The sense-of-coherence and the capability of performing daily occupations in persons with chronic pain

OBJECTIVES: It may be helpful for occupational therapists who promote enabling occupations among persons with chronic pain, to understand the relationship between the persons feelings of meaningfulness, comprehensibility and manageability in life and their capability to perform daily occupations. AIM: The aim of this study was to describe and investigate how these concepts of person and occupational performance of 27 daily occupations in terms of "effort", "inconvenience", "avoidance", "give up", "frequency" and "satisfaction" were related to each other. DESIGN: A prospective correlative study was conducted. METHOD: A consecutive series of eighty-four patients with chronic pain completed a structured interview and responded to the self-assessment instruments Sense-of-Coherence Scale (SOC-13) and Capability of Performing Daily Occupations (CPDO). RESULTS: Weak but significant correlation (p < 0.05) were found between the SOC-13 sub-scale "manageability" and the specific occupations "physical exercise / training" (r = - 0.24), "climb stairs" (r = - 0.27) "social activity" (r= - 0.25) and "wash the laundry" (r = - 0.30), as well as between the SOC-13 sub-scale "meaningfulness" and the CPDO occupations "grocery shopping" (r = -0.22), "performing meals" (r = - 0.24), and "wash the laundry" (r = - 0.31) and the CPDO question "frequency of performing occupations" r = -0.22). The participants' mean value (mean = 58) of SOC-13 was below the other populations represented in a literature review. The mean values for CPDO (3.4-4.3) (optimal score is zero) showed that the participants perceived themselves having activity limitations concerning performance of daily occupations, and the performance area of work productive activities were experienced as more disabling. The degree to which the participants perceived themselves having a strong sense of coherence or being disabled by pain varied greatly both for the results of SOC-13 ( range 32-90 points) and CPDO (range 1.1-7.8 points). CONCLUSION: The expected significant relationship between a person's sense of coherence and the performance of daily occupations was partly verified with weak significant correlations. In clinical practice the assessment instruments are suggested to be of value in rehabilitation clinics for occupational therapists who work with people with chronic pain.     

A study of a multidimensional model of work–family conflict among Iranian employees

The majority of studies of the work–family interface have been carried out in Western societies. They also have some limitations in measuring conflict between work and family domains. This paper reports on a study of 387 male and female Iranian employees from a variety of organizations, using a six-dimensional model of work–family conflict (Carlson, Kacmar, & Williams, 2000) to assess both the nature and construct of conflict. The study used a questionnaire based on existing measures, translated from English to Persian and then back-translated to English. Using confirmatory factor analysis (CFA) the validity and cross validity of the model on employees and across gender was assessed. The final results of the analysis support the generalizability of the six-dimensional model of work–family conflict to the Iranian employees and across gender.     

Effectiveness of a psychosocial intervention model for persons with chronic psychiatric disorders in long-term hospitalization

The article describes a psychosocial model of intervention with psychiatric patients in long-term hospitalization in a psychiatric ward in Israel and reports the findings of the evaluation conducted of its effectiveness. The model was aimed at maintaining or improving the patients' functioning in four main areas: personal hygiene, environmental maintenance, occupational competency, and social and recreational activities. For each patient, an individualized intervention program was designed and implemented by a personal case manager appointed from the ward's clinical staff. The programs involved family and ward staff as well as the patients themselves. The evaluation, based on comparison of monthly data for 4 months before and 12 months during the intervention, showed significant improvement in all but two areas of functioning: social functioning and psychiatric status. The findings, although in need of confirmation in larger, representative samples of patients in Israel and elsewhere, hold promise for effective intervention with patients whose treatment today consists largely of medication.     

Return to work with chronic low back pain: using an evidence-based approach along with the occupational therapy framework

This paper will attempt to apply the occupational therapy framework [1] along with an evidence-based approach and an occupation-based intervention with a population of workers with chronic low back pain (CLBP) to help them return to work and maintain their work status. This paper will focus primarily on those clients with CLBP who still have a link to their employment but who do not perceive themselves as being capable to go back to their job despite conflicting opinions from other stakeholders (primary health care professionals, employer or insurer). They are being evaluated in occupational therapy shortly before return to work and followed until their optimal functional capacities are reached. This means that either all functional goals related to the actual physical demands of their job have been reached or that further treatment does not result in functional improvement.     

A test of the perceived norms model to explain drinking patterns among university student athletes

The author tested the ability of perceived drinking norms to discriminate among drinking patterns in a sample of National Collegiate Athletic Association (NCAA) Division I student athletes. He used an anonymous questionnaire to assess 297 athletes, representing 18 teams, at a public university in the Midwest. Alcohol use patterns showed considerable variation, with many athletes (37.1%) abstaining during their season of competition. A discriminant function analysis revealed that higher levels of alcohol involvement are disproportionately found among athletes who began drinking regularly at an early age. Perceived drinking norms were less important in the discrimination of student athlete drinker groups. Women and those with higher grade point averages were somewhat more likely to refrain from in-season drinking than other survey respondents.     

