CONCEPTUAL FRAMEWORK FOR PARTICPATION IN MENTAL HEALTH: SYSTEMATIC REVIEW AND NARRATIVE SYNTHESIS

Background: When designing a study to test the effectiveness of an intervention, such as occupational therapy, a primary outcome measure needs to be identified. Choosing an outcome measure requires an understanding of the... [ view full abstract ]

Background:
When designing a study to test the effectiveness of an intervention, such as occupational therapy, a primary outcome measure needs to be identified. Choosing an outcome measure requires an understanding of the underlying concept being measured (McDowell, 2006). Although described in the International classification of functioning, disability, and health participation as an outcome lacks conceptual clarity (Khetani & Coster, 2007). This study aimed to understand participation in the context of mental health.

Method:
The systematic review and narrative synthesis described by Leamy et al (2011) was replicated. A conceptual analysis was undertaken which also drew on the theory development approach (Walker & Avant 2011). All relevance checking and analysis was completed by two reviewers. Data was analysed thematic analysis.

Results:
56 papers were included in the review. The thematic analysis identified that participation in mental health is a dynamic process between the individual, their life context, and it occurs through activities. This was summarised diagrammatically and the definition ‘Participation occurs when an individual is involved in activities, within the context of their life, which provides that person with a sense of engagement’ emerged from the data.

Conclusion:
This conceptual analysis, based on a comprehensive systematic review, provides conceptual clarity about the experience of participation in relation to mental health.

Application to Practice:
The definition developed can be used as a basis for selecting measures to assess participation in effectiveness studies of mental health.