September - October 2020: Walking as a meaningful occupation

Topic for September – October 2020: Walking as a meaningful occupation.

Hosted by: Eleanor Dixon, MSc OT student at Sheffield Hallam University, UK.

This article is titled “Walking as a meaningful leisure occupation: the implications for occupational therapy” (Wensley & Slade, 2012), published in the British Journal of Occupational Therapy.

This level of evidence falls into category VI as seen in the following table, which is based on the effectiveness rating scheme by Ackley, Swan, Ladwig & Tucker (2008).

Why was this article selected?

Despite this article being dated 2012, this research article was chosen for Journal Club due to the relevance of walking as an occupation throughout the COVID-19 pandemic, as many occupations were disrupted. It also focuses on individual meanings and experiences of individuals who participate in walking as an occupation, highlighting both the importance of meaning and value for occupation, and the benefits of walking, which are influenced by the individual, activity, environmental and social contexts in which they take place.

Aims and issues presented

This article aims to identify the occupational benefits of walking, to both gain a deeper understanding of individual meanings and experiences of engaging with this occupation, and to evidence the use of walking in therapeutic practice.

The authors suggest that even though literature focusing on leisure occupations is extensive, perhaps due to the promotion of community wellbeing and health promotion, there is a limited amount of literature focusing on walking as an occupation, despite its benefits for both physical and mental health, as well as social functioning, which have been further promoted by public health campaigns.

Design

Qualitative study design, using semi-structured interviews.

Methodology

The researchers gained ethical approval from their host institution ethics process prior to conducting this research.

Primarily, 6 participants with no physical or mental health conditions (2 Male, 4 Female, all Caucasian, mean ages 21-34.5) were recruited using convenience sampling. All participants were current members of a University Walking club.

Each participant gave informed consent, in full knowledge of their right to withdraw and right to confidentiality and anonymity before engaging in a 30-60 minute semi-structured interview. The interview sought to examine their experiences of walking, how long and how often they had been walking for, what interested them about walking and why is was important to each person.

Secondly, the researchers familiarised themselves with the data, transcribing, and re-reading, before coding and developing themes to represent the data. To promote credibility, the researcher sent a summary of the results and themes to the participants, to ensure that the results were representative of their individual experiences.

Findings

The authors highlight that participants had individual and different experiences, engaging in walking occupations to establish and maintain social connectedness, improve fitness and problem solving, and to promote feelings of relaxation, escape, mastery and being within the natural environment.

The themes identified are presented in the table below.

A summary for each theme and sub-theme will now be presented.

Social connectedness

Building new social relationships and a medium for social interactions

The results suggest that the participants main motivation for joining a walking group was to meet new people and make new friends, established due to a similar interest, and often maintained outside of the group environment. Further to this, one participant mentions that being part of a group environment enabled an increase in social interaction skills, built around scenarios specific to the common interest.

Group membership

Participants report that being part of the group enabled a developed social identity and a sense of belonging, as well as a sense of purpose, as well as an increase in motivation due to the support given from the group members.

However, some participants highlight negative experiences, including “stopping walking due to feeling that the group was too fast”, diminishing enjoyment.

Walking and talking

Communication by “walking and talking” had been highlighted as both an important way to share experiences, as well as a more natural way to discuss, share and understand each other’s experiences rather than in a more formal setting.

Wellbeing

Emotional wellbeing

Many participants expressed that walking increased positive feelings and happiness, facilitating relaxation and distraction from other life events. One participant described the positive feeling gained from walking as “transformative”.

Physical wellbeing

Some participants highlighted that the physical aspect of walking was a reason to engage, whereas others did not enjoy the physical aspect of walking. Some participants described “a sense of achievement” from the physical exertion, whilst others highlighted the “unconscious nature” of fitness and physical exercise provided by walking.

Escape

Participants identified that walking is “a nice way of getting away from everything, switching off and relaxing”, and some participants used words such as feeling “free” to describe their experiences.

