Just like every other health profession, with reference to the World Federation of Occupational Therapists’ updated definition, occupational therapy is concerned with promoting health and well-being, however through occupation (2012). Occupational therapists employ occupational therapy by focusing on each person individually and helping them to do activities of everyday life; those being of essential and meaningful. These activities are presented as occupations, in which people take part in to occupy their time. Occupations, as the Royal College of Occupational Therapists (2017) state, are the practical activities that give people the ability to live independently and have a sense of identity. In spite of that, Nelson in 1998 claimed that ‘occupation is an ambiguous term.’
Pierce (2001) interprets occupation as a specific person’s personally constructed non-repeatable experience. In addition, Mackenzie and O’Toole (2011) advocate The American Occupation Therapy Association’s practice framework (2008), who identify eight areas of occupation, in which include the following: activities of daily living (ADLs), instrumental activities of daily living (IADLs), sleep, education, work, play, leisure and lastly, social participation. Activities in the areas of occupation are unique and different to a person as they too, are themselves.
In order that occupational therapists can assess the effectiveness of patients in carrying out activities, utilize occupational performance. It is outcome of the transaction between the person, environment and occupation and the dynamic experience of a person engaged in purposeful activities and tasks in the environment (Law et al., 1996).
It has been over many decades as regards to the World Health Organisation’s (1948) formulation of the definition of health. Ever since, health has been described as state of complete physical, mental and social well-being and as well, that is not merely the absence of disease and infirmity. Health does vary largely according to factors such as
Contrastingly, Orem (1985 cited in Law, Steinwender and Leclair, 1998) looks at well-being as a perceived state of harmony in all aspects of a person’s life and as well, is a state distinguished by the experiences of contentment, pleasure, by spiritual experiences, and a sense of happiness.
Additionally, The American Occupation Association (AOTA, 2016) express that, occupational therapy maximizes health, well-being, and quality of life for all people, populations, and communities through effective solutions that facilitate participation in everyday living, through their ‘Vision 2025.’
Having mentioned AOTA’s vision, this essay will based upon on how occupational therapy in practice, the role of occupational therapists and occupation as a whole, all contribute to human health and well-being.
Firstly, the characteristics of occupation and the positive influence those characteristics has on human health and well-being are one of the reasons for considering the importance of occupation. Occupations are seen as essential by The Canadian Association of Occupation Therapists to people’s lives and classify occupation into three purposes, which is also known as the areas of occupational performance. These include: looking after themselves (self-care), enjoying life (leisure) and contributing to the social and economic fabric of their communities (productivity) (CAOT, 2002). The divisions clearly show the significant role that occupation has in supporting people’s health and wellbeing generally as well as assisting recovery and their social participation. Similarly, this links to the description Molineux (2010, cited in Curtin, Molineux and Supyk-Mellson, 2010) provides of occupation and understands its nature as being of: actively engaged, having a purpose and meaning, contextualised and human characteristic. Each of the key characteristics encourages people to express and understand themselves through activities mattering to them, in which gives them a strong sense of their self. This can help to increase their self-esteem, confidence and happiness and decrease negativity, leading to improve their health and quality of life. Having that said, it can be presented through for example participating in leisure occupations, such as gardening.
Gardening is an instrumental activity of daily living (IADLs), however it is not limited and as implied previously, can fall under more than just one area of occupation. ‘Gardens, as well as the activity of gardening, have been shown to have a positive impact on peoples’ health and wellbeing’ (Garden Organic and Sustain, 2014) and as well, Soga, Gaston and Yamaura (2017) stated that there is increasing evidence that gardening provides substantial human health benefits. A recent case-control study had been undertaken by Wood, Pretty and Griffin (2015) based on allotment gardening and the benefits that this particular type of gardening brings to health and well-being.
