Tore Bonsaksen

• Stigen, Linda; Sveen, Unni; Øvern, Karen Marie; Overvåg, Grete; Bonsaksen, Tore & Horghagen, Sissel [Show all 9 contributors for this article] (2026). Research on Community-based Occupational Therapy in the Nordic Countries: A Scoping Review. Ergoterapeuten. ISSN 0800-3475. 69(5). Full text in Research Archive
• Opdal, Ida Marie; Bonsaksen, Tore; Kleppang, Annette Løvheim; Steigen, Anne Mari & Stea, Tonje Holte (2026). Screen socialising and depressive symptoms among Norwegian adolescents and the impact of the COVID-19 pandemic. Scandinavian Journal of Public Health. ISSN 1403-4948. p. 1–8. doi: 10.1177/14034948261459775. Full text in Research Archive Show summary

  Aims: This study aimed to assess associations between online gaming with others, online socialising and depressive symptoms among adolescents, and whether these associations changed before, during and after the COVID-19 pandemic (2018, 2021 and 2023). Methods: Cross-sectional data among Norwegian adolescents aged 13–19 years in 2018, 2021 and 2023, comprising a total sample of 83,453 adolescents (Oslo: n=69,164; Møre og Romsdal: n=14,289), were used in the analyses. Multivariable binary logistic regression models, stratified by sex, were used to examine associations between online gaming with others, online socialising and depressive symptoms separately for each study year. The models were adjusted for school level, having trusted friends and perceived family economy. Results: Among girls, the results showed slightly higher odds of depressive symptoms during the pandemic than before the pandemic (odds ratio (OR)=1.1; 95% confidence interval (CI): 1.1–1.2). Frequent online gaming with others and online socialising were associated with increased odds of depressive symptoms among boys (OR=1.2; 95% CI 1.1–1.4 and OR=1.5; 95% CI 1.3–1.6) and girls (OR=1.8; 95% CI 1.6–2.0 and OR=1.7; 95% CI 1.5–1.8). Among girls, weekly online gaming with others was associated with higher odds of depressive symptoms in 2021 (OR=1.4; 95% CI 1.2–1.6). Among boys with no online socialising, frequent online gaming with others was associated with increased odds of depressive symptoms (OR=1.8; 95% CI 1.3–2.3). Conclusions: Frequent online gaming with others and online socialising were associated with higher levels of depressive symptoms among both boys and girls, with stronger associations observed among girls, particularly during the pandemic.

• Amayra, Tannoubi,; Mørk, Gry; Redzovic, Skender Elez & Bonsaksen, Tore (2026). Learning environment perceptions among occupational therapy students in Norway: sociodemographic, study behaviors, and performance covariates to cluster allocation. Learning Environments Research. ISSN 1387-1579. 29(45). doi: 10.1007/s10984-026-09603-1. Full text in Research Archive Show summary

  Little is known about how learning environment (LE) perceptions cluster within student populations and how such profiles relate to study behaviors and performance. This study aimed to identify clusters of Norwegian occupational therapy students based on their LE perceptions and to examine sociodemographic, study behaviors, and performance covariates associated with cluster allocation. Data were drawn from a national longitudinal investigation (2017–2020) including 233 students from Norway. The present study used a cross-sectional analysis of averaged measures collected across the three-year study program. A two-step cluster analysis was conducted on six LE dimensions, followed by ANOVAs, chi-square tests, and multinomial logistic regression analyses. A three-cluster solution with acceptable separation was identified, classifying students as LE negative (19.3%), LE neutral (39.5%), and LE positive (41.2%). The clusters differed significantly across all LE dimensions. Greater independent study time was associated with higher odds of LE negative and LE neutral classification, compared to LE positive. Higher grades were associated with increased odds of LE neutral classification. Lower deep approach scores were associated with both LE negative and LE neutral classification, whereas lower strategic and higher surface approach scores were associated with LE negative classification. Students can be meaningfully grouped into LE perception profiles which were associated with study approaches, effort, and academic performance. LE positive students showed a favorable pattern of study approaches, particularly in comparison with LE negative students. Targeted educational strategies addressing LE dimensions and promoting effective study approaches may help improve students’ learning outcomes.

• Taha, Chebbi,; Amayra, Tannoubi,; Bonsaksen, Tore; Adrian, Geantă, Vlad; Hamed, Alliheibi, Abdullah & Alexander, Woll, [Show all 7 contributors for this article] (2026). Teacher Professional Procrastination as a Well-Being and Self-Regulation Challenge: Development and Validation of the Arabic Teacher Professional Procrastination Scale. Frontiers in Education. doi: 10.3389/feduc.2026.1903123. Full text in Research Archive Show summary

  Background/Objective: Educator well-being and resilience are increasingly recognized as critical for sustainable teaching and professional effectiveness. Pro...

• Steigen, Anne Mari; Stea, Tonje Holte; Granrud, Marie Dahlen; Dangmann, Cecilie Ruud & Bonsaksen, Tore (2026). Trends in sexual harassment exposure among adolescents in Norway between 2017 and 2023 and associations with depressive symptoms. Nordic Journal of Psychiatry. ISSN 0803-9488. 80(6), p. 366–374. doi: 10.1080/08039488.2026.2694659. Full text in Research Archive Show summary

  Purpose The aim of this study was to examine trends in sexual harassment victimization and possible changes in the association between sexual harassment victimization and depressive symptoms among adolescents (aged 16–19) in Norway between 2017 and 2023. Methods This study used cross-sectional data from the national Ungdata Survey conducted in upper secondary schools in Norway from 2017 to 2023 (total N = 229 417). Descriptive analyses and chi-square tests were used to examine changes in sexual harassment victimization across years by gender and age. Logistic regression analyses were used to study temporal trends and potential changes in the association between sexual harassment victimization and depressive symptoms. Results The prevalence of any sexual harassment victimization increased significantly among adolescents between 2017 and 2023. Girls reported a higher prevalence of all forms of sexual harassment victimization than boys. When studying the genders separately, the increase in exposure over time was statistically significant only among girls. Sexual harassment victimization was significantly associated with depressive symptoms in all years for both boys and girls. The strength of this association was generally higher among boys than among girls, and this gender difference became more pronounced between 2017 and 2023. Conclusions Our findings indicate a significant increase in sexual harassment victimization among girls between 2017 and 2023. Although girls are more frequently exposed to sexual harassment than boys, the association with depressive symptoms tends to be stronger among boys, and this difference appears to increase over time.

• Amayra, Tannoubi,; Bonsaksen, Tore & Azaiez, Fairouz, (2026). Human-AI Collaborative Lesson Design is Associated with Enhanced Student Outcomes and Planning Quality in Secondary Physical Education: A Randomized Experimental Study. Frontiers in Computer Science. 8. doi: 10.3389/fcomp.2026.1870451. Full text in Research Archive Show summary

  Artificial intelligence (AI) planning tools are emerging in physical education (PE), but evidence for their pedagogical value remains limited. This study compared three PE design conditions—AI-only, Human-only, and Hybrid—on basketball shooting performance, documented lesson-plan quality, student enjoyment, and planning efficiency in secondary school students. Ninety students (Mage = 14.7 ± 1.2 years; 50% girls) were randomly allocated to three groups (n = 30 each) and completed a six-session basketball shooting unit. All sessions were delivered by the same certified PE teacher. Primary outcomes were shooting accuracy (/30), while secondary outcomes included documented planning quality (Assessing Quality Teaching Rubrics; AQTR), and student enjoyment (Physical Activity Enjoyment Scale; PACES). Data were analyzed using one-way ANCOVA, Kruskal–Wallis tests, and repeated-measures ANOVA. All groups improved significantly from pre-to post-test. The Hybrid condition was associated with the largest shooting gain (d = 1.42), followed by Human-only (d = 1.01) and AI-only (d = 0.78). A significant group effect was observed, with the Hybrid condition yielding higher scores than both alternatives. Hybrid sessions achieved the highest total AQTR score, with the largest advantage on the Instructional Guidance sub-dimension. Hybrid group students showed a significantly more positive trajectory of enjoyment across the six sessions, compared to the alternatives. The Hybrid condition also required substantially less planning time than Human-only (−67%). Thus, the Hybrid condition was associated with stronger student outcomes, higher AQTR-rated documented planning quality, and lower planning time than the alternative conditions. These findings support interpreting generative AI in PE as a planning support tool within a co-design process, rather than as a substitute for pedagogical judgment.