De-stressing

Participants described “escaping physically and mentally separating” from everyday scenarios through engaging in walking. However, the authors suggest that the de-stressing effect of walking relates to the meaning that each individual holds, as well as the environment.

Connection to nature

Each participant spoke about the connection to nature when discussing their feelings of pleasure whilst walking, which also added to their sense of achievement. The results report that the connection to nature facilitated feelings of peacefulness, tranquillity, and excitement, exploring new places. The authors report that these findings echo Roe & Aspinall (2011), who highlight the “restorative effect of nature and rural walking”.

Achievement from a challenge

Self-actualisation

Participants reported a sense of achievement, giving a sense of purpose, satisfaction and pride. The researchers suggest a link to self-actualisation through goal achievement, promoting self-worth and self-esteem, as evidenced by one participant who mentioned that “proving yourself to yourself, or achieving something that is just so great and it feels really good to do that”.

Conclusion and practice implications

This research study highlights the value of both walking as a meaningful occupation, and the use of walking in Occupational Therapy intervention. Furthermore, it draws attention to not only the physical, mental health and emotional benefits of walking, but also the potential negatives associated with engagement in activities that are too challenging or activities that do not match an individual’s ability or needs.

Therefore, this study promotes highlights the importance of remaining client-centred, focusing on meaning that occupations hold for each individual, emphasising the benefits for the general population.

The researchers suggest that Occupational Therapists are placed in an ideal situation for health promotion, health prevention and wellness campaigns, including advocating for accessible walking routes, appropriate to different levels of challenge. Furthermore, a sound evidence base could facilitate the promotion of activity, as seen in current practice.

Further research related to this study, as identified by the researchers, could include research into if the benefits and meaning identified within this study are seen in individuals with either physical or mental health conditions, barriers and motivations to walking to inform public health initiatives, or specific benefits such as stress-reduction for the general population.

Comments

I like that this research study highlights the importance of individual meaning when engaging in occupations, highlighting the importance of considering social and environmental contexts. The results emphasise both the physical, mental health and emotional benefits, as well as the possible negatives from engagement in an activity that may not offer an appropriate challenge in relation to the persons individual ability and needs. This is of concern whilst using this occupation within clinical practice, which is often used within mental health practices. Furthermore, it highlights the need for individuality, utilising occupations which hold meaningful and value to the individual.

Although the researchers were able to use some techniques within their methodology to improve credibility and trustworthiness, such as participant checking, the sample may be not representative of the general population, as the participants were all members of a university walking group. Furthermore, future research with a more diverse participant base would be useful to improve the evidence base for using this occupation within OT practice. However, the results draw attention to the benefits of walking for public health, especially considering the physical and mental health impacts of COVID-19.

About me

I am currently studying an Occupational Therapy MSc at Sheffield Hallam University. I am interested in a variety of areas, and I am hoping to work as a rotational Band 5 to gain more experience after graduation in December 2020.

This article is now open for discussion. Please share your thoughts and views on the comments section below.

The article can be accessed by the links below:

Wensley, R. & Slade, A. (2012). Walking as a meaningful leisure occupation: the implications for occupational therapy. British Journal of Occupational Therapy, 75(2), 85-92. DOI: 10.4276/030802212X13286281651117.Retrieved from: https://journals.sagepub.com/doi/pdf/10.4276/030802212X13286281651117

This article can also be accessed from the following link (open link) : https://pearl.plymouth.ac.uk/handle/10026.1/1242

Further references:

Ackley, B. J., Swan, B. A., Ladwig, G., & Tucker, S. (2008). Evidence-based nursing care guidelines: Medical-surgical interventions. (p. 7). St. Louis, MO: Mosby Elsevier.

Maslow, A. H. (1943). A theory of human motivation. Psychological Review, 50(4), 370-96. Image retrieved from: VeryWellMind, 2020.