proportion having risk factors for CVD.

A Rasch analysis of the Danish version of the occupational balance questionnaire (OBQ11).

BACKGROUND: OBQ11 was developed in a Swedish context. To evaluate occupational balance, accurate self-rating instruments in the native language are needed. AIM: The aim was to investigate the measurement properties of the Danish version of OBQ11, using the Rasch analysis. METHOD: Data for the analysis of the Danish version of OBQ11 (OBQ11-DK) was gathered online, and all full data records (n 366) were included in the analysis. RESULTS: Three items showed non-significant marginal under- or overfit, suggesting a degree of misfit between the data and the Rasch model. Unidimensionality was not reached, though, since the proportion of persons with different estimates were more than 5% and thus the OBQ11-DK cannot be said to assess a person's perception of occupational balance. CONCLUSION: The present version of the OBQ11-DK shows the need for further development and testing and is not tested for test/retest or in clinical samples. The results and small number of items may after modifications and further studies make it feasible to implement OBQ11-DK into settings where the measuring of occupational balance is needed.

Validity and Reliability of the Occupational Balance Questionnaire (OBQ11) in a U.S. Sample of Adults With Type 1 Diabetes.

IMPORTANCE: Although occupational balance (OB) is a construct of importance to occupational therapy, existing OB assessments have not been validated in clinical populations. OBJECTIVE: To examine the validity and reliability of the 11-item version of the Occupational Balance Questionnaire (OBQ11) in U.S. adults with Type 1 diabetes. DESIGN: Data were analyzed from adults with Type 1 diabetes enrolled in a larger longitudinal study examining the relationships among blood glucose, emotion, and functioning. Dimensionality of the OBQ11 was assessed with item response theory (IRT); convergent validity was tested by examining whether associations between the OBQ11 and other constructs were consistent with a priori hypotheses. SETTING: Three outpatient clinical sites in the United States. PARTICIPANTS: Data from 208 U.S. adults with Type 1 diabetes were included in the analyses (42% Latino, 29% White, 14% African American, 7% multiethnic, and 8% other). OUTCOMES AND MEASURES: Assessments administered include the OBQ11, Patient Health Questionnaire (depression), and Diabetes Self-Management Questionnaire. RESULTS: Overall, results from IRT models and correlational tests supported the reliability and validity of the OBQ11. For instance, higher scores on the OBQ11 were significantly associated with better self-ratings of diabetes management behaviors (r = .28, p < .001), lower depression symptoms (r = -.53, p < .001), and greater positive affect (r = .32, p < .001). A single-factor generalized partial credit model fit the OBQ11 acceptably well, supporting its unidimensionality. CONCLUSIONS AND RELEVANCE: The OBQ11 may be a reliable and valid measure of OB appropriate for use in clinical populations such as adults with diabetes. What This Article Adds: OB is not often formally assessed by occupational therapists in the United States, even though the contributions of OB to health and well-being are core components of the philosophy of occupational therapy. The current evidence supports the validity of the OBQ11 in a clinical population of adults with Type 1 diabetes and demonstrates significant associations between OB and health management behaviors. Study results may encourage greater consideration and assessment of OB in occupational therapy clinical practice in the United States.

Work-related factors and hair cortisol concentrations among men and women in emergency medical services in Sweden.

Ambulance personnel in emergency medical services are exposed to physical demands and stress during work, and an increased prevalence of ill health has been observed in this group. The aim was to compare hair cortisol concentration (HCC) among Swedish ambulance personnel with HCC in a population-based reference sample, to analyse differences between women and men, and differences due to work-related factors. Samples of hair 1 cm closest to the skin (5-10 mg) were collected and analysed for cortisol by radioimmunoassay. Moreover, the participants responded to a questionnaire regarding their work environment. The HCC among the ambulance personnel did not differ from the HCC in the population-based reference sample (median 19.2 vs. 22.2 pg/mg, p = 0.319), nor were there statistically significant differences between women and men. Furthermore, no associations were found between HCC and physical and psychosocial work demands, work stress, or rest and recovery from work. However, occupational balance was positively correlated with HCC (rp = 0.240; p = 0.044). The association remained statistically significant after adjustment for sex, age, hair bleaching, and corticosteroid treatment in a linear regression model. This study adds knowledge regarding HCC among ambulance personnel, and thus contributes to the overall picture of work environment and health for this group.

