Journal article review
Meaning in life for people with schizophrenia: does it
Meaningful occupation has been a concern for occupational
therapists, possibly to sustain a distinction between occupational
therapy and other approaches to activity within mental health,
which can be more concerned with filling time and diverting people.
Eklund and her colleagues moved beyond this concern with
professional practice and service delivery. By directly asking
people with schizophrenia what they found meaningful, they were
able to investigate the place of occupation in a meaningful life
and its relation to other aspects.
The study involved 10 participants, all residents of supported
accommodation in Sweden with a diagnosis of schizophrenia. All were
interviewed individually, followed by content analysis of the
transcripts. Five categories were identified: social contacts,
engagement in occupations, precious memories, experiencing health
and positive feelings. Each of these categories contributed to a
sense of meaning in life, and the authors suggested that positive
feelings were particularly influenced by the other categories.
Positive feelings could be an intrinsic part of the other
categories, but the subcategories (feeling safe and feeling needed)
suggested that positive feelings should be recognised as a separate
and important element of a meaningful life.
One of the strengths of this study is the strong theoretical
base, which is clearly explained. It is widely understood that
there are different levels of meaning in life, from a sensory level
(making sense of what you see/hear/taste and so on) to ideas about
human existence. This study was clearly located between these
extremes, being concerned with meaning in everyday life, making it
relevant to occupational therapy practice as well as adding to
understanding of occupation. The doing-being-becoming-belonging
synthesis offered a useful, practical framework for discussing the
findings (Wilcock 2006).
The importance of social contacts, and precious memories of
relationships and roles, clearly indicated the importance of social
life in a meaningful life. This aspect of the study could have been
more rigorously investigated as the authors make few links with
current thinking within mental health practice. Issues of social
inclusion/exclusion or a social perspective on mental health were
not clearly indicated. In particular, the observation about
becoming, and the absence of ideas about the future, could have
been linked with current thinking about recovery.
Having said that, I’d really recommend this article for
discussion. The clear and broad focus would make it suitable for
exploring with colleagues, service users and carers. The conclusion
that occupation does have a place in a meaningful life is welcome,
but the simultaneous recognition of the importance of social life,
memories and feelings give the study a credible balance.
Eklund M, Hermansson A, Hakansson C (2011)
Meaning in life for people with schizophrenia: does it include
occupation? Journal of Occupational Science, iFirst 1-13
Wilcock A (2006) An occupational perspective of health. 2nd
edition. Thorofare: Slack.
One of the participants in Eklund et al’s study described the
importance of laying the table for meals