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  • Faith Gallant

The Occupational Therapist's Role in Health Promotion

The World Health Organization (WHO) defines health as a “state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity”. The WHO goes on to describe that the enjoyment of health is a fundamental right for all people and that the attainment of health is key for peace and security. Every year on April 7, the WHO celebrates World Health Day to bring attention to various topics of health and how individuals globally can better achieve holistic health, as their definition suggests.


When people hear “Occupational Therapy” many are drawn to concepts such as “career” or “work”. However the role of Occupational Therapy extends far beyond this and is pivotal in achieving overall health and well-being. An “occupation” can be thought of as a daily task or activity that is meaningful to an individual. Broadly speaking, these occupations, or daily activities, fall into the categories of self-care (i.e., brushing your teething, getting dressing, showering) productivity (i.e., employment, housekeeping chores, grocery shopping), and leisure (i.e., working out, reading a book, spending time with family). The World Federation of Occupational Therapists formally defined occupations as “everyday activities that people do as individuals, in families, and with communities to occupy time and bring meaning and purpose to life”. Occupational Therapists are trained to assess the person, their environment, and their occupation, to pinpoint any barriers to participation in a daily task. With treatment, an occupational therapist will work with an individual to enable their participation and engagement in meaningful daily activities, with the overall goal of maintaining and/or increasing their health.


Why is participation in meaningful occupation important to health and well-being? Well, participation in these important and meaningful daily occupations have a direct path to increased health and well-being. Being able to complete self-care tasks, participate in your community, earn an education, incorporate leisure, and develop daily routines promote a healthy lifestyle including prevention of disease development and recovery from an injury or illness. Two key ways that occupational therapists support this participation is through habit formation and environmental adaptation.


Research has shown that when habits are incorporated into regular routines, they are pivotal to promoting wellness (Thompson, 2013). Consider chronic illnesses such as high blood pressure and diabetes. The management of these diseases falls almost exclusively on the individuals with the illness through occupations such as medication management, meal preparation and feeding, exercise, stress management and others. Developing a routine to complete these daily tasks can be demanding physically (i.e., low activity tolerance), cognitively (i.e., poor memory, limited attention, challenges with planning), and psycho-emotionally (i.e., limited motivation, nervousness about participation). An occupational therapist is skilled at providing education (i.e., correlation between walking 15 minutes a day and diabetes management), resources (i.e., meditation guides for stress management), and equipment (i.e., dosette to enable medication management) to address these barriers and establish a routine. Most importantly, the occupational therapist will continue to monitor and adapt these treatment options to ensure effectiveness for the individual.


Another example of habit formation is implementation of regular skin checks after a spinal cord injury. With increased sitting after a spinal cord injury, an individual is more likely to develop a pressure sore which can lead to infection and further deterioration of health. By incorporating regular skin checks (the habit) every day while dressing (morning routine) to identify early signs of a pressure sore, the individual is able to take a proactive approach to maintaining their health. In both of these examples, with the expertise of occupational therapists, habits have been formed that help manage and prevent deterioration of health.


Occupational therapists are also qualified in assessing and adapting the environment to encourage participation in daily activities. Sometimes, an individual’s participation in a daily activity is limited by the lack of fit between them and their environment. For example, many of us have had to adapt to working from home during the COVID-19 pandemic. Due to the sudden nature of this requirement, many of us did not have home workstations that were a good fit for enabling us to get our work done. This may have lead to back pain (i.e., poorly fit chair), headaches (i.e., close screen), neck pain (i.e., low desk), and other symptoms that limited our ability to engage in work tasks. Not all elements of poor fit are physical in nature. Perhaps the location of your workstation had many distractions which made engaging in work tasks difficult. Occupational therapists are able to assess and address this poor fit, and recommendations may include adjustable chairs with an ergonomic fit, sit-to-stand desks, wireless keyboard/mouse to allow greater monitor depth, and headphone to limit distractions. All of these changes are made to the environment, but enable the individual’s participation.


However not all examples are strictly limited to habit formation or environmental adaptation. In fact, occupational therapists are usually implementing a combination of both during treating. Consider an individual who is experiencing caregiver burnout as a result of looking after a loved one who is ill. Symptoms of this caregiver burnout can include increased physical pain, psycho-emotional stress, physical and psycho-emotional fatigue, lower thresholds for frustration, and challenges concentrating on tasks. This example, like many others, outlines the complexity of the barriers one may face in completing their daily activities. This individual is likely to benefit from environmental adaptation (i.e., introduction of a transfer board to reduce load during transfers) and habit formation (i.e., incorporating daily meditation into bedtime routine for stress management), among other treatment approaches to enable their participation in daily occupations while promoting their health and well-being.


While habit formation and environmental adaptation were the focus of this post, it is important to remember that occupational therapists have a vast toolkit to address unique and individualized barriers to participation in daily tasks from a physical, cognitive, and psycho-emotional perspective. In every case though, the broader goal is to always increase engagement and participation in activities that are meaningful to the individual to maintain and/or increase their health and well-being. We hope that on this world health day you are able to participate in the activities that are meaningful to you!



References:

Thomson, M. (2013). Occupations, habits, and routines: perspective from persons with diabetes. Scandinavian Journal of Occupational Therapy, 21(2), 153-160. doi: 10.3109/11038128.2013.851278



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