Occupational therapy and stress-related exhaustion - a scoping review.

BACKGROUND: Sick leave due to long-term stress is increasing in Finland and other Western countries. Occupational therapists might contribute to the prevention of and/or recovery from stress-related exhaustion. AIMS/OBJECTIVES: To describe what is known about occupational therapy for stress-related exhaustion. MATERIAL AND METHODS: A five-step scoping review included papers published in six databases from 2000 to 2022. Extracted data was summarized to show the occupational therapy contribution within the literature. RESULTS: There were 29 papers meeting the inclusion criteria, of which a limited number described preventive interventions. Most articles described recovery-oriented occupational therapy with group interventions. The occupational therapists contributed with prevention measures, mostly targeting recovery in multi-professional interventions in terms of stress reduction or return-to-work. CONCLUSIONS: Occupational therapy involving stress management both prevents stress and supports recovery from stress-related exhaustion. Occupational therapists internationally use craft, nature activities or gardening as stress management measures. SIGNIFICANCE: Occupational therapy appears to be a potential treatment option for stress-related exhaustion internationally in conditions that could also work in Finland, for example in occupational healthcare.

Quality of life, sense of coherence and occupational balance one year after an occupational therapy intervention for people with depression and anxiety disorders.

BACKGROUND: Quality of life (QOL), sense of coherence (SOC) and occupational balance (OB) have been found to increase after rehabilitation among people living with depression and anxiety. However, these aspects have not been investigated over time in participants with different paid work situations, such as being on sick leave or not. OBJECTIVE: To describe and compare the self-rated QOL, SOC and OB after participation in occupational therapy in three groups of people with depression and anxiety disorders based on their work situation during the study period: continuous sick leave, return to work and continuous work. METHODS: Forty-seven women and seven men, 19-60 years old with depression and anxiety were followed over time. They completed questionnaires on QOL, SOC and OB on four occasions. Data were analyzed with non-parametric statistics. RESULTS: No statistically significant differences between the groups were identified. All groups improved in at least one of the studied areas over time: the sick leave group in OB; the return-to-work group in QOL and OB; and the Work group in QOL and SOC. CONCLUSION: The results indicate variations in QOL, SOC and OB between people with different work situations over time after occupational therapy. Studies with larger samples are, however, warranted.

Validity and reliability of the Turkish Occupational Balance Questionnaire (OBQ11-T) in mental health.

BACKGROUND: People with psychiatric disabilities often find it difficult to maintain a satisfactory occupational balance. AIMS/OBJECTIVES: This study aimed to investigate the validity and reliability of the Turkish version of the Occupational Balance Questionnaire (OBQ11-T) in mental health. MATERIAL AND METHODS: OBQ11-T was applied to 149 people for construct validity analysis and to 61 of them for reliability analysis. Validity was determined using factor analyses. The reliability of the OBQ between the first and second evaluations was assessed using the intraclass correlation coefficient (ICC) for each item and the total OBQ11-T score. Internal consistency was assessed using Cronbach's alpha. RESULTS: The results of factor analysis revealed one factor that explains 35.94% of the total variance in the model. OBQ11-T item 1 had the lowest and OBQ11-T item 4 had the highest factor loadings. The model fits the data according to the indices of relative fit (RMSEA = 0.087, CMIN/DF = 2.129, CFI = 0.901). There was an excellent correlation between test and retest OBQ11-T total scores (ICC = 0.905). All items of the OBQ11-T showed good reliability. Cronbach's alpha for the OBQ11-T total score was 0.839, indicating acceptable internal consistency. CONCLUSIONS AND SIGNIFICANCE: The current study showed that OBQ11-T is a valid and reliable tool for measuring the self-rated occupational balance of people with mental illness.

