Conceptual Model of Leisure Engagement for Quality of Life in Nursing Home Residents (LEQoL-NH)
The Conceptual Model of Leisure Engagement for Quality of Life in Nursing Home Residents (LEQoL-NH) aims to demonstrate the interrelationship between four factors: principles of occupational justice, continuity theory, leisure engagement, and resulting quality of life. Each is considered as important in improving quality of life. This model recognizes persons as occupational beings with valued lifelong interests/activities. When the persons are enabled towards occupational engagement, participation in life results is increased. The model emphases that engagement in meaning or valued occupation is necessary to promote optimal quality of life. It is based on continuity theory, which suggests that people maintain interests, behaviors, and values across the lifespan, with combination of occupational justice ideologies, to support individual client choices and resulting quality of life through leisure engagement. As most nursing homes focus on activities of daily living, this model emphasizes that residents should be offered access to self-perceived meaning occupation for enjoyment to maintain the sense of self-identify. Due to varying needs of residents for ideal functional performance, individualized supports are also required for occupational justice. Moreover, consideration of interest and value, and maintenance of core identity and sense of self are necessary to enhance quality of life. Lack of opportunity to access in valued occupation results in occupational injustices can lead to negative physical, social, emotional, cognitive, and social outcomes. Interventions that minimize leisure constraints should incorporate patterns of leisure activities and interests, compensate for the residents’ declining abilities in older age, increase available resources for leisure engagement, provide appropriate staff education and create cultural changes within institutionalized settings to promote resident autonomy and choice. Occupational therapists can use assessments (e.g., interest checklist, Best Friend’s Assessment, in conjunction with detailed life history) to identify continued value leisure activities individually, and to make recommendations for resources and environmental alterations and supports.
Domain of occupation
The model aims to promote quality of life for nursing home residents through leisure engagement.
Causey-Upton, R. (2015). A model for quality of life: Occupational justice and leisure continuity for nursing home residents. Physical & Occupational Therapy In Geriatrics, 33(3), 175-188.
The Lived Environment Life Quality Model (LELQ) aims to explicate the ecological complexities in using occupations to optimize quality of life of institutionalized people with dementia. This model focuses on factors that affect clients’ opportunity in occupational engagement, mainly on the social and physical environmental supports and barriers. It has two main domains, including the lived-environment domain (specifically for assessment and intervention) and the Quality of Life (QoL) domain (specifically for intervention goals and outcome).
The Occupation-Centred Assessment with Children (OCAC) framework is a top-down, family-centered, ad ecological assessment approach that provides a holistic view of children and their occupational performance within their naturalistic contexts. OCAC focuses on occupational performance issues most relevant and important to a child and his/her family. These may include leisure/play, productivity/school, self-care/activities of daily living, as well as time use, roles, habits, identity, and activity patterns.
The Accountability-Well-being-Ethics (AWE) framework incorporates the humanist and contextualist perspectives to create a balanced foundation of client-centered profession. The conceptual cores include sociocultural, well-being, social/occupational justice, promoting capabilities, accountability, qualitative stories, contingency, hope, solidarity, person directed, coach/partner, and facilitating empowerment, in contrast to different concepts of biomedical health care. This framework is structured for use in education, research, and clinical practice for occupational therapy globally.
The Canadian Model of Occupational Performance and Engagement (CMOP-E) is an occupational performance model, which is evolved from the Canadian Model of Occupational Performance (CMOP). The CMOP-E includes three main components: person, environment, and occupation. In this model, the inner part represents “Person”, and its center is the spirituality of a person. The other components surrounding a person’s spirituality are affective, physical, and cognitive abilities.
The Framework of Occupational Justice (FOJ) offers an occupational perspective of justice or injustice on everyday occupations. This framework emphasizes on the inclusion of every individual in an occupationally just word (i.e., the environment, such as community and government, in which the individuals can do what they decide to be the most meaningful and useful to themselves, family, communities and nations). It illustrates how the inter-relationships of structural factors and contextual factors support or restrict occupational outcomes and occupational rights.