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Occupational participation through community mobility among older men and women
Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of the present thesis was to explore and characterise occupational participation and community mobility from an occupational perspective of health and well-being, and to elucidate potential barriers and facilitators for occupational participation and community mobility in older men and women.

In Study I, questionnaires were sent to a sample of older citizens (75+) in three Swedish mid-sized municipalities. This survey focused on actual and preferred travel opportunities and was returned by 957 persons (response rate 46%). Although older people appreciated the existing travel opportunities, there was evidence of restricted community mobility for some sub-groups of older people, due to various perceived barriers. More efforts must be put into accessibility improvements including usability from the perspective of older people.

In Study II nine focus group interviews with a total of 42 participants (20 men) were conducted, focusing on older peoples’ motives for, and experiences of, community mobility and occupational participation outside the home. The main category “Continuing mobility and occupational participation outside the home in old age is an act of negotiation” summarised the findings. This main category was abstracted from the generic categories “Occupational means and goals”, “Occupational and mobility adaptation” and “Occupational barriers and facilitators”, and their subcategories. Community mobility was identified as an important occupation that in itself also facilitated occupational participation outside the home. Individual community mobility seemed to be influenced by, for example, age and gender, as well as habits acquired over time. Furthermore, community mobility was negatively affected not only by physical barriers, but also by social and attitudinal barriers in the public environment.

Study III identified and described older people’s viewpoints on community mobility and occupational participation in older age through a Q-methodology study conducted with 36 participants, including men and women, both drivers and non-drivers. Three viewpoints were found and assigned content-descriptive denominations; viz.: “Prefer being mobile by car”, “Prefer being mobile by public transport” and “Prefer flexible mobility”. Unfortunately, the existing demand-responsive Special Transportation Systems was not considered an attractive enough alternative by any of the participants. Thus, intermediate community mobility options are needed for those who no longer can drive or use public transport. In

Study IV factors associated with community mobility, and decreased community mobility over time, for older men and women were described. Data were based on the Gender study “Aging in men and women: a longitudinal study of gender differences in health behaviour and health among elderly” and collected through surveys in 1994 and 2007. The base-line sample consisted of 605 twin-pairs, i.e., 1,210 individuals, aged 69-88, and the follow-up of 357 individuals (165 men and 192 women), aged 83-97. This surveycovered health and health-related issues including community mobility and occupational participation. Continuing community mobility was cross-sectionally (at follow-up) and prospectively (from baseline to follow-up) associated with better self-reported subjective health rather than self-reported health conditions for both men and women. For men, community mobility was also cross-sectionally associated with few or non-existant depressive symptoms, while reduced community mobility was prospectively associated with higher age for women. Consequently, interventions aiming to enable community mobility must move beyond interventions directed towards health conditions and instead target subjective health and well-being.

Place, publisher, year, edition, pages
Jönköping: School of Health Sciences , 2012. , 123 p.
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 33
National Category
Occupational Therapy
Identifiers
URN: urn:nbn:se:hj:diva-19486ISBN: 978-91-85835-32-4 (print)OAI: oai:DiVA.org:hj-19486DiVA: diva2:555397
Public defence
2012-10-12, Forum Humanum, HHJ (School of Health Sciences), Jönköping, 13:00 (English)
Opponent
Supervisors
Available from: 2012-09-19 Created: 2012-09-19 Last updated: 2012-09-19Bibliographically approved
List of papers
1. Older people and local public transit: Mobility effects of accessibility improvements in Sweden
Open this publication in new window or tab >>Older people and local public transit: Mobility effects of accessibility improvements in Sweden
2009 (English)In: Journal of Transport and Land Use, ISSN 1938-7849, Vol. 2, no 2, 49-65 p.Article in journal (Refereed) Published
Abstract [en]

Several transportation factors concerning older and disabled people are under transition in Sweden at present. By the year 2010, the public transit system must be fully accessible for all passengers. The present survey studied older people, in order to assess the perceived travel opportunities. Questionnaires were sent to a sample of older citizens (75+) in three Swedish mid-sized municipalities. The general conclusions were that even though older people show appreciation of the existing travel opportunities, there was evidence for restricted mobility for some sub-groups of these older people, due to various perceived barriers. These groups have few optional modes, and despite various accessibility measures, special transportation services – the mandatory demand-responsive transport service – continues to provide crucial mobility. Hence, there is more to be done regarding accessibility and usability in public transit for older people. Further studies have to clarify reasons for bus travel cessation. Even larger efforts have to be put into accessibility improvements, in particular intermediate transit solutions in order to meet the regulations and policies.