Occupational performance problems in people with depression and anxiety.

BACKGROUND: Depression and anxiety often reduce people's ability to cope with everyday occupations. There is a lack of knowledge about such problems in people of working age with depression and anxiety. AIM: To describe which problems people with depression or anxiety disorders experience when performing everyday occupations and which occupations are affected. MATERIALS AND METHODS: Data based on the Canadian Occupational Performance Measure was used in this cross-sectional study. A total of 118 participants aged 18-65 years, with depression or anxiety, were recruited from primary healthcare and general mental healthcare services. The data were analysed with descriptive statistics and directed content analysis. RESULTS: The participants rated a low level of occupational performance, and their satisfaction with performance even lower. They described a great number of problems with their everyday occupations. The most frequent problem areas concerned household management, socialization and personal care. Detailed descriptions of which type of problem they experienced during everyday occupations are included. CONCLUSIONS: This study provides knowledge of which problems people with depression and anxiety disorders experience in everyday occupations within self-care, productivity, as well as leisure. Furthermore, they rate performance and satisfaction with performance of the five occupations they find the most important to change in everyday life.

Occupational balance in parents of pre-school children: Potential differences between mothers and fathers.

BACKGROUND: Parents of young children are a vulnerable group with an increased risk of stress-related health problems compared to adults without children. Low occupational balance has been identified as a risk factor for stress-related disorders. AIM: The study aimed to describe occupational balance in parents of pre-school children and to explore potential differences between mothers and fathers. METHOD: Data were collected by a web-based survey based on the Occupational Balance Questionnaire (OBQ11). A total of 302 working parents (200 mothers and 102 fathers) with at least one child under seven years of age were included in the study. FINDINGS: Mothers reported lower occupational balance than fathers with a median value of 10 for mothers and 12 for fathers (p = 0.029). Mothers rated significantly lower than fathers in three items; 'Balance between work, home, family, leisure, rest and sleep', 'Having sufficient time for doing obligatory occupations' and 'Balance between doing things for others and for oneself'. CONCLUSION: The results indicate that caring for pre-school children may negatively impact both parents, impacting mothers' occupational balance to a greater degree. SIGNIFICANCE: Occupational therapists' knowledge could be utilised to increase awareness of the importance of occupational balance within health services and improve mothers' occupational balance.

Occupational performance issues in a longitudinal perspective in people with depression and/or anxiety on sick leave, returning to work or working.

BACKGROUND: People with depression and anxiety disorder may experience occupational performance issues (OPIs). Further knowledge about these issues longitudinally and about potential differences between people is valuable. AIM: To explore experienced OPIs longitudinally in a sample living with depression and/or anxiety disorder participating in occupational therapy and varying in terms of their work situation. MATERIAL AND METHODS: The Canadian occupational performance measure (COPM) was completed by 54 participants with depression and/or anxiety at four measure-points from baseline to one-year after participation in occupational therapy. The participants constituted three groups: continuously on sick leave (SL), returned to work within a year and continuing working. Descriptive and non-parametric analysis was used. RESULTS: Participants in all groups identified OPIs in all occupational areas in the COPM. All groups increased their occupational performance and satisfaction with their occupational performance in the area socialisation. Each group also made improvements in relation to other occupational areas, varying between the groups. CONCLUSIONS: OPIs and improvements were identified among the participants regardless of them being on SL, returning to work or working. SIGNIFICANCE: The diverse nature of OPIs and improvements in the clients indicate the relevance of occupational therapy.

Occupational balance of Spanish occupational therapists - a challenge.

