To be able to participate in one's own life, to do the things we want to do, and to competently perform the activities that form part of our daily, weekly or monthly routines, is a common goal for most people. This not only includes taking part in the basic activities of self-care, such as grooming and dressing, but also extends to our work and leisure activities. It is through doing things that we learn and develop as human beings. The occupational therapy profession believes that being prevented or hindered in some way from participating in the activities that are important to us could adversely affect our health and wellbeing.
Health is a complex term to define because it not only means different things to different people, but is a dynamic process that changes throughout our lives (Seedhouse, 2001). It changes between people of different age groups, different genders, different cultures and different abilities (Wilcock, 2006). With so many different perspectives, it is easy to see why health is a difficult concept to define. The World Health Organisation defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (as cited in Seedhouse, 2001. p41). This definition shows that health issues are not only concerned with disease and the physical functioning of the body, but also include a person’s state of mind and the environment and communities within which they live. In western society, health is usually linked to autonomy, the more freedom a person has to make choices and to independently participate in life, the greater their health is perceived to be (Seedhouse, 2001).
Wellbeing is slightly different to health in that it has wider meaning. It is a very personal and subjective feeling that a person has about themselves, a feeling of being content or at peace (Crepeau et al, 2009). Feelings of well-being arise when people are satisfied with life, when they are able to participate in and balance the routines that make up the fabric of their lives (Crepeau et al, 2009). To participate is to engage in activity, to be active in daily life, work, family and communities. Each individual engages in activities that are personal to them and to their routines and roles in life. These meaningful activities are called occupations, and a healthy person is often considered to be someone who is able to competently perform their daily occupations, even despite impairment (Creek, 2003).
Occupations are everything people do to occupy themselves, including washing and dressing, enjoying life and contributing to their communities through work and social engagement (Crepeau et al, 2009). These three areas (self-care, leisure and productivity) are called our occupational performance areas and it is through these different areas that people express themselves and develop their own unique occupational identity. Christiansen (1999) proposed that meaning is what gives rise to occupational identity (as cited in Townsend and Polatajko, 2007). He argued that the link between well-being and engagement in activity could be better understood by examining a person’s occupational identity (Townsend and Polatajjko, 2007) because identity is dictated by an individual’s cultural and social environments, it defines their role in society and gives meaning to the everyday activities that they participate in (Hagedorn, 1995).
Occupations develop in childhood, but change throughout the lifespan, and it is occupation that is the core concept of occupational therapy (Kramer et al, 2003). If there is dysfunction in one of the occupational performance areas it could lead to health issues and a sense of loss of well-being (Crepeau et al, 2009). It is also important to have balance between these areas (Townsend and Polatajko, 2007). In today’s society this is most often seen in relation to...