Occupational Perspectives on Health in People with Schizophrenia

Abstract: The thesis has provided with systematic information about how people with schizophrenia live their everyday life, and the results have shown significant relationships between occupational perspectives and health. The thesis departed in two in-depth studies that concerned time use and occupational engagement in relation to what people with schizophrenia do in their everyday life, with whom they are with, where they are and how they perceive and experience what they do, as reflected by time-use diaries. The first study showed that most time was spent alone, at home, where few occupational situations worked as a routine, providing a structure in terms of familiarity of habits. The second study showed that the participants functioned at different levels of occupational engagement, which ranged from performing mostly quiet activities alone, at home, with few routines and a little sense of meaning, to having ongoing occupational engagement that were interpreted as having meaning, in a greater variety of social and geographical environments. In particular, the function of performing quiet activities, the different ways of being social and of interpreting on experiences, have provided with new aspects that concern the occupational behaviour in people with schizophrenia. Based of these findings elucidated so far, the third and fourth study concerned the development of a reliable and valid instrument, the Profiles of Occupational Engagement in people with Schizophrenia. In study four and five, the POES was used to assess occupational engagement in relation to health related variables. The results showed that a high level of occupational engagement was related to higher ratings of self-related variables, fewer psychiatric symptoms, and better ratings of quality of life, and vice versa. The results of this thesis add a new dimension to understanding mental health. Consequently, identifying the level of occupational engagement in clients with schizophrenia is imperative to, understanding occupational balance and disability, the forming of a supporting relationship, providing appropriate occupational challenges and environmental support with intention to facilitate self-definition.