BACKGROUND: Occupational balance is a central aspect in occupational therapy. Awareness of occupational balance/imbalance among occupational therapists could influence the orientation of their professional interventions. OBJECTIVE: To describe and compare the occupational balance status of occupational therapists working in Spain. MATERIAL AND METHODS: Cross-sectional descriptive study using an online questionnaire. Participants were occupational therapists working in Spain who answered a questionnaire including 22 questions on the sociodemographic and employment data and the Spanish version of the Occupational Balance Questionnaire (OBQ-E) ranging 0-65 where higher ratings equal better occupational balance. RESULTS: A total of 648 currently working occupational therapists participated. Mostly women, with median age of 32 years, without partner, children, or dependents. The median OBQ-E was 37 (IQR = 27; 45). Statistically significant differences were found between the medians of participants varying in the categories 'hired as an occupational therapist', weekly work hours, and population working with children and adults. CONCLUSIONS AND SIGNIFICANCE: Spanish occupational therapists presented a moderate occupational balance that varied between subgroups. Professional recognition, working hours, and the population they attend are aspects that influence their occupational balance. Knowledge of occupational therapists' occupational balance could contribute to the development of policies aimed at promoting it.

Outcomes of the Tree Theme Method versus regular occupational therapy: A longitudinal follow-up.

INTRODUCTION: Depression and anxiety disorders affect individuals' everyday lives, and treatments that can help them to perform everyday occupations are needed. Occupational therapy for this group has been evaluated from a short-term perspective but not from a long-term perspective; further research is thus warranted. The aim of the study was to investigate the longitudinal outcomes of the Tree Theme Method (TTM) compared with care as usual, provided by occupational therapists, in terms of everyday occupations, psychological symptoms, and health-related aspects. METHODS: This randomised controlled trial comprised a follow-up 3 and 12 months after an intervention. A total of 118 participants (19-64 years) with depression or anxiety disorders and problems with everyday occupations completed the base line questionnaires, 100 completed the follow-up at 3 months, and 84 completed the follow-up at 12 months. Imputations of missing data were performed using the last observation, and parametric analysis was used. RESULTS: Both groups showed significant improvements (P value ≤ 0.01) in everyday occupations, psychological symptoms and health-related aspects after 3 and 12 months. No significant differences were found between the groups. CONCLUSION: This study contributes with knowledge about the outcomes of occupational therapy for clients living with depression and anxiety disorders. Both TTM and care as usual lead to significant improvements over time concerning everyday occupations, psychological symptoms, and health-related aspects. The fact that both occupational therapy methods were associated with improvements for clients with depression and anxiety supports client-centredness in enabling an occupational therapist to choose the method best suited for the individual.

Catching sight of well-being despite a stress-related disorder.

BACKGROUND: Stress-related disorders cause suffering and difficulties in managing occupations and relationships in everyday life. A previous study of women with stress-related disorders, who photographed well-being and talked about the photographs in interviews, showed that moments of well-being still exist but further knowledge is needed about their perceptions of participating in such a study. AIM: To describe how people with stress-related disorders experience taking photographs related to well-being in everyday life and reflecting on and talking about these photographs. MATERIAL AND METHODS: Twelve women, 27-54 years with stress-related disorders were recruited from primary healthcare centres. They participated in interviews based on the photographs and qualitative content analysis was used. RESULTS: One theme 'catching a glimpse of and momentarily capturing well-being' and four categories were identified: 'Photographing moments of well-being visualizes well-being', 'Using photographs could either facilitate or complicate the narrative', 'Changing perspective in everyday life' and 'Creating recollections of well-being'. CONCLUSIONS AND SIGNIFICANCE: Introducing a focus on well-being in everyday life despite living with a stress-related disorder might contribute a valuable complement to stress rehabilitation for occupational therapists and other health professionals. Using photographs as a basis for reflections about everyday life and health/well-being also seems positive for this group.

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 the Associations Among Occupational Balance and Health of Adults With and Without Inflammatory Arthritis.

