Balance and time use
Patterns of daily occupation (PDO) and occupational balance(OB) impact both occupational performance and engagement.1 Occupational therapists who work with post-secondary students should consider both PDO and OB as it relates to student health, well-being and success – since students who believe that they have positive balance and better time use may have better quality of life and success.2,3
Patterns of daily occupation: This refers to the “doing of” occupation in time and space and will be influenced by social context.4 For example, PDO in a university population will be influenced by course schedule, social activities, work schedule, and commute time between activities.
Occupational balance5,6 – This is the subjective feeling that a student has the right amount and right variety of occupations. Students may feel occupational imbalance as the demands of university coursework pull them away from rest/sleep, physical activity, social or leisure activities. For example, a university student with depression might be sleeping excessive amounts of time and finding it difficult to participate in basic ADLs and academics.
Model of occupational balance and patterns of daily occupation1
Eklund et al (2017) suggest an interrelationship between PDO and OB.1 Patterns of daily occupation are viewed as the objective element: What are students doing and when? Where are they and with whom? Occupational balance is the subjective element: Are students satisfied with the variety of occupations they have? Do the occupations they participate in have a match between value and meaning? How do the mix of occupations fulfill their needs?
The relationship between PDO and OB can influence the development of both positive and negative patterns of behaviors. Negative patterns that have been seen in university students include reduced physical activity levels, excessive substance use, and poor nutritional choices.7,8,9 Once the OT understands a student’s use of time and their subjective feelings of balance, it would be helpful to explore how roles, habits, and routines affect a student’s time use in order to plan interventions to improve OB.
Time use in post-secondary students
Fosnacht, McCormick, & Lerma (2017)10 described four time use profiles and found relationships between student characteristics and how they spend their time. On average, students spent 13-15 hours per week in class preparation, regardless of time use profile. Interestingly, more time spent in academic pursuits (in a given day) led to less positive mood.11
Common time use profiles in university students10
- Balanced. This is the typical student (67% of the population). They have the lowest time commitment to class preparation with similar time devoted to school, co-curricular activities and volunteering, working for pay, relaxing and socializing, caring for dependents, and commuting to campus.
- Involved: These students demonstrate more participation in co-curricular activities (4-6 times more than other groups). Students in the involved time use category are more likely to be male, white, student-athletes, or identify with Greek membership. They also report more engagement in higher-order learning, reflective and integrated learning; quantitative reasoning, learning strategies, and collaborative learning.
- Partiers: These students spend more time in social activities (2-3 times more than other groups) than other activities. They are more likely to be male and living on campus. They report fewer gains in their learning and development, had the least amount of student-faculty interaction, and felt that there was the least benefit to education.
- Parents: These students are those who care for dependents. They are typically part-time and non-traditional. They find that parenting inhibits engagement in educational activities.
Eakman12 recently discussed the importance of understanding an individual’s engagement in meaningful occupation and their desire for more engagement. He suggested four levels of balance: Balanced, exploring (both positively associated with well-being), resigned, and imbalanced (not positively associated with well-being). Understanding a student’s profile will help the OT plan intervention.
OT assessment for PDO and OB:
Here are a few assessments on occupational balance and patterns of daily occupation that might be helpful (these were hard to track down – I did my best!):
PATTERNS OF DAILY OCCUPATION
Time budget (ie Barth Time Construction)– This can be a retrospective or prospective 24 hour recall or 7 day diary. If possible, using an electronic prompt (i.e. text message) to have a student describe what he/she is doing at the moment may be helpful.
Time geography – This is a time diary, but additionally asks for the physical and social context when reporting occupations.
Profiles of occupational engagement (specifically for people with mental illness but might work in post-secondary settings) – This is another time diary. Individuals discuss their occupational balance in terms of person-environment-occupation – which gets at the intersection of time use and balance.12,16 (If you have an AOTA membership, you can get full details about this tool by looking up the BJOT issue about it – reference #16 below!)
Pie of Life – Simple tool. Students fill out how satisfied they are with a number of occupations and look to see “how full his/her pie is” – and decide if they need to work on “pieces of the pie”.
Occupational balance questionnaire (OBQ) – 13 items that looks at satisfaction with amount and variety of occupation.
Satisfaction with daily occupations and balance (SDO-OB) – Five questions that ask about caring for oneself and one’s home, work, and leisure. Participant is asked if they have “just-enough”, “too much”, or “too little” to do in each of these areas.