• Skogstad, Laila; Schou-Bredal, Inger; Ekeberg, Øivind; Grimholt, Tine Kristin; Bonsaksen, Tore & Heir, Trond (2026). Lifetime exposure to bullying and its association with health status and quality of life in the general Norwegian population: a cross-sectional study. Frontiers in Public Health. 14. doi: 10.3389/fpubh.2026.1811310. Full text in Research Archive Show summary

  Background: Bullying may have a considerable negative impact on health and well-being. Nevertheless, there is a lack of studies investigating exposure to bullying in the general population. Thus, we aimed to assess the prevalence of lifetime exposure to bullying in the adult Norwegian population and to compare health-related quality of life (HRQoL), and physical and psychological health problems between bullied and non-bullied.Methods: We measured lifetime exposure to bullying in the general Norwegian population using a self-report questionnaire. The study was part of a cross-sectional national health survey (n = 1733) conducted in 2014–2015, to which a probability sample of people in the general population was recruited. Reports on socio-demographic data, HRQoL and a wide range of mental and somatic health problems provided the basis for a comparison of those who were bullied with those who were not. Chi square tests and logistic regression analyses were used to assess associations with lifetime exposure to bullying.Results: Across age groups, 28.2% reported exposure to bullying during their lifespan. Adjusted for other variables, the odds of bullying were higher in younger age groups, for those who lived as singles, and for those who were not working or in education. Respondents who had been bullied reported more mental problems such as depression, anxiety, insomnia, eating disorder, psychosis, self-harm, and suicide attempts, and they had lower HRQoL. They also reported more chronic pain, fibromyalgia, rheumatoid arthritis, diabetes mellitus, obesity, and musculoskeletal-, respiratory- and gastrointestinal diseases than people who had not been exposed to bullying.Conclusion: Bullying is common in the general Norwegian population, where more than a quarter of respondents had experienced exposure to bullying during their lifespan. Substantial more mental and somatic health problems among those exposed to bullying require a broad effort against bullying in central arenas in society.

• Hiba, Boughanmi,; Ben, Lakhal, Tarek; Amayra, Tannoubi,; Bonsaksen, Tore; H., Alliheibi, Abdullah & Fairouz, Azaiez, (2026). Spiritual well-being and daily spiritual experiences as protective factors against academic burnout among physical education students in Arabic-speaking universities. Discover Psychology. 6. doi: 10.1007/s44202-026-00665-z. Full text in Research Archive Show summary

  This study examined how spiritual well-being and daily spiritual experiences are associated with burnout dimensions among physical education and sport students. A cross-sectional analytical design recruited 1,000 participants (516 females, 484 males; mean age 24.21 ± 4.52 years) across bachelor’s, master’s, and doctoral programs. The sample comprised 513 bachelor’s, 335 master’s, and 152 doctoral students pursuing degrees in physical education and sport. Validated instruments comprised the Spiritual Well-Being Scale (SWBS), Daily Spiritual Experience Scale (DSES), and Maslach Burnout Inventory-Student Survey (MBI-SS). Hierarchical multiple regression analysis investigated predictive correlations between spiritual qualities and burnout components. Psychometric validation demonstrated exceptional internal consistency among instruments (α = 0.877–0.934). Daily spiritual experiences exhibited the most significant correlation with cynicism, indicating a momentary protective aspect. There were strong negative associations between spiritual measures and maladaptive burnout aspects. For example, emotional tiredness was linked to daily spiritual experiences (r=-0.785, p < 0.001), existential well-being (r=-0.745, p < 0.001), and religious well-being (r=-0.651, p < 0.001). Cynicism had similar negative correlations (r=-0.695 to -0.621, all p < 0.001). Academic efficacy exhibited strong positive correlation with religious well-being (r = 0.742, p < 0.001). Hierarchical regression models achieved substantial explanatory capacity: spiritual variables accounted for 71.7% of emotional exhaustion variance, 58.2% of cynicism variance, and 71.4% of academic efficacy variance. Spiritual well-being dimensions and daily spiritual experiences function are associated with lower levels of academic burnout among physical education students in Arabic-speaking countries. Religious well-being emerged as the primary predictor of academic efficacy, while daily spiritual experiences demonstrated strong inverse associations with burnout dimensions. These findings establish empirical foundations for spiritual integrated suggesting that spiritual well-being showed a strong association with in academic efficacy.

• Redzovic, Skender Elez; Moloudi, Mehdi & Bonsaksen, Tore (2026). Influence of mental health and physical activity on memory complaints in older adults: results from the HUNT study. BMC Geriatrics. 26(1). doi: 10.1186/s12877-026-07015-7. Full text in Research Archive Show summary

  Background Subjective memory impairment, including short-term (STM) and long-term (LTM) memory complaints, is common in older adults and may signal underlying cognitive decline. Good mental health (MH) and physical activity (PA) have been associated with better cognitive functioning and reduced risk of memory problems, yet their relationships with self-reported memory complaints remain ambiguous. Additionally, the impact of mid-adulthood MH and PA on later-life memory complaints is not well understood. Few large-scale population-based studies have examined these associations longitudinally. Aim This population-based study has two primary aims: (a) to examine the concurrent associations between self-reported MH, PA, and subjective memory complaints in older adults, and (b) to investigate the longitudinal associations between mid-adulthood MH and PA and memory complaints 11 years later, with both analyses controlling for demographic factors. Methods This mixed cross-sectional and longitudinal study used data from the third (2006–2008) and the fourth (2017–2019) waves of the HUNT Study in Norway. Subjective self-reported STM and LTM complaints were measured by the nine-item Meta-Memory Questionnaire. The sample included 9,226 and 6,986 healthy participants from the HUNT3 and HUNT4 waves, respectively, who completed the questionnaire and were aged 60 or above by HUNT4. Independent t-tests, ANOVAs and linear regression analysis were used to examine group differences and associations between PA, MH, and memory complaints. Results While individuals with lower levels of PA had more STM complaints in both HUNT3 and HUNT4, these associations did not hold after adjustment for sociodemographic and mental health-related variables. However, male gender and MH problems – in particular depressive symptoms – were found to be related to LTM and STM complaints, concurrently and in part longitudinally. Conclusion Male gender and MH - particularly depressive symptoms—emerged as consistently associated with both STM and LTM complaints in older adults, both concurrently and, to an extent, over time. Although PA initially appeared related to memory complaints, this association weakened after accounting for MH and sociodemographic factors. These findings highlight MH as a key modifiable factor in addressing memory complaints in aging. Future research should clarify the causal mechanisms linking depressive symptoms and subjective memory complaints.

• Mariem, Zaibi,; Amayra, Tannoubi,; Bonsaksen, Tore; Elvis, Hagan, John; Medina, Srem-Sai, & H., Allihebi, Abdullah [Show all 8 contributors for this article] (2026). Psychometric validation and gender invariance of the Arabic Athlete Burnout Questionnaire among Tunisian handball players. Discover Psychology. doi: 10.1007/s44202-026-00619-5. Full text in Research Archive Show summary

  Athlete burnout has been a real problem in the sport context. It has been defined as a syndrome that contains three dimensions: emotional and physical exhaustion, sport devaluation, and reduced sense of accomplishment. Thus, to assess burnout among Arab athletes, the need for a validated version of a suitable scale seems essential. The aim of this study was to validate an Arabic version of the Athlete Burnout Questionnaire (ABQ) and to assess its construct validity, reliability, and gender invariance. Following a rigorous cross-cultural adaptation process, 500 Tunisian handball players from 37 teams (298 males and 202 females) with ages ranging from 18 to 26 years (M = 22.67, SD = 3.64) participated in this study. The athletes were asked to fill in basic sociodemographic information and the Arabic version of the ABQ. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to assess the factorial structure, reliability, sensitivity, and validity of the Arabic ABQ. The CFA revealed excellent fit indices (x2(46) = 147.152; x2/df = 1.98; p < 0.05; CFI = 0.984, TLI = 0.978, AGFI = 0.904, RMSEA = 0.057, GFI = 0.941) for the three-factor solution. Cronbach’s alpha showed high internal consistency for all three dimensions (Physical and Emotional Exhaustion (PEE) = 0.916; Devaluation of Sports Practice (DSP) = 0.982; Reduced Sense of Achievement (RSA) = 0.909). The results of the measurement invariance analysis of the A-ABQ scale demonstrated robust invariance between male and female athletes. The results of the Arabic version of the athlete burnout questionnaire proved that the scale is a valid and reliable tool for assessing burnout among Tunisian handball players, filling a critical gap in sport psychology resources for Arabic-speaking populations.

• Amayra, Tannoubi,; Ibrahim, Ouergui,; Bonsaksen, Tore; Medina, Srem-Sai,; Elvis, Hagan Jnr., John & Edi, Setiawan, [Show all 7 contributors for this article] (2026). Comparing E-Quizzes (Trivia Maker™) and Paper-based Tests on Cognitive Load, Usability, and Performance Outcomes among University Students. Frontiers in Education. 11. doi: 10.3389/feduc.2026.1780194. Full text in Research Archive Show summary

  Background: Digital educational platforms have gained notable traction as assessment tools alongside traditional methods. These different assessment tools may impact on several educational and psychological variables. This study investigated the effects of two evaluation modalities, namely Electronic-Quizzes and Paper-Pencil, on cognitive load, usability perception, and performance outcomes among university students. Methods: In a quasi-experimental pre/post-test study design with two intact classes was employed. Ninety-four (94) undergraduate students (age: 23±1.6 years) were allocated by class to an Electronic-Quiz group (E-quiz, n=47; male=42%; female=58%) or a Paper-Pencil group (PP, n=47; male= 53%; female= 47). Before and after 8-weeks, students completed identical performance-based quizzes and evaluated their cognitive load using the Cognitive Load Scale (CLS), comprising three dimensions: Intrinsic load (IL), Extraneous Load (EL), and Germane Load (GL), as well as their perception of usability (System Usability Scale, SUS). Results: Mixed-model ANOVA revealed significant Time x Group interactions for most primary outcomes. For GL, the E-quiz group showed a large within-group gain (d = 1.40), while the PP group showed negligible change (d = 0.15); between-group post-test difference was medium (d = 0.67, ?p² = 0.256). For SUS, the E-quiz group demonstrated large improvement (d = 0.96) compared to PP (d = 0.17), with a medium between-group effect (d = 0.66, ?p² = 0.516). For performance, the E-quiz group exhibited a very large within-group gain (d = 1.71), whereas the PP group showed negligible change (d = 0.05); the post-test between-group difference was large (d = 1.82, ?p² = 0.623). IL increased only in the E-quiz group (d = 1.15, ?p² = 0.203), while both groups showed comparable increases in EL (?p² = 0.030, ns). Conclusions: In this sample, E-quizzes were associated with larger gains in germane load, perceived usability, and academic performance than paper-based tests, and uniquely elevated perceived intrinsic complexity. These findings align with cognitive load theory predictions regarding the potential role of digital assessment design in supporting germane processing, though the mechanisms remain hypothetical and warrant further investigation. Well-designed digital assessment tools may merit consideration for integration in higher education, contingent on careful design to minimize extraneous load.

