OccupationOccupationAn Exploration and ReviewAn Exploration and Review

Theory of Human Nature (Wilcock)Theory of Human Nature (Wilcock)““We are born with a need to We are born with a need to

engage in occupationengage in occupation”” People spend their lives engaged in People spend their lives engaged in

purposeful “doing” even when free of purposeful “doing” even when free of obligation or necessityobligation or necessity

Allows us to demonstrate what we are or Allows us to demonstrate what we are or hope to becomehope to become

Humans need a novel way to pass timeHumans need a novel way to pass time

Occupation DefinedOccupation Defined Patterns of Patterns of culturally culturally and and personallypersonally

meaningful activity in which humans engage meaningful activity in which humans engage (Clark et al. 1991)(Clark et al. 1991)

Self-initiated, self-directed, adaptive and organizedSelf-initiated, self-directed, adaptive and organized A purposeful form of human endeavor…it A purposeful form of human endeavor…it

provides longitudinal provides longitudinal organization of timeorganization of time and and effort in a person’s life effort in a person’s life (Hagedorn)(Hagedorn)

The dominant activity of human beings that The dominant activity of human beings that includes serious, productive pursuits and includes serious, productive pursuits and playful, creative and festive behaviors. playful, creative and festive behaviors. (Kielhofner)(Kielhofner)

Occupation Occupation (AOTA)(AOTA) Activities of everyday lifeActivities of everyday life

““Named”Named” OrganizedOrganized Given value and meaning Given value and meaning (individually and/or culturally)(individually and/or culturally)

Everything people do to “occupy” themselvesEverything people do to “occupy” themselves Viewed as both a “means” and an “end”.Viewed as both a “means” and an “end”. Occupation vs. ActivityOccupation vs. Activity

Occupations are activities that have unique meaning Occupations are activities that have unique meaning and purpose in a person’s lifeand purpose in a person’s life

Activities are more general classes of human actionsActivities are more general classes of human actions

Key perspectives of Occupation Key perspectives of Occupation (AOTA, 1997)(AOTA, 1997)

1.1. Occupations have personal and specific Occupations have personal and specific meaning to a personmeaning to a person

2.2. This personal meaning is variable and This personal meaning is variable and involves many different involves many different dimensionsdimensions

3.3. The occupations that a person engages The occupations that a person engages in helps to “define” that personin helps to “define” that person

4.4. Over time or situation, a person’s Over time or situation, a person’s occupations are likely to changeoccupations are likely to change

Dimensions of OccupationDimensions of Occupation

1.1. Biological DimensionBiological Dimension

2.2. Temporal-Spatial DimensionTemporal-Spatial Dimension

3.3. Socio-cultural DimensionSocio-cultural Dimension

4.4. Psychological DimensionPsychological Dimension

5.5. Spiritual DimensionSpiritual Dimension

Biological DimensionBiological Dimension The needs, drives, The needs, drives,

abilities and limitations of abilities and limitations of the person at the the person at the physiological level and at physiological level and at the organism levelthe organism level

Occupation provides a Occupation provides a mechanism for humans to mechanism for humans to fulfill needs for survivalfulfill needs for survival

Upright walking, hand Upright walking, hand dexterity, communication, dexterity, communication, vision, socializationvision, socialization

Temporal-Spatial DimensionTemporal-Spatial Dimension

Time and space factorsTime and space factors Length of occupationLength of occupation Participants sense of Participants sense of

past, present and futurepast, present and future The subjective The subjective

experience of timeexperience of time Nature of the Nature of the

environmentenvironment The immediate spaceThe immediate space

Socio-cultural DimensionSocio-cultural Dimension

Considers the Considers the relationship with relationship with others within the others within the immediate social immediate social environment AND environment AND those that result from those that result from commonly valued commonly valued behaviors of their behaviors of their cultureculture

Psychological DimensionPsychological Dimension

Refers to all the Refers to all the emotional and emotional and cognitive aspects of cognitive aspects of human occupationhuman occupation

Example: happiness, Example: happiness, ecstasy, joy, anger, ecstasy, joy, anger, bitterness, jealousybitterness, jealousy

Cognition and Cognition and PerceptionPerception

Spiritual DimensionSpiritual Dimension

Understanding one’s Understanding one’s “place” in the universe“place” in the universe

Making “meaning” Making “meaning” through purposeful through purposeful activityactivity

The essence of a person The essence of a person expressed in daily actions expressed in daily actions as influenced by values, as influenced by values, belief systems and socio-belief systems and socio-cultural backgroundscultural backgrounds

