ENGAGED IN LIFE

Daphne Kos, PhD, OTKU Leuven & AP Antwerp (Belgium)

ENGAGED IN LIFE

STRATEGIES

PERSPECTIVESASSESSMENT

INFLUENCES

MY LIFE

LIFE OF PEOPLE WITH MS?

rehabilitationwork

personal care

friendsfamily

domestic work

partner

leisure

travel

…

ENGAGED IN LIFE

STRATEGIES

PERSPECTIVESASSESSMENT

INFLUENCES

BALANCEWOMEN WITH MS

basic needs

meet releva

nt goals

feel engaged

create meaning

relationships

Matuska & Erickson (2008)

PERSPECTIVES OF PEOPLE WITH ADVANCED MSday-to-day variation

social context

“killing time”

autonomy

capacity decreases

interests do not change Van Holderbeke & Kos, 2015

BALANCE IN DAILY LIFE

Håkansson et al., J Occ Sci, 2006, 13,(1), pp 74-82

load capacity

or underload

LIFESTYLE BALANCE

Matuska & Christiansen, J Occ Sci, 2008, 15(1), pp 9-19

OCCUPATIONAL PERFORMANCE

person

environment

activity/occupation

Occupational performance

Law et al., 1996

OCCUPATIONAL BALANCE

Occupational performance

Law et al., 1996

ENGAGED IN LIFE

STRATEGIES

PERSPECTIVESASSESSMENT

INFLUENCES

INFLUENCES

person

environment

activity/ occupation

coping stylecapacities

anxietypreferencesmotivation

social physical

socio-economic political cultural

(changed) time use: • leisure time

• self care• work

engagementmeaning

Law, et al.,1996

OCCUPATIONAL IMBALANCEP

E

O

Law et al., 1996 , Christiansen & Matuska , 2006Christiansen & Townsend, 2009

P

E

OE

O

Palineation

disruption

deprivation

INFLUENCES - CHALLENGES

stressfatigue

medical management

social roles

loss of meaningfuloccupations

decrease mental & physical capacities

Van Holderbeke & Kos (2015); Matuska & Erickson (2008)

autonomy

acceptance

physicalenvironment

ENGAGED IN LIFE

STRATEGIES

PERSPECTIVESASSESSMENT

INFLUENCES

ASSESSMENT LIFE BALANCE

Wagman, P., Håkansson, C., & Björklund, A. (2012)

Domains Meaning or dimension Time use

ASSESSMENT OF LIFE BALANCE• Self report questionnaire• Diary• Measuring activity

REPORT DOMAIN

week day

self care

work/ study

leisure

rest

relation ships

care for others

GRAPHIC REPORT DOMAINS

Orban, K., Edberg, A.-K., & Erlandsson, L.-K. (2012). Using a time-geographical diary method in order to facilitate reflections on changes in patterns of daily occupations. Scandinavian Journal of Occupational Therapy, 19(3), 249–59.

TIME-USE PROFILE DIARY• 24-hour recall diary• Typical day (weekday, weekendday, holiday…)• Apportion 24h across categories (e.g. sleeping,

working, studying, self-care, personal relationships….)• Actual vs. desired time use

• Actual-ideal time-use variable=(ideal sleep hours – actual sleep hours) + (ideal work hours – actual work hours) …. large discrepancy decreased balance

Sheldon, 2009, in: Matuska & Christiansen (eds.), Life Balance, Slack & AOTA,pp.61-72)

GRAPHIC REPORT TIME USE24%

39%

37%Self-care

Productivity

Leisure

20%

67%

13%

actualvs

desired

LIFE BALANCE INVENTORY (LBI)

Matuska, 2010

OCCUPATIONAL BALANCE QUESTIONNAIRE (OBQ)

ENGAGED IN LIFE

STRATEGIES

PERSPECTIVESASSESSMENT

INFLUENCES

STRATEGIES TO OPTIMIZE BALANCE• awareness – register

(diary)• acceptance• allow help• show preferences -

communicate• change standards• set goalsperson

• adapt physical environment

• stimulate awareness• use social environment• devices (e.g. “On Wheels”)• modelling with peersenvironment

• prioritize meaningful occupations • plan ahead• balance time use• alter activ. perform.• devices (e.g. Pulse+)activity

EXAMPLE DEVICE OUTDOOR MOBILITY:APP ‘ON WHEELS’

http://onwheelsapp.com/en

EXAMPLE REGISTRATION ACTIVITIES: APP PULSE+

under construction

EXAMPLE ELECTRONIC DIARY

Van Malleghem, Huybrechts & Kos, 2015

EXAMPLE REGISTRATION PHYSICAL ACTIVITY & COACHING: MS TELECOACH

Balance your activities. Try not to do all

activities in de morning, but spread them over

the day.Respect a regular sleep pattern. Try to go to sleep and wake up at a regular time. Do not perform intensive physical activities just before going to bed.

Van Gassen, D’hooghe, Kos et al., 2015

MONITORING OCCUPATIONAL BALANCE: OCCUBUZZ

http://frederickroad.blogspot.co.uk/p/occubuzz.html

ENGAGED IN LIFE

STRATEGIES

PERSPECTIVESASSESSMENT

INFLUENCES

mpowerngagenhancenableE

FURTHER READING

eurims.org

Matuska & ChristiansenSLACK Incorporated, 2009

Finlayson (ed), CRC Press, 2012

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