Keyword
Local public transit, Older people, Preferences, Special transportations services
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-10482 (URN)
Available from: 2009-09-30 Created: 2009-09-30 Last updated: 2015-12-22Bibliographically approved
2. Continuing Mobility and Occupational Participation Outside the Home in Old Age is an Act of Negotiation
Open this publication in new window or tab >>Continuing Mobility and Occupational Participation Outside the Home in Old Age is an Act of Negotiation
2011 (English)In: Activities, Adaptation & Aging, ISSN 0192-4788, E-ISSN 1544-4368, Vol. 35, no 4, 275-297 p.Article in journal (Refereed) Published
Abstract [en]

Facilitated by mobility, occupational participaton is vital in old age. However, the relative importance of other influencing factors remains unclear. The present study describes older people's motives for, and experiences of, mobility and occuoational participation outside the home. Nine focus group interviews were conducted and analyzed using content analysis. Occupational participation and mobility was individually experienced even if some subjective perspectives were common. Continuing mobility and occupational participation outside the home in old age is an act of negotiation, encompassing occupational means and goals, occupational and mobility adaptation, and occupational barrieres and facilitators.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2011
Keyword
Activity, Content analysis, Focus group, Mobility, Occupation
National Category
Occupational Therapy Other Social Sciences not elsewhere specified
Identifiers
urn:nbn:se:hj:diva-13615 (URN)10.1080/01924788.2011.625213 (DOI)
Available from: 2010-10-24 Created: 2010-10-24 Last updated: 2017-12-12Bibliographically approved
3. Viewpoints on community mobility and participation in older age
Open this publication in new window or tab >>Viewpoints on community mobility and participation in older age
Show others...
2012 (English)In: Journal of Human Subjectivity, ISSN 1598-8643, Vol. 10, no 1, 103-123 p.Article in journal (Refereed) Published
Abstract [en]

Background/Aim: Community mobility supports participation in activities. However, knowledge about issues that influence community mobility and, hence, participation in activities outside the home is limited. Since participation and community mobility are subjectively defined phenomena, further knowledge from an insider’s perspective is needed. The aim of this study was to identify and describe viewpoints on community mobility and participation in older age. Methods: A Q-methodology study was conducted with 36 male and female participants, including drivers and non-drivers. Participants sorted 45 Q-statements along a most to least continuum, indicating their current habitual situation of mobility and participation in activities outside their homes. Results: Three viewpoints were found and assigned content-describing denominations; “Prefer being mobile by car, “Prefer being mobile by public transport” and “Prefer flexible mobility”. Conclusions: All participants were satisfied with their actual participation in activities outside their homes. However, those who preferred to use public transport were less satisfied with their opportunities and possibilities to participate in activities outside their homes. The existing demand-responsive Special Transportation System was not considered to be an attractive enough alternative by any of the participants. Intermediate community mobility options are thus needed for those who can no longer drive or use public transport.

Keyword
Activity, Q methodology, Sweden, Northern Europe
National Category
Gerontology, specializing in Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-19481 (URN)HHJADULTIS, HHJCHILDIS, HHJKvalitetIS, HHJÅldrandeIS (Local ID)HHJADULTIS, HHJCHILDIS, HHJKvalitetIS, HHJÅldrandeIS (Archive number)HHJADULTIS, HHJCHILDIS, HHJKvalitetIS, HHJÅldrandeIS (OAI)
Available from: 2012-09-21 Created: 2012-09-19 Last updated: 2015-12-22Bibliographically approved
4. Changes in community mobility in older men and women. A 13-year prospective study
Open this publication in new window or tab >>Changes in community mobility in older men and women. A 13-year prospective study
Show others...
2014 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, no 2, e87827- p.Article in journal (Refereed) Published
Abstract [en]

Community mobility, defined as "moving [ones] self in the community and using public or private transportation", has a unique ability to promote older peoples' wellbeing by enabling independence and access to activity arenas for interaction with others. Early predictors of decreased community mobility among older men and women are useful in developing health promoting strategies. However, long-term prediction is rare, especially when it comes to including both public and private transportation. The present study describes factors associated with community mobility and decreased community mobility over time among older men and women. In total, 119 men and 147 women responded to a questionnaire in 1994 and 2007. Respondents were between 82 and 96 years old at follow-up. After 13 years, 40% of men and 43% of women had decreased community mobility, but 47% of men and 45% of women still experienced some independent community mobility. Cross-sectional independent community mobility among men was associated with higher ratings of subjective health, reporting no depression and more involvement in sport activities. Among women, cross-sectional independent community mobility was associated with better subjective health and doing more instrumental activities of daily living outside the home. Lower subjective health predicted decreased community mobility for both men and women, whereas self-reported health conditions did not. Consequently, general policies and individual interventions aiming to improve community mobility should consider older persons' subjective health.

National Category
Gerontology, specializing in Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-19485 (URN)10.1371/journal.pone.0087827 (DOI)000330834400020 ()24516565 (PubMedID)2-s2.0-84895512185 (Scopus ID)
Available from: 2012-09-19 Created: 2012-09-19 Last updated: 2017-12-07Bibliographically approved

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