OBJECTIVE: Occupational balance is a person's subjective perception of the amount and variation of their everyday activities. Evidence suggests an association between occupational balance and health. However, the impact of arthritis on occupational balance and its association with health is unclear. This exploratory study was undertaken to examine associations between occupational balance and measures of health and between-group differences in adults with and without inflammatory arthritis (IA). METHODS: In a cross-sectional study, participants completed the 11-item Occupational Balance Questionnaire (OBQ-11) and the Short Form 36 (SF-36) health survey (physical and mental component summary scores) and provided demographic information. Telomere lengths were analyzed from dried blood spots. RESULTS: A total of 143 adults participated (67 with IA, 76 from the healthy comparison [HC] group). Occupational balance was higher in the HC group than in the IA group (mean difference 3.5 [95% confidence interval 1.0, 5.9; P = 0.01]), but this difference was not statistically significant when adjusted for physical health. The association between occupational balance and physical health was stronger in the IA group (R2  = 0.17, P = 0.001) than in the HC group (R2  = 0.05, P = 0.05). Occupational balance was associated with mental health (R2  = 0.26, P < 0.001) but not associated with telomere length (R2  = 0.02, P = 0.24). CONCLUSION: Occupational balance is associated with mental health for all participants and associated with physical health and disease activity in participants with IA. Attention to assessment of and strategies for improving occupational balance in rehabilitation practice and arthritis self-management programs may contribute to sustaining physical and mental health.

Manoeuvring between interplay and context- an ethnographic study of social interaction in encounters between registered nurses, older patients and their relatives.

BACKGROUND: Social interactions between registered nurses, older patients and their relatives are essential and play a central role in developing a successful care relationship in healthcare encounters. How nurses interact with patients affects the patient's well-being. Limited time and demands for efficiency influence the encounter and complaints from patients and relatives often concern social interactions. Therefore, the aim of this study was to explore the social interaction in encounters between registered nurses, older patients and their relatives at a department of medicine for older people. METHODS: The study has an ethnographic approach including participatory observations (n = 21) and informal field conversations (n = 63), followed by a thematic analysis with an abductive approach reflecting Goffman's interactional perspective. RESULT: The result revealed a pattern where the participants manoeuvred between interplay and context. By manoeuvring, they defined roles but also created a common social situation. Nurses led the conversation; patients followed and described their health problems, while relatives captured the moment to receive and provide information. Finally, nurses summarised the encounter using ritual language, patients expressed gratitude through verbal and non-verbal expressions, while relatives verbally confirmed the agreements. CONCLUSION: The social interaction between registered nurses, older patients and relatives was shaped by a pattern where the participants manoeuvred between interplay and context. When all participants assume responsibility for the social interaction, they become active and listen to each other. The approach adopted by nurses is crucial, thus training in communication and social interaction skills are important. When the asymmetry due to imbalance, is reduced, less misunderstanding and a satisfactory care relationship can be achieved.

A study protocol of the photo-supported conversations about the well-being intervention (Be Well™) for people with stress related disorders.