A comparison of self-perceived physical and psycho-social worker profiles of people with direct work injury, chronic low back pain, and cumulative trauma

This study investigated the psycho-social factors among injured workers and the influence of their psycho-social profile on the readiness of return to work. Sixty-four subjects with injuries on the upper limbs or lower limbs, low back pain, or cumulative trauma disorder were recruited. The workers' profiles (self-perceived physical health, mental health, and work readiness) together with the impact and types of work injury on the workers' perceived wellness were measured. The regression model of work readiness was constructed to develop a theoretical background for predicting work readiness based on different factors. The results showed that injured workers with chronic injury such as low back pain or cumulative trauma had poorer self-perception of physical health and psycho-social/mental health compared to those with direct trauma. The regression analysis further affirmed that self-perceived pain and physical functioning were significant factors influencing the readiness for returning to work. Workers with low back pain were found to have lower motivation for returning to work. Other factors such as the non-verbal intelligence of the injured workers, their anxiety level, and the support they received from family members were found to have some indirect impact on their ability to return to work, but this was not statistically proven.     

The experiences of “aging” among formerly homeless adults with chronic mental illness: A qualitative study

Little is known about the life course of older adults with serious mental illness who have also been homeless. Using 44 life history interviews with 25 study participants ages 40 to 62, this study used case study and thematic analysis to examine the lived experience of such individuals as they enter their mid- and later-life years. Participants, whose lives were marred by early-onset substance abuse, symptoms of mental illness and a descent into homelessness, spoke of an awareness of aging and premature mortality. Major themes that emerged were: (1) reflecting on losses, (2) growing older and wiser, (3) struggling with normality, (4) having space and time to reevaluate, and (5) awareness of the future and “time left.” Life histories which focus on the person-in-context and their subjective experiences provide a viable research method to further the understanding of one of the most underserved and hardest-to-reach populations.     

A model for collaboration networks giving rise to a power-law distribution with an exponential cutoff

Recently several authors have proposed stochastic evolutionary models for the growth of complex networks that give rise to power-law distributions. These models are based on the notion of preferential attachment leading to the “rich get richer” phenomenon. Despite the generality of the proposed stochastic models, there are still some unexplained phenomena, which may arise due to the limited size of networks such as protein, e-mail, actor and collaboration networks. Such networks may in fact exhibit an exponential cutoff in the power-law scaling, although this cutoff may only be observable in the tail of the distribution for extremely large networks. We propose a modification of the basic stochastic evolutionary model, so that after a node is chosen preferentially, say according to the number of its inlinks, there is a small probability that this node will become inactive. We show that as a result of this modification, by viewing the stochastic process in terms of an urn transfer model, we obtain a power-law distribution with an exponential cutoff. Unlike many other models, the current model can capture instances where the exponent of the distribution is less than or equal to two. As a proof of concept, we demonstrate the consistency of our model empirically by analysing the Mathematical Research collaboration network, the distribution of which has been shown to be compatible with a power law with an exponential cutoff.     

Using modern methods for missing data analysis with the social relations model: A bridge to social network analysis

Social network analysis identifies social ties, and perceptual measures identify peer norms. The social relations model (SRM) can decompose interval-level perceptual measures among all dyads in a network into multiple person- and dyad-level components. This study demonstrates how to accommodate missing round-robin data using Bayesian data augmentation, including how to incorporate partially observed covariates as auxiliary correlates or as substantive predictors. We discuss how data augmentation opens the possibility to fit SRM to network ties (potentially without boundaries) rather than round-robin data. An illustrative application explores the relationship between sorority members’ self-reported body comparisons and perceptions of friends’ body talk.     

A public good version of the collective household model: an empirical approach with an application to British household data

In this paper we consider an empirical collective household model of time allocation for two-earner households. The novelty of this paper is that we estimate a version of the collective household model, where the internally produced goods and externally purchased goods are assumed to be public. The empirical results suggest that (1) Preferences of men and women differ; (2) Although there are significant individual variations, on average the utility functions of men and women are equally weighted in the household utility function; (3) Differences in the ratio of the partners’ hourly wages are explanatory for how individual utilities are weighted in the household utility function. (4) The female’s preference for household production is influenced by family size, but this does not hold for the male; (5) Both the male and the female have a backward-bending labor supply curve; (6) Labor-supply curves are forward-bending with respect to the partner’s wage rate; (7) Our model rejects the unitary Slutsky symmetry condition.

A model for the multiplex dynamics of two-mode and one-mode networks,with an application to employment preference,friendship, and advice

We propose a new stochastic actor-oriented model for the co-evolution of two-mode and one-mode networks. The model posits that activities of a set of actors, represented in the two-mode network, co-evolve with exchanges and interactions between the actors, as represented in the one-mode network. The model assumes that the actors, not the activities, have agency.