• Hilmi, Jelleli,; Nashwan, Nashwan,; Omar, Hindawi,; Ben, Aissa, Mohamed; Mahmoud, Rebhi, & Wiem, Melki, [Show all 9 contributors for this article] (2025). Validation of the arabic multidimensional facebook intensity scale and its relationships with life satisfaction, happiness, and physical activity. Physical Activity and Nutrition. 29(4), p. 1–14. doi: 10.20463/pan.2025.0029. Full text in Research Archive Show summary

  Purpose Despite Facebook’s widespread use in Arab countries, validated Arabic tools to assess the intensity of its use and related psychological and behavioral outcomes are lacking. This study aims to validate the Arabic version of the Multidimensional Facebook Intensity Scale (A-MFIS) and examine its associations with life satisfaction, happiness, and physical activity in a large Tunisian adult sample. Methods A cross-sectional online survey was conducted with 1,068 adults. The survey included sociodemographic questions, the A-MFIS, the Arabic Satisfaction with Life Scale (ASWLS), the Arabic Scale of Happiness (ASH), and the International Physical Activity Questionnaire (IPAQ). The sample was randomly split into an exploratory group and a confirmatory group. Exploratory and confirmatory factor analyses were used to assess the factorial structure, internal consistency, and construct validity of the A-MFIS. Results Analyses supported a second-order model with four factors and 13 items, showing acceptable model fit. The A-MFIS demonstrated strong internal consistency and construct validity. Significant negative correlations were found between Facebook intensity and life satisfaction, happiness, and physical activity levels. Conclusion The A-MFIS is a reliable and valid tool for assessing Facebook use intensity in Arabic-speaking contexts. It can facilitate future research, clinical assessments, and interventions aimed at improving digital well-being. Future studies should explore its applicability in other Arab cultures and longitudinal settings. This validated instrument provides researchers and practitioners in Arabic-speaking populations with a culturally appropriate tool to assess Facebook usage intensity, enabling future research and interventions on digital well-being.

• Bonsaksen, Tore; Moen, Geir; Hansen, Tone & Baklien, Børge (2025). Pilotstudie av EQUAL-modellen: En modell for arbeidsforberedende trening blant unge med nedsatt arbeidsevne. Fontene forskning. ISSN 1890-9868. 18(2), p. 46–60. Full text in Research Archive Show summary

  En betydelig andel unge voksne står utenfor arbeidsliv og utdanning. Det er behov for nye metoder og praksisformer som kan hjelpe unge i denne situasjonen. Artikkelen beskriver en pilotstudie av EQUAL-modellen, som i denne studien er brukt i forbindelse med arbeidsforberedende trening blant unge. Problemstillingen for studien er: Kan EQUAL-modellen forbedre arbeidsforberedende trening for unge som står utenfor arbeid og utdanning, og hvilke erfaringer har arbeidsveiledere med modellen? Det ble utviklet et multi-methods-design med bruk av spørreskjemaer og intervjuer. Av 131 forespurte personer, som i 2024 deltok i relevante tiltak, valgte 35 personer (26,7 prosent) å delta i prosjektet. 23 personer deltok i oppfølgingsundersøkelsen tre måneder etter oppstart, mens åtte arbeidsveiledere ble intervjuet i grupper om sine erfaringer. Blant deltakerne samlet var det en økning i livskvalitet gjennom oppfølgingsperioden. Deltakere på EQUAL-baserte tiltak hadde lavere arbeidsmotivasjon enn andre deltakere ved oppstart og økte sin motivasjon i løpet av oppfølgingsperioden, mens deltakere i kontrollgruppen hadde høy og uendret arbeidsmotivasjon gjennom oppfølgingsperioden. Arbeidsveiledere tematiserte bruken av EQUAL-modellen, forholdet mellom arbeid og livskvalitet, og betydningen av gode relasjoner. Pilotstudien antyder at arbeidsforberedende trening med EQUAL-modellen som rettesnor kan ha en positiv betydning for deltakernes arbeidsmotivasjon og livskvalitet.

• Bonsaksen, Tore (2025). Loneliness and Social Media Use: Do Motives for Using Social Media Matter? In Nelson, Todd (Eds.), The Handbook of Loneliness. Springer. ISSN 9783032029584. p. 363–376. doi: 10.1007/978-3-032-02959-1_23. Full text in Research Archive Show summary

  This chapter focuses on people’s motives for using social media in relation to loneliness. Based on a review of the relevant literature, a typology of motives for social media use is developed consisting of four main categories: interpersonal connection, compensation, entertainment and escape, and self-expression and self-promotion. Research findings connecting these motives to loneliness are reviewed and interpreted. While studies are still relatively few in numbers, and longitudinal studies mostly lacking, it appears that using social media for interpersonal connection can have different outcomes for different people. For those who already have sufficient relationships, social media can be a platform for communicating with them, and thereby prevent or reduce loneliness. For those who have insufficient real-life relationships, turning to social media as a compensatory strategy may rather increase their loneliness. While less evidence concerns the entertainment/escape and self-expression/self-promotion motives, some studies suggest that such motives can be related to higher loneliness. Awareness of one’s motives for using social media may help individuals use them with most benefit, and avoid using them when their goals can be more effectively pursued by other means.

• Kleppang, Annette Løvheim; Hagquist, Curt; Stea, Tonje Holte; Leonhardt, Marja; Bonsaksen, Tore & Lien, Lars [Show all 7 contributors for this article] (2025). Social media use, gaming and quality of life among adolescents in Norway: results from the Young-HUNT study. Health and Quality of Life Outcomes. 23(1). doi: 10.1186/s12955-025-02428-1. Full text in Research Archive Show summary

  Abstract Background The use of screens, especially mobile devices like tablets and smartphones has increased over the last years and have become an integral to daily life. Adolescents today spend a lot of time using screens both at school and outside school. Identifying possible associations between gaming, social media use and quality of life (QoL) may inform the development of public health guidelines targeting adolescent behaviour. The purpose of this study is to examine the association between gaming, social media use and quality of life (QoL) among adolescents, and whether sex, spending time with friends or psychological distress moderate these associations. Methods This study was based on cross-sectional data from the Trøndelag Health study (Young-Hunt4), collected in 2017–2019. The target group comprised 8066 adolescents (13–19 years). QoL was measured with the Norwegian version of the Inventory of Life Quality (ILC). Electronic media use was measured using the two variables social media use and gaming. Multiple linear regression was used to analyse the association between social media use, gaming, and QoL. Results Results showed a negative association between gaming (> 3 h per day) after school and quality of life (b = -0.26) and social media use (> 3 h per day) after school and quality of life (b = -0.20). Similar negative associations were observed between more time spent on gaming (> 3 h per day) during weekends and quality of life (b = -0.33) and more time spent on social media (> 3 h per day) during weekends and quality of life (b = -0.16). An interaction effect was observed between sex and social media use (after school), between sex and gaming (after school and during weekends), and between psychological distress and gaming during weekends. Conclusions More than three hours spent on gaming or social media per day, both during weekdays and weekends, was negatively associated with QoL. Sex moderated these associations; however, for social media use this was shown only after school. Additional research is needed to further explore these associations.

• Edvardsen, Even Elias; Bonsaksen, Tore; Horghagen, Sissel; Arntzen, Cathrine; Sveen, Unni & Gramstad, Astrid [Show all 8 contributors for this article] (2025). Fieldwork supervision, motivation and competency among Norwegian community-based occupational therapists. Journal of Occupational Therapy Education. 9(4). doi: 10.26681/jote.2025.090417. Full text in Research Archive Show summary

  Occupational therapists’ supervision of students remains a critical component during occupational therapy education. This study aimed to examine supervision practice, motivation, and competency among community-based occupational therapists in Norway, exploring organizational and personal factors associated with formal and perceived supervision competency, willingness to serve as fieldwork educators, and collaboration with educational institutions. A cross-sectional survey was distributed among occupational therapists in community-based practice in Norway. A total of 617 occupational therapists participated in the study. Free-text responses were thematically analyzed and interpreted. Differences between fieldwork educators and non-fieldwork educators’ training, recency of being fieldwork educators, willingness to assume the role as fieldwork educator, formal supervision training and perceived supervision competency were examined with independent t-tests and Chi Square tests. Four multivariate logistic regression analyses were conducted to assess factors associated with serving as a fieldwork educator. The study found that lower age and working alongside other occupational therapists were associated with higher likelihood of being a fieldwork educator the preceding year. Higher motivation for being a fieldwork educator was associated with lower age. Formalized supervision competency was associated with higher age, further education, and longer work experience, while self-perceived supervision competency was associated with more work experience and working alongside other occupational therapists. The thematic analysis showed that there is a need for more support among fieldwork educators and for further developing the collaboration between fieldwork educators and educational institutions.