Facilitates one’s Facilitates one’s acceptance of a greater acceptance of a greater realityreality

One of the only One of the only functional domains functional domains likely to be intact and likely to be intact and growing at the end of growing at the end of lifelife

Plays influential role in Plays influential role in directing which activities directing which activities are meaningfulare meaningful

Examining the Examining the Dimensions of Dimensions of

OccupationOccupationchoose an occupation choose an occupation

Discuss how and if Discuss how and if each of the 5 each of the 5 dimensions are dimensions are reflected in each of your reflected in each of your chosen occupationschosen occupations

Benefits of OccupationBenefits of Occupation

1.1. Promotes LearningPromotes Learning

2.2. Provides a Role Provides a Role IdentityIdentity

3.3. Involves use of the Involves use of the handshands

4.4. Challenges and Challenges and changes the internal changes the internal organism to promote organism to promote adaptive responsesadaptive responses

5.5. Provides structure and Provides structure and integration of a integration of a person’s “wholeness”person’s “wholeness”

6.6. Provides balance and Provides balance and meaningmeaning

7.7. Reduce awareness of Reduce awareness of physical or physical or psychological psychological symptomssymptoms

8.8. Promotes recovery Promotes recovery from illness and traumafrom illness and trauma

HealthHealth

Varies according to:Varies according to: CultureCulture Spiritual Spiritual

PhilosophiesPhilosophies Economy Economy TechnologyTechnology Socially accepted Socially accepted

theoriestheories TimeTime

World Health World Health Organization Organization Definition:Definition:

•A state of complete physical, mental and social well-being not merely the absence of disease.

Well-beingWell-being

Defined as: A Defined as: A Subjective Subjective assessment of health assessment of health which is less which is less concerned with concerned with biological function than biological function than with feelings such as with feelings such as self-esteem and a self-esteem and a sense of belonging sense of belonging through social through social integrationintegration

Physical Well-beingPhysical Well-being

Easiest to understandEasiest to understand Internal need to make Internal need to make

use of our physical use of our physical capacitiescapacities

Increased use of Increased use of alternative medicine alternative medicine in today’s worldin today’s world

Mental Well-beingMental Well-being

Associated with spiritual Associated with spiritual as well as cognitive as well as cognitive factorsfactors

Pre-requisites for well-Pre-requisites for well-beingbeing

Associated with balance Associated with balance of occupationsof occupations

Reflective of coping skillsReflective of coping skills Stress, Boredom, Stress, Boredom,

BurnoutBurnout

Social Well-beingSocial Well-being Associated with Associated with

satisfying interpersonal satisfying interpersonal relationships, ability to relationships, ability to interact happily and interact happily and effectively with other effectively with other people in cultural and people in cultural and social parameters social parameters without fearwithout fear

It is suggested that It is suggested that physical and mental physical and mental well-being are well-being are dependent on social dependent on social well-beingwell-being

An introduction to An introduction to occupational Scienceoccupational Science

Somaya Malkawi, PhDSomaya Malkawi, PhD

October, 3, 2012October, 3, 2012

Introduction Introduction

Occupational science emerged from the Occupational science emerged from the early 20early 20thth century century

Occupational therapy and science both Occupational therapy and science both focus on occupation but occupational focus on occupation but occupational science is an academic discipline science is an academic discipline

It studies the science of doing occupations It studies the science of doing occupations and how it relates to the health and well and how it relates to the health and well being of the person being of the person

Occupational Science is: Occupational Science is:

It is the study of the human as an It is the study of the human as an occupational being including the need for occupational being including the need for and capacity to engage in and orchestrate and capacity to engage in and orchestrate daily occupations in the environment over daily occupations in the environment over the lifespan. Because of the complexity of the lifespan. Because of the complexity of occupation occupational science occupation occupational science synthesises knowledge from an array of synthesises knowledge from an array of disciplines (biological and social scineces) disciplines (biological and social scineces)

Occupational science Occupational science

It specifically focuses on the form, function It specifically focuses on the form, function and meaning of human occupation and meaning of human occupation

1. FORM

Directly Observable Aspects of

Occupations

3. Meaning, the Significant of

Occupation withinThe context of real

Lives and in theCulture

2. Function

Ways in which Occupation

Serves adaptation

From of occupation From of occupation

Refers to aspects of occupations that are Refers to aspects of occupations that are directly observabledirectly observable

To study this aspect you would study how To study this aspect you would study how

different cultures do things, eat, drink, different cultures do things, eat, drink, dress…etc. dress…etc.

