Conceptualizing life balance from an empirical and

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Conceptualizing life balance from an empirical and

Transcript Of Conceptualizing life balance from an empirical and

School of Health Sciences, Jönköping University
Conceptualizing life balance from an empirical and occupational therapy perspective
Petra Wagman
DISSERTATION SERIES NO. 25, 2012 JÖNKÖPING 2012

© Petra Wagman, 2012
Publisher: School of Health Sciences Print: Ineko AB
ISSN 1654-3602 ISBN 978-91-85835-24-9

The urge to puzzle over definitions of the primary concepts of a field is irresistible to scholars (1, p. 138).

Abstract
Introduction
Although it is an important concept in occupational therapy, there is a need for further knowledge about life balance. This thesis explores the concept of life balance - how people think about it and how it is used in occupational therapy.
Aim
The overall aim of the present thesis was to conceptualize life balance from an empirical and occupational therapy perspective in order to contribute to knowledge regarding the use of the concept in occupational therapy. The specific aims were to:
 explore the perceptions of life balance among working people who had not recently been on long-term sick leave
 explore what is considered important for life balance and whether or not this differs between people
 use perceptions of life balance data from men and women in a healthy population to validate the Model of Lifestyle Balance
 clarify the content in the concept of occupational balance as used within published articles related to occupational therapy
Methods
In Study I, 19 participants were interviewed about their perceptions of life balance. In Study II, 32 participants sorted statements about life balance according to their importance. In Study III, data from Study I were reanalysed in relation to Matuska and Christiansen’s Model of Lifestyle Balance. In Study IV a concept analysis of occupational balance in occupational therapy was conducted, encompassing 43 articles.
Results
Life balance was shown to be a subjective, dynamic, health-related and multidimensional concept. Similarities and differences between what the participants consider to be important for their life balance were revealed. Occupational balance was, in the concept analysis, shown to be a subjectively defined perception of having the right amount and variation of occupations.

Conclusions
The results of the thesis indicate that life balance and occupational balance are two separate concepts. While life balance includes occupational balance, it goes beyond it and also includes other aspects. Future research is required to investigate the generality of the findings.

Original papers
The thesis is based on the following papers, which are referred to by their Roman numerals in the text:
Paper I
Wagman P, Björklund A, Håkansson C, Jacobsson C, Falkmer T. Perceptions of life balance among a working population in Sweden. Qualitative Health Research 2011; 21(3): 410-418.
Paper II
Wagman P, Håkansson C, Jacobsson C, Falkmer T, Björklund A. What is considered important for life balance? Similarities and differences among some working adults. Scandinavian Journal of Occupational Therapy. Accepted for publication.
Paper III
Wagman P, Håkansson C, Matuska K, Björklund A, Falkmer T. Validating the model of lifestyle balance on a working Swedish population. Journal of Occupational Science. Published online 110712
Paper IV
Wagman P, Håkansson C, Björklund A. Occupational balance as used in occupational therapy: A concept analysis. Scandinavian Journal of Occupational Therapy. Published online 110725
The articles have been reprinted with the kind permission of the respective journals.

Preface
Some questions have followed humans over time, perhaps even since our “beginning” as human beings. One of these questions relates to “a good life”: what it is and how to attain it. Life balance is a commonly used metaphor and phenomenon related to the question of a good life. I am interested in such broad questions of potential relevance to all of us.
Occupational therapy, as I see it, goes beyond working solely among people with health conditions, etc., but may also contribute to all people whose occupational needs are not being met (e.g., to participate in certain occupations). Therefore, I agree with the World Federation of Occupational Therapy that the profession “can work with all people” as well as with the following statement:
Occupational therapy is a client-centred health profession concerned with promoting health and well being through occupation. The primary goal of occupational therapy is to enable people to participate in the activities of everyday life (2).
I believe occupational therapy may contribute to life balance issues and to an occupationally good life among people. However, in order to do so, and because of the potential universal characteristic of life balance, we need to know more about how people think about it since they are indeed experts on their own life. Their descriptions may therefore promote insights that can be used to guide occupational therapists in how to enable clients attain life balance and decrease the risk of losing it.
From the beginning, however, this thesis was related to recovery after stressrelated disorders. When planning for the studies, I wanted to include a measurement of occupational balance, which can be described as life balance related to occupations. I imagined that the participants’ occupational balance had been disturbed and that they might regain it during their recovery. To my surprise I found no such instrument. When the project I was supposed to follow was cancelled, I took the chance to dig deeper into something that interested me so much. Although I had started looking for instruments, I realized it was not yet time to start instrument development since too much was still unclear.