• Bonsaksen, Tore; Price, Daicia; Lamph, Gary; Kabelenga, Isaac & Geirdal, Amy Østertun (2025). Sleep problems were unrelated to social media use in the late COVID-19 pandemic phase: A cross-national study. PLOS ONE. 20(1), p. e0318507–e0318507. doi: 10.1371/journal.pone.0318507. Full text in Research Archive Show summary

  Sleep problems are commonly related to stress and mental health problems. However, social media use has become widespread in the general population during recent years, and their addictive potential may influence people’s sleep routine. In addition, the COVID-19 pandemic gave rise to substantial mental health problems in the population, and restrictions in social life gave social media a unique position as means for both entertainment and interpersonal contact. The aim of the study was to examine sleep problems in relationship to social media use in a cross-national sample two years after the COVID-19 outbreak. Participants were 1405 adults from four countries who completed a cross-sectional online survey. The data were analyzed with independent samples t-tests, Chi Squared tests of independence, and single and multivariable logistic regression analyses. Of the 858 (61.1%) participants who reported sleep problems during the past weeks, a substantial proportion (n = 353, 41.1%) related their sleep problems to their experience with COVID-19. With adjustments for age, gender, employment, and psychological distress, more hours of daily social media use was not significantly associated with sleep problems. However, higher age (OR: 1.13, p = 0.01), female gender (OR: 1.69, p<0.001), having employment (OR: 1.34, p = 0.04), and higher levels of psychological distress (OR: 1.20, p<0.001) were independently associated with sleep problems. While the debate about the pros and cons of social media use continue, this study suggests that higher levels of social media use was not of great concern for people’s sleep quality in the late COVID-19 pandemic phase. However, other aspects of social media use (eg, time of the day, content of interactions, associated stress experience) may be more relevant for understanding sleep problems and may be taken into consideration for people who experience such problems.

• Tannoubi, Amayra; Bonsaksen, Tore; Mørk, Gry; Ahmedov, Farruh; Setiawan, Edi & Azaiez, Fairouz (2025). Engagement factors affect academic success through study approaches among physical education and sport university students: a mediation analysis. Frontiers in Education. 10. doi: 10.3389/feduc.2025.1512557. Full text in Research Archive Show summary

  Introduction University students should engage with the study and ensure they adopt productive study approaches, but the nature of relationships between engagement and study approaches are under-researched. The study aimed to investigate how emotional, cognitive, and behavioral engagement affect academic success through study approaches among physical education and sports students. Methods Online forms were submitted by 488 students in physical education and sports (age range 19–25 years, Mean = 21 ± 1.5 year). They completed surveys regarding their academic engagement, study approaches, and grade point average (GPA). Analyses of associations were conducted through linear regression analysis and mediation analysis. Results Results from the linear regression analysis showed correlations between academic engagement factors, study approach variables, and GPA, with higher GPA correlating with higher scores on behavioral engagement, cognitive engagement, surface theory task, and deep theory task, and with lower scores on surface practical task. The analysis of total and direct effects revealed positive associations between all academic engagement factors and GPA. Emotional engagement exhibited a positive association with GPA mediated by study approaches. All engagement dimensions appear to influence academic success among these students. Conclusion The influence of emotional engagement on academic success appears in part to be operating through its effects on study approaches. The study can enable educators in monitoring and enhancing student engagement, thereby supporting students in their pursuit of high academic performance in physical education and sport.

• Redzovic, Skender Elez; Johansen, Ingvill Jeanette Hektoen & Bonsaksen, Tore (2025). Profiling adolescent participation in wildlife activities and its implications on mental health: evidence from the Young-HUNT study in Norway. Frontiers in Public Health. 13. doi: 10.3389/fpubh.2025.1517089. Full text in Research Archive Show summary

  Background: Adolescent mental health challenges are on the rise globally, and Norway is no exception. Wildlife activities (WAs) have been increasingly promoted as a potential measure to improve adolescent well-being. However, there is limited research on the extent of adolescent participation in these activities and its association with mental distress among Norwegian adolescents. Aim: This study has a twofold aim: to explore the degree of adolescent participation in WAs and to examine the association between this participation and mental distress. Methods: The study design was cross-sectional, using Young-HUNT data from Norway collected between 2017 and 2019. A total of 6,361 participants were included in the final sample. Participants were categorized based on their level of participation in WAs, and ordinal regression analysis was conducted to assess factors associated with their level of wildlife activity. Furthermore, multivariate linear regression analysis assessed the association between wildlife activity and mental distress. Results: The majority of participants reported low levels (34.6%) or medium levels (53.2%) of engagement in WAs. Adjusted analyses showed that higher levels of participation in WAs were associated with a range of factors, particularly female sex, having both parents born in Norway, and maintaining a medium or high level of physical activity. A weak yet statistically significant relationship was identified between higher levels of wildlife activity and increased mental distress among the participants. Conclusion: Various sociodemographic, lifestyle, and social factors influence the involvement in WAs. The observed weak but significant association between higher participation in WAs, and increased mental distress raises questions about the assumption that nature and WAs are universally beneficial for adolescent mental health. These results highlight the need for further research to explore the underlying mechanisms of this relationship. These findings also caution policymakers against making generalized claims about the mental health benefits of WAs without a deeper consideration of individual and contextual factors.

• Breen-Franklin, Adele; Maher, Colleen M. & Bonsaksen, Tore (2025). Work Readiness among Occupational Therapy Students in the USA: Associations with Approaches to Studying. Journal of Occupational Therapy Education. 9(3). Full text in Research Archive Show summary

  Previous studies have looked at the association between study approaches and student grades with a focus on deep, strategic, and surface learning. This study used a cross-sectional design to examine the association between study approaches and students’ feelings of readiness to practice. Thirty-five students in master’s and clinical doctoral programs completed the Work Readiness Scale and the short 18-item version of the Approaches and Study Skills Inventory for Students (ASSIST). Using a linear regression analysis, higher scores on the strategic study approach (β=0.38, p<0.05) and lower scores on the surface study approach (β=-0.44, p<0.05) were associated with higher scores on the Work Readiness Scale. Studying harder (i.e. spending more hours studying) was not related to feeling ready to practice. Rather, studying wisely, meaning using a strategic approach to studying and avoiding using a surface approach, was associated with students’ increased feeling of readiness to practice.

• Grimholt, Tine Kristin; Gjesdal, Ola; Bonsaksen, Tore; Heir, Trond; Ekeberg, Øivind & Schou-Bredal, Inger [Show all 8 contributors for this article] (2025). Posttraumatic stress disorder symptoms in adults with congenital heart disease (ACHD) during the COVID-19 pandemic in Norway. International Journal of Cardiology Congenital Heart Disease. 20. doi: 10.1016/j.ijcchd.2025.100585. Full text in Research Archive Show summary

  The aims were to study symptom defined post-traumatic stress disorder, self-assessed anxiety and depression, and concerns about COVID19 in Norwegian adults with congenital heart disease compared to the general population during the COVID-19 pandemic. Further, the aim was to compare simple vs. complex CHD on these measures.

• Boussayala, Ghada; Tannoubi, Amayra; Hagan, John Elvis; Amouadu, Mustapha; Srem-Sai, Medina & Bonsaksen, Tore [Show all 10 contributors for this article] (2025). Is It Time to Address Burnout in the Military? Initial Psychometric Validation of the Maslach Burnout Inventory Among Tunisian Military Personnel (A-MBI-MP). Behavioral Sciences. 15(3). doi: 10.3390/bs15030385. Full text in Research Archive Show summary

  The military’s high-pressure environment can lead to burnout syndrome, characterized by emotional fatigue, depersonalization, and decreased personal accomplishment. Validating a culturally appropriate tool for assessing burnout among military personnel is crucial for early detection and intervention. This study assessed the psychometric properties of the Arabic version of the Maslach Burnout Inventory (MBI) and its validity among Tunisian military personnel. A validation study was conducted among 520 Tunisian military personnel (mean age = 36 ± 9.3 years; male (n = 486) and female (n = 34)), including commandos, pilots, and divers. The Arabic version of the Maslach Burnout Inventory MBI-HSS was administered, including participants’ sociodemographic characteristics. The exploratory (EFA) and confirmatory (CFA) factor analyses were performed to identify the factor structure, with assessments of the internal consistency of the model. The factor analysis confirmed the three-factor model of burnout: emotional exhaustion, depersonalization, and personal accomplishment consistent with the original MBI. The A-MBI-MP demonstrated strong internal consistency, with Cronbach’s alpha values exceeding 0.8 for all subscales. The test–retest reliability was also excellent, confirming the stability of the instrument. The CFA validated the three-factor structure of the A-MBI-MP. The fit indices demonstrated an acceptable model fit: Comparative Fit Index (CFI) = 0.949, Tucker–Lewis Index (TLI) = 0.943, and Root Mean Square Error of Approximation (RMSEA) = 0.0742 (95% CI: 0.068–0.0797). These results validate the reliability of the A-MBI-MP in assessing burnout in the military context. The Arabic version of the Maslach Burnout Inventory (A-MBI-MP) is a valid and reliable tool for assessing burnout among Tunisian military personnel. The validated instrument can be used to offer early treatments and to promote the mental health of military personnel in high-stress situations.