Function of occupation Function of occupation

Refers to the ways occupation influences Refers to the ways occupation influences development, adaptation, health, and development, adaptation, health, and quality of life quality of life

Ex. If you eat vs. how someone else feeds Ex. If you eat vs. how someone else feeds you reflects on your satisfaction and you reflects on your satisfaction and physical health physical health

Meaning of occupation Meaning of occupation

It is the subjective experience of It is the subjective experience of engagement in occupations engagement in occupations

How does this occupation relate to this How does this occupation relate to this culture and what is its meaning culture and what is its meaning

Historic relationship of occupational Historic relationship of occupational therapy to occupational science therapy to occupational science

Occupational therapy was there before Occupational therapy was there before occupational science occupational science

1.1. The early 1900s, when the core premise of OT The early 1900s, when the core premise of OT was formulated was formulated

2.2. The 1920s, AOTA began making decisions The 1920s, AOTA began making decisions about what is the base of knowledge for about what is the base of knowledge for occupational therapy occupational therapy

3.3. The 1960s, when critical re-evaluation of the The 1960s, when critical re-evaluation of the base of knowledge of occupational therapists base of knowledge of occupational therapists was many new theoretical concepts were was many new theoretical concepts were added added

4.4. The late 1980s and 1990s, when occupational The late 1980s and 1990s, when occupational science was formally founded and academic science was formally founded and academic curricula curricula

Well-being and Well-being and IncapacityIncapacity

Can people experience “good” health and well-Can people experience “good” health and well-being despite some form of incapacity?being despite some form of incapacity?

Terminology derived from Occupational ScienceTerminology derived from Occupational Science

Occupational Justice

• Addresses what people DO in their relationships and conditions for living

• Humans have a need for occupation and should be enabled to engage in occupation

• Occupational Risk Factors– Occupational Imbalance– Occupational Deprivation– Occupational Alienation

Health and Occupational Risk Health and Occupational Risk FactorsFactors

Occupational Risk: Actions or lack of Occupational Risk: Actions or lack of actions that lead to “pre-clinical” health actions that lead to “pre-clinical” health disorders such as boredom, burnout, disorders such as boredom, burnout, depression, increased blood pressure, depression, increased blood pressure, decreased fitness…when can THEN lead decreased fitness…when can THEN lead to:to:

DiseaseDisease

DisabilityDisability

DeathDeath

Occupational Imbalance

• Balance between use of physical, mental, social capacities and rest

• Associated with BOTH intrinsic and extrinsic factors

• Boredom vs. Burnout (both are forms of stress!)

Occupational Deprivation• A state of prolonged preclusion from

engagement in occupations due to factors which stand outside of the control of the individual

• Implies the influence of some type of external(EXTRINSIC) force or agency that keeps a person from acquiring, using or enjoying something (vs. life in general)

• Possible sources:– Technology, division of labor, lack of

employment, poverty or affluence, cultural values, regulations, ill health or disability that results in limited participation

Occupational Deprivation cont’d.

• Geographic Isolation

• Problem conditions of unemployment

• Incarceration

• Refugeeism

• Prisoners of War

• Astronauts/Isolation

Occupational Disruption

• Occupational Disruption– Temporary or transient– Results from factors internal to the person– Example: breaking your leg

Occupational Alienation• The belief that we have innate and

natural needs but our society, culture, technology and evolution create a life that sometimes denies our ability to express those inner needs

• More than just not being able to do something….

• More abstract than deprivation– ex. Steroids in sports, lack of face-

to-fact communication, changing role of families with regards to activities/meals….

What type of occupational risk?What type of occupational risk? Wall street broker who works, on average, 80 hours per Wall street broker who works, on average, 80 hours per

weekweek Child with active leukemiaChild with active leukemia Young woman in middle eastern country who is forbidden Young woman in middle eastern country who is forbidden

to learn to readto learn to read Single mother caring for four children including one special Single mother caring for four children including one special

needs childneeds child Middle-aged divorced male living alone and unable to find Middle-aged divorced male living alone and unable to find

any sort of employmentany sort of employment Kind and compassionate physician working in a group Kind and compassionate physician working in a group

practice that demands he see 40-50 patients per day and practice that demands he see 40-50 patients per day and strongly discourages all interpersonal discussion or strongly discourages all interpersonal discussion or relationship building with the patientsrelationship building with the patients

Questions? Questions?