Togetherness in everyday occupations : how participation in on-going life with others enables change

Sammanfattning: The overall aim of this thesis is to provide knowledge of how everyday occupations with others can be understood as an on-going and evolving process in people’s lives. This thesis includes four papers, all with a qualitative approach and a focus on everyday occupations with others from the perspective of people in different life situations. In Study I, nine persons with rheumatoid arthritis were interviewed on how they experienced the influence of others on their engagement in occupations. Data was analyzed using a constant comparative method, showing how everyday occupations with others could be understood as constructive collaboration or insufficient collaboration. These kinds of collaboration were related to different actions, undertaken by other persons, which created or restricted possibilities for occupational engagement and the experience of it, such as autonomy and meaning. Study II was conducted with five elderly persons living with late-life depression focusing on how they engaged in everyday occupations with others, over time, and how this was related to their experience of meaning. Repeated interviews and participant observations generated data that was analyzed using a narrative approach. Based on the analysis, the concept of enacted togetherness was constructed, comprehending togetherness as an acted relation, creating an acted belonging rather than just a feeling or sense of belonging. Being part of an enacted togetherness was a way for the participants to negotiate and create meaning in their everyday lives. Further, findings suggest that being part of an enacted togetherness created possibilities to enact agency. Study III explored how agency is enacted in everyday occupations with others and evolves over time for an older woman living with late-life depression. A contextualized in-depth story was created through narrative analysis based on interviews and participant observations. Findings provide an example of how conditions for agency is related to socially situated and embedded experiences rather than associated with the individual’s capacity or ability to act independently in different situations. In Study IV focus group discussions was conducted with twelve old persons and a constant comparative method was used to explore and gain insight into how togetherness in everyday occupations with others was experienced and discussed. Findings show how everyday occupation with others can be comprehended as a multifold transactional process, emphasizing how an acted belonging was a situated experience connecting people and places through an unfolding story. In conclusion, this thesis contributes with an understanding of how everyday occupations with others can be comprehended as an arena where togetherness and belonging can be created. Engaging in occupations with others was a way to gain access to and become part of an unfolding story where issues related to meaning-making could be negotiated. Moreover, this thesis emphasizes how situated experiences connected to occupations with others promote participation and enable change. Therefore, it is of importance to consider occupation as transactional and focus on the situations in which people’s everyday occupations take place, in order to support agency and participation when empowering clients to achieve change.