1. What is the Relationship Between Occupational Engagement and Depression in the Elderly Population? Group 6

2. Overview of Presentation Initial Model Initial Model Definition of Terms Definition of Terms Process and research Process and research Critical Analysis of the research Critical Analysis of the research Final Model Final Model Gaps in the research Gaps in the research Areas for future research from an OT perspectives Areas for future research from an OT perspectives Facilitated Discussion Facilitated Discussion

4. Definition of Terms: Depression: Depression: DSM-IV: general loss of interest in everyday activities and at least four of the following symptoms: change in appetite, fatigue, sleep disturbance, concentration difficulties, thoughts of death, and feelings of worthlessness. (DSM-IV, 1994) DSM-IV: general loss of interest in everyday activities and at least four of the following symptoms: change in appetite, fatigue, sleep disturbance, concentration difficulties, thoughts of death, and feelings of worthlessness. (DSM-IV, 1994)

5. Definitions Continued… Occupation: Occupation: “Groups of activities and tasks of everyday life, named, organized and given value and meaning by individuals and a culture. Occupation is everything people do to occupy themselves, including looking after themselves (self-care), enjoying life (leisure), and contribution to the social and economic fabric of their communities (productivity).” (CAOT, 2002, p.234) “Groups of activities and tasks of everyday life, named, organized and given value and meaning by individuals and a culture. Occupation is everything people do to occupy themselves, including looking after themselves (self-care), enjoying life (leisure), and contribution to the social and economic fabric of their communities (productivity).” (CAOT, 2002, p.234)

6. Definitions Continued… Occupational Engagement: Occupational Engagement: The engagement of the individual’s mind, body and soul in goal directed pursuits. (Renwick Class Notes, September 15, 2004) The engagement of the individual’s mind, body and soul in goal directed pursuits. (Renwick Class Notes, September 15, 2004)

7. Process of Discovering our Question Discussion of different topic areas Discussion of different topic areas Decision to focus on the elderly population Decision to focus on the elderly population Initially wanted to look at the link between retirement and depression…too narrow Initially wanted to look at the link between retirement and depression…too narrow Finally decided on present topic Finally decided on present topic

8. Research Process Searched many different disciplines Searched many different disciplines Used Ovid and Cambridge Scientific to search many databases Used Ovid and Cambridge Scientific to search many databases A variety of keywords were used A variety of keywords were used

9. Evolution of Thought Process Evolution of Thought Process Stopped looking for direct, correct answer, and began looking at mediating factors Stopped looking for direct, correct answer, and began looking at mediating factors Began to see commonalities in diverse research Began to see commonalities in diverse research

10. Critical Analysis of Research 6 Qualitative versus 8 Quantitative research studies 6 Qualitative versus 8 Quantitative research studies 3 research studies at Level 3 of Research Design and 5 at Level 2 3 research studies at Level 3 of Research Design and 5 at Level 2 2 studies at Level 4 of Levels of Evidence and 1 at Level 3 2 studies at Level 4 of Levels of Evidence and 1 at Level 3

11. General Limitations Unable to find proper definitions of what constitutes meaningful occupations Unable to find proper definitions of what constitutes meaningful occupations Unable to discern cultural influence on occupation and depression as most studies used an exclusively Caucasian population Unable to discern cultural influence on occupation and depression as most studies used an exclusively Caucasian population The effect of gender on different occupations was not fully examined The effect of gender on different occupations was not fully examined

12. Critical Analysis of Selected Studies Religiosity and mental health in southern, community-dwelling older adults (Roff, Klemmack & Koenig, 2002) Religiosity and mental health in southern, community-dwelling older adults (Roff, Klemmack & Koenig, 2002) Elders living in Alabama Elders living in Alabama Generality? Generality?

13. Critical Analysis Continued Exploring the therapeutic environment for older women with late-life depression (McWha, Pachana, & Alpass, 2003) Exploring the therapeutic environment for older women with late-life depression (McWha, Pachana, & Alpass, 2003) Positive impact of social environment on mental illness Positive impact of social environment on mental illness Measurement? Measurement? Severity of depression? Severity of depression? Enjoyment? Enjoyment?

14. Critical Analysis Continued Occupations and signs of reduced hope (Borell, Lilja, Sviden, & Sadlo, 2000) Occupations and signs of reduced hope (Borell, Lilja, Sviden, & Sadlo, 2000) Engagement in meaningful occupations acted as barrier to hopelessness Engagement in meaningful occupations acted as barrier to hopelessness Disengagement due to impairment? Disengagement due to impairment? Definition of impairment? Definition of impairment? Severity? Severity?

16. Gaps in the Model Causal relationship between occupational engagement and depression Causal relationship between occupational engagement and depression Activity or socialization? Activity or socialization? Ability versus desire in relation to occupation and depression Ability versus desire in relation to occupation and depression Choice and occupational engagement Choice and occupational engagement Relevance for people with severe depression Relevance for people with severe depression

17. Areas for Future Research Study the effect of meaningful occupations that are performed exclusively in the home for people who are confined to the home. Study the effect of meaningful occupations that are performed exclusively in the home for people who are confined to the home. What are the occupations of people with severe depression? What are the effects of these occupations on their mental well- being? What are the occupations of people with severe depression? What are the effects of these occupations on their mental well- being?

18. Facilitated Discussion Study Recreational folk dance: A multicultural exercise component in healthy ageing Margaret Connor (2000)

19. Questions for Facilitated Discussion What are the limitations of this study? What are the limitations of this study? How would you improve on this study? How would you improve on this study?