• Stea, Tonje Holte; Bonsaksen, Tore; Smith, Pierre; Kleppang, Annette Løvheim; Steigen, Anne Mari & Leonhardt, Marja [Show all 8 contributors for this article] (2024). Are social pressure, bullying and low social support associated with depressive symptoms, self-harm and self-directed violence among adolescents? A cross-sectional study using a structural equation modeling approach. BMC Psychiatry. 24(1). doi: 10.1186/s12888-024-05696-1. Full text in Research Archive Show summary

  Background: More in-depth evidence about the complex relationships between different risk factors and mental health among adolescents has been warranted. Thus, the aim of the study was to examine the direct and indirect effects of experiencing social pressure, bullying, and low social support on mental health problems in adolescence. Methods: A school-based cross-sectional study was conducted in 2022 among 15 823 Norwegian adolescents, aged 13–19 years. Structural Equation Modelling was used to assess the relationships between socioeconomic status, social pressure, bullying, social support, depressive symptoms, self-harm and suicide thoughts. Results: Poor family economy and low parental education were associated with high pressure, low parental support and depressive symptoms in males and females. Moreover, poor family economy was associated with bullying perpetration and bullying victimization among males and females, and cyberbullying victimization among females, but not males. Low parental education was associated with bullying victimization among males, but not females. Further, high social pressure was associated with depressive symptoms among males and females, whereas high social pressure was linked to self-harm and suicide thoughts among females, but not males. Bullying victimization and cyberbullying victimization were associated with depressive symptoms, self-harm, and suicide thoughts among males and females. Bullying victimization was associated with depressive symptoms among males, but not females, whereas bullying perpetration was linked to self-harm and suicide thoughts among females, but not males. Low parental support was associated with bullying perpetration, bullying victimization, depressive symptoms, self-harm and suicide thoughts among males and females, whereas low parental support was associated with high social pressure among females, but not males. Low teacher support was associated with high social pressure and depressive symptoms. Low support from friends was associated with bullying victimization, depressive symptoms and suicide thoughts among males and females, whereas low support from friends was linked to self-harm among males, but not females. Finally, results showed that depressive symptoms were associated with self-harm and suicide thoughts among males and females. Conclusion: Low socioeconomic status, social pressure, bullying and low social support were directly and indirectly associated with depressive symptoms and self-directed violence among Norwegian adolescents.

• Mørk, Gry; Johnson, Susanne Grødem; Gramstad, Astrid; Stigen, Linda; Carstensen, Tove & Bonsaksen, Tore (2024). Associations Between Learning Environment and Study Satisfaction Across Time: Two Cross-Sectional Analyses of Occupational Therapy Students. The Open Journal of Occupational Therapy. 12(2), p. 1–9. doi: 10.15453/2168-6408.2214. Full text in Research Archive Show summary

  There is increasing attention toward students’ satisfaction and how they perceive the quality of the program they attend. This study examined stability and change across time with regard to the relationships between learning environment factors and occupational therapy students’ satisfaction with the program. In the two consecutive cross-sectional analyses performed in this study, 163 second-year students and 193 third-year students from all six occupational therapy education programs in Norway participated. The Course Experience Questionnaire was used to assess learning environment factors and study satisfaction. The data were analyzed with Pearson’s correlation coefficient r and with hierarchical linear regression. Bivariate associations between the learning environment scales were positive and most associations were statistically significant in both study years. Relatively stable associations between the learning environment variable “good teaching” and higher study satisfaction were detected, while other associations differed between years of study. Embedding quality into the learning process, in particular by emphasizing good teaching and the clear dissemination of goals and standards, is important for student satisfaction throughout years of study.

• Tannoubi, Amayra; Mørk, Gry; Stigen, Linda; Gramstad, Astrid; Magne, Trine A & Carstensen, Tove [Show all 7 contributors for this article] (2024). Occupational Therapy students’ Concepts of Learning: Cross-Sectional and Longitudinal Associations With Deep, Strategic, and Surface Study Approaches. Occupational Therapy in Health Care. ISSN 0738-0577. doi: 10.1080/07380577.2024.2325073. Full text in Research Archive Show summary

  This study aimed to gain knowledge about the cross-sectional and longitudinal associations between learning concepts and approaches to studying among occupational therapy students. A repeated cross-sectional design was combined with a longitudinal study design. Self-report questionnaires assessed sociodemographic variables, learning concepts, and approaches to studying (deep/strategic/surface). Linear regression analyses (n ranging between 109 and 193 in the analyses) showed that higher transforming concept ratings were consistently associated with higher ratings on the deep study approach, both cross-sectionally and longitudinally. Higher reproducing concept ratings were positively associated with higher strategic approach ratings in the second and third study years. In view of the results, students’ understanding of what learning is impacts on their study attitudes and behaviors, which in turn is likely to influence learning outcomes and academic performance.

• Horghagen, Sissel; Bonsaksen, Tore; Arntzen, Cathrine; Maass, Ruca Elisa Katrin; Sveen, Unni & Hustoft, Merethe [Show all 7 contributors for this article] (2024). Community-Working Occupational Therapists’ Involvement in Research and Development Projects in Norway. Occupational Therapy in Health Care. ISSN 0738-0577. doi: 10.1080/07380577.2024.2364178. Full text in Research Archive Show summary

  The aim of this study was to explore community-working occupational therapists’ involvement in research and development projects. A cross-sectional survey of occupational therapists working in community-based services in Norway (n = 617) was conducted. In all, 117 of the 617 participants responded that they were involved in research and development projects. Greater likelihood of participation in research and development work were found for occupational therapists who had completed further education. Current and prioritized research topics were professional development and the development of interprofessional and professional service designs for occupational therapy. Service and quality development, rehabilitation and technology were areas where more knowledge was considered needed. To increase the growth and success of occupational therapy research and development, it is important that more occupational therapists in the municipality continue to complete further education. High-quality occupational therapy practice should be based on research and development projects in the municipalities.

• Grimholt, Tine Kristin; Bonsaksen, Tore; Heir, Trond; Schou-Bredal, Inger; Skogstad, Laila & Ekeberg, Øivind (2024). Prevalence of suicide attempt and associations with deliberate self-harm, mental health problems, drug misuse and traumatic experiences - a cross sectional survey of the Norwegian population. BMC Psychiatry. 24(1). doi: 10.1186/s12888-024-05610-9. Full text in Research Archive Show summary

  Background: Monitoring self-reported suicide attempts (SA) with nationally representative surveys is important to initiate suicide prevention strategies. The aim of the study was to assess the prevalence of SA and compare deliberate self-harm, (DSH), mental health, drug misuse and traumas between SA and non-suicide attempters (NSA). Methods: In this cross-sectional survey of a representative sample (N=1757) of the Norwegian population, we compared people with self-reported SA (n=54) to NSA (n=1703) regarding sociodemographic data, mental health problems, drug misuse and exposure to trauma. Results: The prevalence of SA was 3.1 %. There was a higher proportion of welfare recipients and more deliberate selfharm, mental health problems, drug misuse and traumas in the SA group compared to NSA. Conclusion: This national study confrms the association between suicide attempt and deliberate self-harm, mental health problems, drug misuse and traumas.

• Ragnhildsløkken, Hege; Bonsaksen, Tore; Aakhus, Eivind; Kabelenga, Isaac; Lamph, Gary & Price, Daicia [Show all 7 contributors for this article] (2024). Social Media Use and Associations with Psychological Distress Among Older Adults During the COVID-19 Pandemic. Social Sciences. 13(12). doi: 10.3390/socsci13120634. Full text in Research Archive Show summary

  Social media may have the double potential to support and undermine mental health, and research is needed to investigate these relationships in age-specified populations. The purpose of this study was to investigate associations between the use of social media and psychological distress among older adults (60 years and above) both nine and 19 months after the outbreak of the COVID-19 pandemic. An online repeated cross-sectional survey was conducted in Australia, Norway, the United Kingdom, and the United States. Participants (9 months: n = 679; 19 months: n = 238) reported the extent of social media use, motives for using social media, and level of psychological distress using the 12-item version of the General Health Questionnaire (GHQ-12). The data were analysed with descriptive analyses, independent t-tests and multiple linear regression analyses. Time spent on social media was not associated with psychological distress. Higher psychological distress was associated with higher scores on using social media to ‘reduce loneliness’ at both measurement points. At nine months, higher psychological distress was associated with higher scores on using social media for ‘entertainment’, but the association was not statistically significant at 19 months. Psychological distress was associated with the motive to ‘maintain relationships’ at 19 months, but not at nine months. Guidance for older adults’ use of social media should emphasise how they can be used to promote communication and maintain existing relationships.