A mixture of allotment gardeners and non-gardeners during their sessions of allotment gardening were both observed on their self-esteem and mood and compared on their mental well-being. Results of the study declared that ‘paired t-tests revealed a significant improvement in self-esteem (P < 0.05) and mood (P < 0.001) as a result of one allotment session' (Wood, Pretty and Griffin, 2015), demonstrating the fast action that the gardening took to make a positive difference to the partakers wellbeing in such a short period of time. Wood, Pretty and Griffin (2015) as well declares; one-way ANCOVA revealed that allotment gardeners had a significantly better self-esteem, total mood disturbance and general health (P < 0.001), experiencing less depression and fatigue and more vigour (P < 0.0083). The end result of this study is evident of how gardening promotes a sense of wellbeing and reduces stress as it covers most of the seven dimensions of wellness (Developed By Dr. Bill Hettler, Co-Founder Of et al., 2018). Not only does the activity contribute to wellness mentally and emotionally by reducing negative moods such as anxiety and sadness, but also physically as well as it encourages exercise and helps the body to reach to a more balanced state. Furthermore, it can be suggested that gardening is associated to environmental, social, spiritual, intellectual and occupational wellness. For instance, other types of gardening such as community gardening, as it hints in the name, helps in bringing communities all together. This indicates the opportunities that community gardening can provide for people to interact and socialise as well as share their knowledge about gardening with others, in which can also lead them to raise environmental awareness. In addition, gardening is recognised as an activity for people to grow and eat fresh food, which can minimise their environmental impact and lead to good nutrition and improved health. It is also considered as an activity that promotes serenity, in a sense that it brings peace and tranquillity and as well, can be served as a profession, hobby or even a form of art. Despite the positive impact occupation has on a person's health and well-being, it can be argued the opposite as occupation has its restrictions and limitations. This is dependent on a person's occupational performance. Wilcock (1998b, cited in Creek, Lougher and Van Bruggen, 2011) established this as occupational injustice, which can be due to three occupational risk factors: occupational imbalance, deprivation and alienation. For example, brushing or combing hair is an activity of daily living (ADLs) in which covers self-care. It is considered as a factor that contributes to good personal hygiene. Regular practice of this leads to a healthier lifestyle as maintaining good hygiene, in the instance of brushing or combing hair, potentially helps to treat or prevent scalp and hair conditions, such as dandruff and head lice. However, to brush or comb hair excessively or aggressively increases the likelihood of causing hair damage as well as loss of hair. This illustrates occupational imbalance and there is a lack of balance in participating in the activity, which results in harm to health and overall dissatisfaction. Another example of a participating in an occupation in which occupational injustice can occur is work. Work, paid or unpaid, is an instrumental activity of daily living (IADLs) in which involves productivity. Work creates many opportunities to help learn, grow and succeed. Teamwork in the workplace, for instance, allows improved communication, in which helps to build better and trusting relationships with members of the team as well as solves issues and work more effectively as a team. However, to work as a team which involves miscommunication causes conflict between team members. This can be because of team members acting unjustly, which can indicate all three risk factors. It adds pressure and stress to leaders of the team, deprive and alienate them from working cooperatively as a team to accomplish goals. Nevertheless, occupational therapists play an important role in enabling a person's need for occupation and addressing the occupational injustices that may restrict or limit them in performing or participating in occupations. This is achieved by occupational therapists as they encourage occupational injustice by recognising and providing for the occupational needs of each person as well as communities as part of a fair and empowering society (Wilcock and Townsend, 2000 cited in Pettican and Bryant, 2007). This signifies the profession occupational therapy as it is a patient-centred approach. Occupational therapists implement patient-centred principles into practice in order to provide care to patients. One of the principles includes respecting patients and the values, preferences and expressed needs they may have (Picker Institute, 1987). This approach promotes the health, well-being and satisfaction of patients as it brings a sense of value and belonging, help them to feel comforted and safe. Justice is produced by occupations and are applied by occupational therapists in order to achieve patient-centred practice.