BACKGROUND: Stress-related illnesses constitute a huge problem in society. The primary care services in Sweden form the first line of care whose role is to coordinate interventions for reducing symptoms, as well as health-promoting interventions. There is lack of knowledge concerning health-promoting interventions for these illnesses. The aim of this study is to evaluate whether photo-supported conversations about well-being (Be Well™) as an intervention, in addition to care as usual within the primary care services, improves health and well-being for patients with stress-related illnesses. The intervention will be compared to a control group, who receive care as usual. A further aim is to conduct a process evaluation. METHODS/DESIGN: This ongoing project has a quasi-experimental design, using quantitative and qualitative methods, and includes patients from primary care centres in two Swedish counties. Seventy patients, 20-67 years, with stress-related illnesses will be recruited. They constitute an intervention group, which receive the intervention together with care as usual, and a control group, which receive care as usual. The intervention, photo-supported conversations about well-being, involves 12 sessions. Care as usual entails medication, occupational therapy, physiotherapy and/or psychotherapy. Data collection is carried out at baseline, and outcomes are assessed directly after the intervention, as well as six months after completion of the intervention. The outcomes are evaluated based on factors related to health, well-being and everyday occupations. Furthermore, data concerning experiences of well-being and perceptions of the intervention will be collected in interviews. The therapists will also be interviewed about their experiences of performing the intervention. Data will be analysed with non-parametric statistics, and qualitative methodology. DISCUSSION: The project is based on the concept that focusing on well-being despite living with stress-related illness may positively impact health and well-being as well as activity-related aspects, and that photo-supported conversations about well-being can contribute a complement to other treatment and rehabilitation. A strength is the use of a wide range of methods: such as quantitative measures, photographs, and qualitative interviews with participants and therapists. The results will thus provide knowledge about potential effects of this health-promoting intervention. Trial registration Clinical Trials.gov: NCT04832295; retrospectively registered 2nd April 2021 https://clinicaltrials.gov/ct2/show/NCT04832295.

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 (rs (Spearman rho) = 0.73), and acceptable convergent validity (overall status, rs = 0.37; Related Quality of Life, rs = 0.42; Satisfaction with Life Scale, rs = 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.

Rasch Analysis of the Norwegian Version of the Occupational Balance Questionnaire in a Sample of Occupational Therapy Students.

BACKGROUND: Recently, the Occupational Balance Questionnaire developed in Sweden was translated into Norwegian. No studies to date have examined the measurement properties of the Norwegian version of this questionnaire. AIM: The study is aimed at examining the psychometric properties of the Norwegian version of the Occupational Balance Questionnaire, the OBQ11-N. METHODS: Along with sociodemographic data, 180 occupational therapy students enrolled at two Norwegian universities completed the OBQ11-N as well as one question each related to health and quality of life and some sociodemographic variables. Rasch analysis was employed for examining rating scale functioning, item and person validity, dimensionality, and differential item functioning. RESULTS: Item categories were ordered, but there were potential gaps in the measurement of the construct. Person reliability was fair, whereas item reliability was low. Point biserial correlations were positive, indicating that all items contributed to the construct. Factor loadings were low for two items, and there were indices of a second underlying dimension and item redundancy. Many people were not aligned with the items, and some items functioned differently across various demographic variables. Conclusion and Significance. The OBQ11-N did not function as an adequate measure of occupational balance in a sample of students. Potentially, the detected measurement problems may be solved by adding more relevant items to a larger item pool, from which the best fitting items should be selected.

Factors associated with higher occupational balance in people with anxiety and/or depression who require occupational therapy treatment.

BACKGROUND: Anxiety and depressive disorders are associated with problems with everyday occupations, including difficulties achieving occupational balance. The aim of this cross-sectional study was to describe occupational balance in people suffering from anxiety and/or depression and the factors that are associated with better self-rated occupational balance. MATERIAL: One hundred and eighteen participants were recruited from outpatient mental health care and primary health care. The participants were 18-65 years, had a diagnosis of anxiety and/or depression, and had problems in everyday occupations. They answered questionnaires on occupational balance, psychological symptoms, quality of life and everyday occupations. RESULTS: A generally low rating of occupational balance was found; however, the scores differed depending on the participants' degree of anxiety and depression, their quality of life, their occupational performance and satisfaction with their occupational performance. Logistic regression analyses revealed that high quality of life, high satisfaction with occupational performance and low level of depression were associated to occupational balance. CONCLUSION: The results indicate that enhanced satisfaction with life and with performance of everyday occupations are relevant factors for achieving occupational balance in clients diagnosed with anxiety and/or depression. SIGNIFICANCE: The results will be valuable for professionals working to support their clients in enhancing their occupational balance.