• Jelleli, Hilmi; Aissa, Mohamed Ben; Kaddech, Nabil; Saidane, Mouna; Guelmami, Noomen & Bragazzi, Nicola L. [Show all 9 contributors for this article] (2024). Examining the interplay between physical activity, problematic internet use and the negative emotional state of depression, anxiety and stress: insights from a moderated mediation path model in university students. BMC Psychology. 12(1), p. 1–13. doi: 10.1186/s40359-024-01736-3. Full text in Research Archive Show summary

  Background: The aim of this study was to investigate the relationship between Problematic Internet Use (PIU), emotional states of stress, anxiety and depression, and the practice of physical activity among Tunisian students. Methods: Cross-sectional data were collected from 976 university students aged 20.76 ± 1.63 years (46.8% female). They filled out an online survey comprised of a socio-demographic questionnaire, the depression, anxiety and stress scale– 21 items (DASS-21), the international physical activity questionnaire (IPAQ) and the compulsive internet use scale (CIUS). Students were divided, based on their economic levels, into three groups: low (n = 256, 26.23%), medium (n = 523, 53.59%) and high (n = 197, 20.18%). Results: Mediation analysis: Indirect effects of IPAQ and gender on DASS-21 were highlighted: β= -0.18 (p < 0.01) and β= -0.04, P < 0.01) respectively. In addition, a significant and negative effect of IPAQ on CIUS was demonstrated (β = -0.45, P < 0.01). In addition, the effect of CIUS on DASS-21 was significant (β = 0.39, P < 0.01). Also, the effect of gender on CIUS was significant (β=-0.10, P < 0.01) However, its effect on DASS-21 was not significant (β = 0.05, p = 0.078). The total effect of IPAQ on DASS21 was significant (β= -0.52, p < 0.01) but the effect of Gender on DASS-21 was not significant (β = 0.01, p = 0.817). Moderation analysis: the results showed a significant moderation effect of the interaction between IPAQ and Gender on CIUS (β = 0.07, p < 0.01). However, it was not significant between Gender and CIUS on DASS-21 (β = 0.09, p = 0.390) and between IPAQ and Gender on DASS21 (β = 0.01, p = 0.736) Also, the interaction between IPAQ and CIUS did not have a significant moderation effect on DASS-21 (β = 0.15, p = 0.115). Conclusions: Findings suggest that relationships between PIU and negative emotional state of depression, anxiety and stress are mediated via physical exercise. These results underscore the importance of the physical activity factor in the studies analyzing longitudinal effects of PIU on mental health outcomes.

• Arntzen, Cathrine; Bonsaksen, Tore; Sveen, Unni; Gramstad, Astrid; Stigen, Linda & Maass, Ruca Elisa Katrin [Show all 7 contributors for this article] (2024). Ergoterapeuter i fremtidens primærhelsetjeneste: Hva skal de løse, og for hvem? En analyse av helsepolitiske styringsdokumenter. Tidsskrift for omsorgsforskning. ISSN 2387-5976. 10(1), p. 1–20. doi: 10.18261/tfo.10.1.4. Full text in Research Archive Show summary

  Bakgrunn: Endrede politiske og organisatoriske rammebetingelser aktualiserer spørsmål om omprioriteringer, omorganiseringer, nye arenaer og nytt innhold i den kommunale ergoterapitjenesten. I studien undersøker vi hvordan ergoterapi fremstilles i helsepolitiske styringsdokumenter. Vi utforsker spesifikt hvilke roller ergoterapeuter tilskrives i fremtidens primærhelsetjeneste, og hva kommuneergoterapeuter bes om å løse for hvem. Metode: Studien har et diskursanalytisk design, og vi har valgt ut tre stortingsmeldinger og én NOU (Norges offentlige utredninger), som samlet sett representerer sentrale styringssignaler for fremtidens kommunale helse- og omsorgstjenester. Resultat: Vi finner stor variasjon i måten ergoterapi fremstilles på i styringsdokumentene. Det er i forbindelse med tverrfaglig samhandling, velferdsteknologi og proaktive borgere at ergoterapi særlig nevnes. Videre finner vi at det er innenfor tjenestediskursene proaktive tjenester og aktiv omsorg at ergoterapeutene ses på som en del av løsningen i fremtidens helsetjenester. Konklusjon: Selv om ergoterapi kobles til sentrale politiske virkemidler for fremtidens tjenesteutforming, synes ikke profesjonen å ha fått en endret posisjon eller tydeligere funksjon i de utvalgte stortingsmeldingene. Skal ergoterapi som profesjon inngå som en del av det politiske virkemiddelapparatet, kreves det mer inngående analyser og reelle diskusjoner om rekruttering og dimensjonering av ergoterapi i kommunehelsetjenesten. Det trengs en tydeligere konkretisering av hvordan ergoterapi skal organiseres, hvilke kompetanser som skal utvikles, og hvilke oppgaver som skal prioriteres i de kommunale helse- og omsorgstjenestene.

• Bonsaksen, Tore; Kleppang, Annette Løvheim & Steigen, Anne Mari (2024). Cyberbullying Among Adolescents in Norway: Time Trends and Factors Associated with Perpetration and Victimization. Behavioral Sciences. 14(11), p. 1–13. doi: 10.3390/bs14111043. Full text in Research Archive Show summary

  There is limited knowledge about time trends in cyberbullying involvement, and whereas previous studies have often focused on various mental health outcomes, possible outcomes of cyberbullying may concern a wide range of areas. A better understanding of cyberbullying development over time, as well as of the possible consequences, is needed for effective prevention and intervention efforts. The aims of this study were (i) to gain knowledge of time trends in cyberbullying among Norwegian adolescents, and (ii) to better understand how different forms of cyberbullying involvement is related to a variety of outcomes. Data from the Norwegian Ungdata surveys (2014–2016) were used to assess involvement in cyberbullying over time. Associations with cyberbullying involvement and four outcome variables (belief in a good and happy life, loneliness, school thriving, and depressive symptoms) were assessed using logistic regression analyses. Across years of study, the prevalence rates for cyberbullying involvement were 1.5% for perpetration, 3% for victimization, and 1% for perpetration-victimization. Compared with non-involvement, involvement in cyberbullying in any role was associated with poorer outcomes on all variables. Cyber-victims who were also perpetrators were less likely to have high levels of loneliness and depressive symptoms, compared to cyber-victims only. The prevalence of cyberbullying involvement among adolescents in Norway was relatively unchanged between 2014 and 2016. Cyberbullying involvement is associated with negative outcomes related to mental health, loneliness, school thriving, and beliefs in one’s personal future, and victims of cyberbullying appear to be the most vulnerable group.

• Mørk, Gry; Gramstad, Astrid; Stigen, Linda; Johnson, Susanne Grødem & Bonsaksen, Tore (2024). Profiles of Occupational Therapy Students: A Cluster Analysis. Education Sciences. 14(6). doi: 10.3390/educsci14060654. Full text in Research Archive Show summary

  While studies have examined predictors of study performance in various student groups, cluster analytic studies identify groups of students with similar characteristics. The purpose of this study was to explore relevant clusters of occupational therapy students and examine profile differences between participants in different clusters. A total of 177 first-year students from six occupational therapy programs in Norway participated in this study. Data on age, gender, study approaches, study effort, and study performance were collected. A two-step cluster analysis was conducted. Three clusters were identified. Cluster 1, the high-strategic high-performing students, comprised the successful students, mostly females, who invested much effort and used productive approaches to studying. Cluster 2, the high-surface average-performing students, consisted of less successful female students, who used poor study strategies and made little effort. Cluster 3, the low-strategic low-performing students, comprised the least successful students, who were all male, with study efforts and study strategies in the middle range. Overall, this study suggests that occupational therapy students can be classified into clusters based on a combination of measures. To enhance student learning and performance, educators should pay particular attention to male students and to students investing little effort and using poor study strategies.

• Bonsaksen, Tore; Tannoubi, Amayra; Stigen, Linda; Gramstad, Astrid; Carstensen, Tove & Mørk, Gry (2024). Study approaches mediate associations between learning environment and academic performance. Scandinavian Journal of Occupational Therapy. ISSN 1103-8128. 31(1). doi: 10.1080/11038128.2024.2385043. Full text in Research Archive Show summary

  Background While study approaches have been directly associated with students’ academic performance, learning environment factors may play a more indirect role. The aim of this study was (i) to assess learning environment factors as predictors of students’ average exam grades, and (ii) whether study approaches mediated associations between learning environment factors and exam grades. Methods Three annual surveys (2017–2019) yielded data from a total of 263 Norwegian occupational therapy students. Learning environment factors were assessed with the Course Experience Questionnaire, and the Approaches and Study Skills Inventory for Students were used to assess study approaches. Linear regression analyses and mediation analyses were performed. Results Higher levels of ‘student autonomy’ were directly associated with lower averaged grades whereas higher levels of ‘appropriate workload’ were associated with higher averaged grades. There were statistically significant total indirect effects of ‘clear goals’ and ‘appropriate workload’ on grades; these effects occurred through the study approach variables. However, all learning environment variables showed one or more relationships with academic performance that was mediated by study approach variables. Conclusion Learning environment variables appear to be complexly associated with academic performance, both directly and indirectly.