Therefore, my aim with this thesis has been to contribute to further knowledge about life balance in occupational therapy, by describing how people think about it as well as how this relates to the concept’s use in occupational therapy.
I will start the Introduction by giving a brief presentation of how life balance has been used historically and how it is used today. This is followed by a presentation of occupational therapy and the occupational therapy perspective of life balance. The introduction ends with some assumptions about life balance.
The Background section then, starts by describing three approaches to life balance in occupational therapy. These are followed by a model in occupational therapy and thereafter a presentation of recent research. The background finishes with my rationale for writing this thesis.
The Methods and Results sections follow, and the four studies are presented. Next, the findings are discussed in the Results discussion section, which is followed by Methodological considerations. Finally, future research and some clinical implications are proposed, and some conclusions are drawn.

Contents
Abbreviations.............................................................................................. 11 Definitions ................................................................................................... 11 1 Introduction ........................................................................................ 12 2 Background......................................................................................... 15
2.1 Approaches to occupational balance in occupational therapy ...... 15 2.1.1 A classical approach – balance between occupational categories.............................................................................................. 16 2.1.2 An experiential approach...................................................... 17 2.1.3 The Life Balance Model ....................................................... 19
2.2 The Person-Environment-Occupation Model............................... 21 2.3 Recent empirical research related to occupational balance .......... 21
2.3.1 Characteristics of occupational balance ............................... 23 2.3.2 Of importance for attaining occupational balance................ 24 2.3.3 The relationship between occupational balance and time spent in occupation ........................................................................................ 25 2.4 Rationale for the thesis ................................................................. 25 2.4.1 The need to know about people’s perceptions of life balance and whether they differ......................................................................... 26 2.4.2 The need for clarification of occupational balance .............. 27 2.4.3 The importance of relating people’s perceptions to occupational therapy uses..................................................................... 27 2.5 Demarcation of the thesis ............................................................. 29 3 Aim....................................................................................................... 30 4 Methods and materials....................................................................... 31 4.1 Sampling and data collection ....................................................... 32 4.2 Data analysis................................................................................. 34 4.3 Ethical considerations................................................................... 35 5 Results ................................................................................................. 36 5.1 Summary of Study I ..................................................................... 36 5.2 Summary of Study II .................................................................... 37 5.2.1 Irrelevant and missing statements ........................................ 37

5.3 Summary of Study III................................................................... 39

5.4 Summary of Study IV .................................................................. 39

6 Discussion............................................................................................ 40 6.1 Results discussion ........................................................................ 40

6.1.1 The participants’ perceptions of life balance........................ 40

6.1.2 Similarities and differences between the participants regarding what is more or less important for their life balance............ 45

6.1.3 Participants’ perceptions of life balance and the Life Balance Model .............................................................................................. 46

6.1.4

Occupational balance as used in occupational therapy articles .............................................................................................. 46

6.1.5 The relationship between the participants’ perceptions of life balance and occupational balance in occupational therapy articles ..... 47

6.1.6 The results in relation to the Person-Environment-Occupation Model .............................................................................................. 47

6.1.7 A proposed separation of life balance and occupational balance, and proposed definitions ........................................................ 48

6.2 Methodological considerations..................................................... 49

6.2.1 Methodological issues related to each study ........................ 51

7 Future research and some clinical implications .............................. 55 8 Conclusions ......................................................................................... 57 Svensk sammanfattning............................................................................. 58 Acknowledgements..................................................................................... 64 References ................................................................................................... 66
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