Life balance inventory – This tool has 53 predefined activities and the participant can rate how much time they have spent in each activity over the last month. The tool measures congruence and equivalence (if there is a match between actual and desired performance).13
Interference scale of the Inter-goal Relations Questionnaire (IRQ)14– This tools looks for a discrepancy between goals and activities. While not an occupational balance assessment, this “mismatch” between goals and activities can be a proxy for desired occupational balance.
Meaning activity wants and needs assessment – MAWNA15 — 21 item tool which measures balance between actual and desired engagement in meaningful occupations. Measures meaning through: competence and goal achievement, pleasure and enjoyment, and social connectedness.
Engagement in Meaningful Activities – This is a 12 item tool that looks at meaningful activity experiences. Taken with the MAWNA, individuals can be categorized into several categories: Balanced, Exploring, Resigned, or Imbalanced.
- Eklund,M., Orban, K., Argentzell, E., Bejerholm, U., Tjörnstrand, C., Erlandsson, L. & Håkansson, C. (2017) The linkage between patterns of daily occupations and occupational balance: Applications within occupational science and occupational therapy practice, Scandinavian Journal of Occupational Therapy, 24(1), 41-56, DOI:10.1080/11038128.2016.1224271
- Håkansson C, Lissner L, Bj€orkelund C, et al.(2009) Engagement in patterns of daily occupations and perceived health among women of working age. Scand J Occup Ther, 16, 110–117.
- Wilcock AA, Chelin M, Hall M, et al. (1997) The relationship between occupational balance and health: A pilot study. Occup Ther Int.,4, 17–30.
- Zemke R. The 2004 Eleanor Clarke Slagle Lecture –Time, space, and the kaleidoscopes of occupation. Am J Occup Ther, 58, 608–620.
- Wagman P, Håkansson C, Björklund A. (2012). Occupational balance as used in occupational therapy: A concept analysis. Scand J Occup Ther, 19, 322–327.
- Wagman, P., Håkansson, C. & Jonsson, H. (2015). Occupational balance: A scoping review of current research and identified knowledge gaps. Journal of Occupational Science, 22(2), 160-169. Doi:10.1080/14427591.2014.986512
- Doumas, D. M., Nelson, K., DeYoung, A., & Renteria, C. C. (2014). Alcohol-related consequences among first-year university students: Effectiveness of a web-based personalized feedback program. Journal of College Counseling, 17(2), 150-162. doi:10.1002/j.2161-1882.2014.00054.x
- Kwan, M. W., & Faulkner, G. J. (2011). Perceptions and barriers to physical activity during the transition to university. American Journal of Health Studies, 26(2), 87-96.
- Tomasone, J. R., Meikle, N., & Bray, S. R. (2015). Intentions and trait self-control predict fruit and vegetable consumption during the transition to first-year university. Journal of American College Health, 63(3), 172-179. doi:10.1080/07448481.2014.1003375
- Fosnacht, McCormick, & Lerma (2017). First-year students’ time use in college: A latent profile analysis. Research in Higher Education doi:10.1007/s11162-018-9497-z
- Greene, K.L. & Maggs, J.L. (2017). Academic time during college: Associations with mood, tiredness, and binge drinking across days and semesters. Journal of Adolescence, 56, 24-33. doi:10.1016/j.adolescence.2016.12.001
- Bejerholm U. (2010). Occupational balance in people with schizophrenia. Occup Ther Ment Health,26, 1–17.
- Matuska K. (2012). Description and development of the life balance inventory. OTJR, 32, 220–228.
- Riediger, M., & Freund, A. M. (2004). Interference and facilitation among personal goals: differential associations with subjective well-being and persistent goal pursuit. Personality and Social Psychology Bulletin, 30, 1511–1523.
- Eakman, A.M. (2016). A subjectively-based definition of life balance using personal meaning in occupation. Journal of Occupational Science, 23(1), 108-127/ doi:10.1080/14427591.2014.955603
- Bejerholm, U., Hansson, L., & Eklund, M. (2006). Profiles of Occupational Engagement in People with Schizophrenia (POES): The Development of a New Instrument Based on Time-Use Diaries. British Journal of Occupational Therapy, 69(2), 58–68. https://doi.org/10.1177/030802260606900203