• Mørk, Gry; Larsen, Ole Sønnik Dydland; Kunnikoff, Hans Martin; Bonsaksen, Tore & Lie, Silje Stangeland (2024). Virtual Reality Simulation in Undergraduate Health Care Education Programs: Usability Study. JMIR Medical Education. 10. doi: 10.2196/56844. Full text in Research Archive Show summary

  Background: Virtual reality (VR) is increasingly being used in higher education for clinical skills training and role-playing among health care students. Using 360° videos in VR headsets, followed by peer debrief and group discussions, may strengthen students’ social and emotional learning. Objective: This study aimed to explore student-perceived usability of VR simulation in three health care education programs in Norway. Methods: Students from one university participated in a VR simulation program. Of these, students in social education (n=74), nursing (n=45), and occupational therapy (n=27) completed a questionnaire asking about their perceptions of the usability of the VR simulation and the related learning activities. Differences between groups of students were examined with Pearson chi-square tests and with 1-way ANOVA. Qualitative content analysis was used to analyze data from open-ended questions. Results: The nursing students were most satisfied with the usability of the VR simulation, while the occupational therapy students were least satisfied. The nursing students had more often prior experience from using VR technology (60%), while occupational therapy students less often had prior experience (37%). Nevertheless, high mean scores indicated that the students experienced the VR simulation and the related learning activities as very useful. The results also showed that by using realistic scenarios in VR simulation, health care students can be prepared for complex clinical situations in a safe environment. Also, group debriefing sessions are a vital part of the learning process that enhance active involvement with peers. Conclusions: VR simulation has promise and potential as a pedagogical tool in health care education, especially for training soft skills relevant for clinical practice, such as communication, decision-making, time management, and critical thinking.

• Helgøy, Kjersti Velde; Bonsaksen, Tore & Mørk, Gry (2024). Occupational therapy students’ experiences and perceptions of journal club participation. Scandinavian Journal of Occupational Therapy. ISSN 1103-8128. 31(1), p. 1–13. doi: 10.1080/11038128.2024.2328712. Full text in Research Archive Show summary

  Background: Journal clubs can be used as a learning activity for developing students’ skills in critical appraisal and are perceived as suitable for increasing students’ exposure to research methods. Aims/objectives: To explore how undergraduate occupational therapy students experienced journal club and how they perceived their learning outcomes from participating in this learning activity. Materials and methods: A mixed methods study comprised of a survey followed by two focus groups was conducted. Seventeen occupational therapy students completed the survey, four of whom also participated in a total of two focus groups. Results: The participants perceived journal clubs as suitable and they suggested that emphasis on this learning activity be increased. Across the two focus groups, four integrated themes were identified: ‘organisational prerequisites’; ‘potential for learning’; ‘learning barriers’; and ‘journal club as an integrated learning activity’. Conclusions and significance: Journal clubs were described as having the potential for increasing students’ learning regarding research methods, promoting skills in reading and critically reviewing research articles and having relevance for professional practice. Some barriers were identified, and changes are suggested for future educational practice.

• Price, Daicia; Bonsaksen, Tore; Leung, Janni; Ruffolo, Mary; Lamph, Gary & Hawkins, Karis [Show all 7 contributors for this article] (2024). The Psychosocial Health of Black/African Americans Compared with People of Other Races/Ethnic Origins during the COVID-19 Pandemic. COVID. 4(4), p. 506–517. doi: 10.3390/covid4040034. Full text in Research Archive Show summary

  This study compared the psychosocial health between Black/African Americans and other ethnic groups during the COVID-19 pandemic. Using self-report questionnaires, data were collected at three time points from April 2020 to January 2022, controlling for education and employment status. Surprisingly, Black/African American participants consistently reported lower psychological distress compared to their counterparts. However, they initially reported lower quality of life, which improved over time, eventually surpassing that of the other groups by January 2022. These findings suggest resilience among Black/African Americans despite historical marginalization. Socioeconomic factors and historical context may have influenced these disparities, highlighting the need for targeted interventions to support marginalized communities during crises.

• Bonsaksen, Tore; Thygesen, Hilde; Leung, Janni; Lamph, Gary; Kabelenga, Isaac & Geirdal, Amy Østertun (2024). Patterns of Social Media Use across Age Groups during the COVID-19 Pandemic: A Study across Four Countries. Social Sciences. 13(4), p. 1–13. doi: 10.3390/socsci13040194. Full text in Research Archive Show summary

  The aim of this study was to examine patterns of social media use across age groups in four countries (Norway, USA, UK, and Australia) two years after the COVID-19 pandemic outbreak, and whether types of use and time spent using social media was related to health worries. A cross- sectional online survey was completed by 1578 adult participants. The data were analysed with one-way analyses of variance and a linear regression analysis. Younger people spent more time on and were more likely to be passive users of social media than older people. Motives for social media use, and perceived effects of using social media, varied by participants’ age. Passive social media use and more time spent using social media were related to higher levels of health worries. Thus, an age perspective is relevant for understanding patterns of social media use, and different types of social media use appear to be differently related to health worries.

• Mørk, Gry; DaLomba, Elaina; Breen-Franklin, Adele & Bonsaksen, Tore (2024). Differences in Approaches to Learning Between Occupational Therapy Students in the USA and Norway. Occupational Therapy in Health Care. ISSN 0738-0577. doi: 10.1080/07380577.2024.2310209. Full text in Research Archive Show summary

  Students approach learning in different ways, and this study aimed to examine and understand differences in learning approaches between occupational therapy students in Norway and the USA. A total of 321 students, from two universities in the USA and six higher education institutions in Norway, completed the short version of the Approaches and Study Skills Inventory for Students. The data were analyzed with linear regression analyses. U.S. students had substantially higher scores on the strategic approach and higher scores on the deep approach, compared to the Norwegian students. Differences may be due to different national regulations and levels of education required for entering the programs, or personal factors such as predisposition for learning.

• Torland, Emilie Aas; Karlstad, Cecilie; Thørrisen, Mikkel Magnus; Bonsaksen, Tore; Haslerud, Sturla Inge & Aas, Randi Wågø (2024). School characteristics and pupils' thoughts of leaving upper secondary school: The INSchool project. Frontiers in Psychology. 15. doi: 10.3389/fpsyg.2024.1270139. Full text in Research Archive Show summary

  INTRODUCTION: Understanding pupils' thoughts about leaving school may contribute to better identify those at risk of dropping out. Thus, we explored the associations between perceived psychological demands, decision control, and social support from teacher and fellow pupils, and pupils' thoughts about leaving upper secondary school. METHODS: Cross-sectional data from a convenience non-probability sample of 249 pupils from 12 Norwegian upper secondary schools were collected using a school-modified version of the work-focused Job Content Questionnaire (JCQ). Adjusted logistic regression was used to analyze the data. RESULTS: Pupils who experienced higher psychological demands and lower social support from fellow pupils were more likely to experience thoughts of leaving school compared to those who experienced lower demands and high levels of social support. Decision control was not significantly associated with thoughts about leaving school. CONCLUSION: High psychological demands may increase the likelihood of considering leaving school. Peer support can lessen such thoughts. Implication: Identifying whether pupils are thinking about leaving school can help identify those who are at risk of dropping out of upper secondary school.

• Guelmami, Noomen; Fekih-Romdhane, Feten; Ghouili, Hatem; Jelleli, Hilmi; Rebhi, Mahmood & Saidane, Mouna [Show all 11 contributors for this article] (2024). Cross-cultural adaptation and validation of an Arabic version of the Cognitive-Affective Mindfulness Scale (CAMS-R). Cogent Social Sciences. 10(1). doi: 10.1080/23311886.2024.2306919. Full text in Research Archive Show summary

  No arabic version of the Revised cognitive-affective Mindfulness Scale (caMS-R) was found, prompting this study’s threefold objectives: first, to validate an arabic translation of caMS-R among tunisian students; second, to assess its factor structure and reliability; and third, to explore its validity by investigating the relationship between caMS-R scores, grit, and academic success. cross-sectional online data were collected from 705 university physical education students (mean age 21.62 ± 1.38 years) in two distinct time periods, with participants divided into exploratory and confirmatory samples. the 12-item caMS-R scale underwent both exploratory factor analysis and confirmatory factor analysis (cFa), confirming a second-order structure (χ2 (53) = 77.997, p = 0.014; χ2/df = 1.47; comparative fit index (cFi) = 0.995; cFi = 0.994; RMSea (90% confidence interval [ci] 0–0.013–0.042) = 0.029. Strong internal consistency was indicated by cronbach α indices ranging from 0.865 to 0.880 for all subscales. Results from Roccurve analysis revealed the arabic caMS-R’s ability to distinguish effectively between students with low and high-grade point averages (gPa; area under the curve [aUc] = 0.782, ci 95%: 0.726–0.838, p < 0.001), confirming its sensitivity. convergent and discriminant validity were supported by the average variance extracted (aVe) of the four scale factors and adherence to the Fornell and larcker discriminant validity criterion. additionally, caMS-R scores displayed positive associations with gPa and grit scores, establishing the concurrent validity of the scale. in conclusion, these findings collectively suggest that the arabic version of caMS-R is a recommended self-report assessment tool for mindfulness in tunisia and other arabic countries.

