Spending my time- Time use and meaningfulness in daily occupations as perceived by people with persistent mental illness

Sammanfattning: Engagement in daily occupations, especially those perceived as meaningful, is essential for health and well-being. According to evaluation reports, many individuals with persistent mental illness seem to lack meaningful everyday occupations. The aim of this thesis was to investigate possible relationships between occupation, operationalised as time use and daily rhythm in daily activities, among individuals with persistent mental illness and relationships to different aspects of well-being, and identify sociodemographic and clinical risk factors for any imbalance in daily activities. A further aim was to investigate perceived meaningfulness in daily occupations, with a specific focus on work. The thesis is based on four studies. Studies I-III are based on a randomised sample of 103 participants from a psychiatric outpatient unit, and Study IV included 12 participants that were interviewed about perceived meaningfulness in their work. The results showed that spending much time in activities in everyday life, especially in work and other productive activities, and having a beneficial daily rhythm were associated with several factors of well-being. Spending much time asleep, especially at daytime, was associated with worse well-being. Among the risk factors for imbalance in daily activities was having high levels of general symptoms, which explained most of the risk of spending short periods in work/education, having an abnormal time asleep and an adverse daily rhythm. Further, having a diagnosis of schizophrenia meant an increased risk of spending little time in daily activities. Being occupied per se, as well as having organised activities and routines, was perceived as meaningful and generated a feeling of occupational balance. Further, social life and a feeling of being needed by others was the aspect of meaningfulness most frequently reported in everyday life. Other aspects of meaningfulness in daily occupations were enjoyment, a sense of achievement and doing occupations to take care of oneself to maintain health. Work, in terms of employment, was perceived as meaningful since it had certain unique characteristics, gave structure to the day, a feeling of normality and acceptance, a balanced everyday life, and increased well-being. However, it was important that the demands at work and the individuals’ interests and skills were well matched. A tentative model was suggested, integrating these aspects of meaningfulness in work.