• Bonsaksen, Tore; Steigen, Anne Mari; Granrud, Marie Dahlen; Dangmann, Cecilie Ruud & Stea, Tonje Holte (2024). Sexual harassment exposure among junior high school students in Norway: prevalence and associated factors. Frontiers in Public Health. 12. doi: 10.3389/fpubh.2024.1307605. Full text in Research Archive Show summary

  Background: Sexual harassment is common in most countries and cultures. Less is known about sexual harassment, its risk factors, and psychosocial outcomes among young adolescents. The aim of the study was to examine the 12-month prevalence of sexual harassment exposure, and sociodemographic and psychosocial factors associated with exposure among junior high school students in Norway. Methods: A comprehensive cross-sectional study was completed by 83,297 Norwegian adolescents in junior high school in 2021. Data on exposure to sexual harassment were used in combination with sociodemographic measures and psychosocial outcomes: depressive symptoms, loneliness, self-esteem, and well-being. Group differences were analyzed with Chi Square tests, and sociodemographic risk factors were analyzed with logistic regression. Psychosocial outcomes were assessed with multivariate and univariate ANOVAs, and dose–response relationships were assessed with linear regression. Results: Among the adolescents, 32.6% had experienced sexual harassment during the past year. Girls had higher odds of exposure (OR: 1.90, 95% CI: 1.84– 1.96), whereas adolescents whose parents had higher education had lower odds (OR: 0.95, 95% CI: 0.90–0.99). Exposure was associated with higher levels of depressive symptoms (partial η2 [ES]  =  0.11) and loneliness (ES  =  0.07), and with lower self-esteem (ES  =  0.06) and well-being (ES  =  0.06). Among exposed adolescents, more frequent exposure was associated with poorer outcomes. Conclusion: Exposure to sexual harassment affects one third of junior high school students in Norway. Those who are exposed have poorer psychosocial outcomes, and there is a dose–response relationship between exposure and outcomes. Awareness of sexual harassment among young adolescents, and interventions to prevent and reduce it, are needed.

• Price, Daicia; Bonsaksen, Tore; Leung, Janni; McClure-Thomas, Caitlin; Ruffolo, Mary & Lamph, Gary [Show all 8 contributors for this article] (2023). Factors Associated with Trust in Public Authorities Among Adults in Norway, UK, US, and Australia Two Years after the COVID-19 Outbreak. International Journal of Public Health. ISSN 1661-8556. 68(68), p. 1–7. doi: 10.3389/ijph.2023.1605846. Full text in Research Archive Show summary

  Objectives: This study aimed to examine the levels of trust in information provided by public authorities 2 years after the COVID-19 outbreak and to examine factors associated with trust. Methods: Using a cross-national approach, online survey data was collected from four Western countries—Australia, Norway, the United Kingdom, and the United States of America. Differences in reports of very low or low levels of trust were examined by age, gender, area of residence, and the highest level of education in the four countries. Results: Levels of trust in the public authorities’ information were highest among Norwegian respondents and lowest among U.K. respondents. Lower levels of trust in public authorities were found among males, individuals living in rural or remote areas, and those with lower levels of education. Conclusion: The outcomes contribute to knowledge regarding differences between socio-demographic groups and countries regarding the levels of trust people have in public authorities’ information concerning a crisis, such as COVID-19. Strategies to promote trust in societies in different countries could consider these socio-demographic differences.

• Leung, Janni; Price, Daicia; McClure-Thomas, Caitlin; Bonsaksen, Tore; Ruffolo, Mary & Kabelenga, Isaac [Show all 8 contributors for this article] (2023). Motivation and Hesitancies in Obtaining the COVID-19 Vaccine—A Cross-Sectional Study in Norway, USA, UK, and Australia. Vaccines. 11(6). doi: 10.3390/vaccines11061086. Full text in Research Archive Show summary

  Background: Vaccinations protect the public against serious diseases or death; however, some individuals are hesitant in obtaining them. We aim to contribute to the understanding of the challenges of vaccination roll-out by examining the motivations, hesitancies, and their associated factors, in obtaining the COVID-19 vaccines two years into the pandemic. Methods: Cross-sectional online surveys were conducted in Norway, the USA, the UK, and Australia (N = 1649). The participants self-reported whether they had obtained one of the COVID-19 vaccines. Those who had obtained a vaccine reported the reason for their motivation, and those who had not obtained a vaccine reported the reason for their hesitancies. Results: More than 80% of the total sample obtained a COVID-19 vaccine because of public health recommendations and trusted that it was safe. Among those who had not obtained one, the most frequent reason was concerns about side effects. Most who obtained the vaccine reported that they believed in science, but many of those who had not obtained one reported distrust. Among those who had not obtained a vaccine, reports of distrust in policies and science were frequent. Concerns about side effects were more common in males and those with lower education, and those living in rural or remote areas. Conclusion: People who endorsed the vaccine believed that the vaccine reduces the risk of illness, protects the health of others, and had trust in scientific vaccination research. Conversely, the most frequent reason for vaccine hesitancy was concerns about side effects, followed by distrust in healthcare and science. These findings could inform public health strategies that aim to increase vaccination rates.

• Tannoubi, Amayra; Quansah, Frank; Hagan, John Elvis; Srem-Sai, Medina; Bonsaksen, Tore & Chalghaf, Nasr [Show all 10 contributors for this article] (2023). Adaptation and Validation of the Arabic Version of the University Student Engagement Inventory (A-USEI) among Sport and Physical Education Students. Psych. 5(2). doi: 10.3390/psych5020022. Full text in Research Archive Show summary

  The present study validated the University Student Engagement Inventory (USEI) in the Arabic language (A) by assessing its factor structure, construct validity, reliability, and concurrent validity. A total of 864 Tunisian Physical Education and Sport students provided data which was used to perform exploratory and confirmatory factor analyses, using samples comprising 366 (aged 19–25 years) and 498 (aged 19–26 years) students, respectively. The A-USEI, grade-point average (GPA), and Physical Education Grit (PE–Grit) scales were completed via online surveys. The exploratory factor analysis revealed that the A-USEI had three dimensions. The confirmatory factor analysis indicated that the second-order model was more suitable than the first-order multi-factor model. Using the indicators for the second-order model, the three factors showed good reliability, with their average variance extracted (AVE) values reflecting sufficient validity. The correlation analyses between the two scales’ scores and the A-USEI scores showed a moderate correlation, confirming the adapted scale’s concurrent validity. The study concludes that A-USEI is a valid tool for assessing student engagement among Arabic students. In addition, the practical implications and directions for future research are discussed.

• Bonsaksen, Tore; Steigen, Anne Mari; Stea, Tonje Holte; Kleppang, Annette Løvheim; Lien, Lars & Leonhardt, Marja (2023). Negative social media-related experiences and lower general self-efficacy are associated with depressive symptoms in adolescents. Frontiers in Public Health. 10, p. 1–13. doi: 10.3389/fpubh.2022.1037375. Full text in Research Archive Show summary

  Social media are an integral part of adolescents' daily lives, and reviews have suggested an overall small association between more social media use and mental health problems. However, researchers have commonly investigated social media use in a time use perspective, rendering nuances in adolescents' social media experience less well explored. Thus, studies of relationships between social media use and mental health problems need also examine the nature of the events taking place on social media. This study aimed to examine depressive symptoms in adolescents in relationship to time spent on social media, negative social media-related experiences, and general self-efficacy. Data collected in a national survey, Ungdata 2021 (n = 139,841), was used. Multivariate linear regression analyses showed that time spent on social media was associated with depressive symptoms (β = 0.09, p < 0.001). However, negative social media-related experiences were more strongly associated with depressive symptoms (β ranging 0.09–0.22, all p < 0.001), and their inclusion weakened the initial association between time on social media and depressive symptoms. General self-efficacy was directly associated with lower symptom levels (β = −0.29, p < 0.001) but did not change the associations between social media use and depressive symptoms. The findings imply that not only time spent on social media, but in particular negative social media-related experiences, are related to depressive symptoms in Norwegian adolescents. General self-efficacy is an important resource for adolescents' mental health.

• Bonsaksen, Tore; Horghagen, Sissel; Arntzen, Cathrine; Gramstad, Astrid & Stigen, Linda (2023). Job Satisfaction among Occupational Therapists Employed in Primary Care Services in Norway. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 20(6). doi: 10.3390/ijerph20065062. Full text in Research Archive Show summary

  The aging population will place healthcare services under considerable strain in the years ahead. Occupational therapists play a vital role in securing sustainable healthcare services and are increasingly employed by municipalities. To promote sustainable services, the job satisfaction among core professional groups needs monitoring. A comprehensive cross-sectional survey was distributed among municipality-employed occupational therapists in Norway during May–June 2022, to which 617 responded. Job satisfaction was assessed with the Job Satisfaction Scale (JSS), and factors associated with job satisfaction were assessed with linear regression analysis. The mean JSS score in the sample was 51.4. The regression model explained 14.4% of the variance in job satisfaction scores. Having more work experience as an occupational therapist (β = 0.16, p = 0.02) and having higher perceived influence on the work unit’s goals (β = 0.31, p < 0.001) were significantly related to higher job satisfaction. The study implies that job satisfaction in the occupational therapy profession increases with years of experience and also with the ability to engage with and influence the larger work environment. Thus, to promote job satisfaction, occupational therapists should seek to engage not only with their own work at hand but also with the larger goals and strategies of the organization they work for.

• Bonsaksen, Tore; Ruffolo, Mary; Price, Daicia; Leung, Janni; Thygesen, Hilde & Lamph, Gary [Show all 8 contributors for this article] (2023). Associations between social media use and loneliness in a cross-national population: Do motives for social media use matter? Health Psychology and Behavioral Medicine. 11(1). doi: 10.1080/21642850.2022.2158089. Full text in Research Archive Show summary

  Background: We aimed to examine the association between social media use and loneliness two years after the COVID-19 pandemic outbreak. Methods: Participants were 1649 adults who completed a cross-sectional online survey disseminated openly in Norway, United Kingdom, USA, and Australia between November 2021 and January 2022. Linear regressions examined time spent on social media and participants’ characteristics on loneliness, and interactions by motives for social media use. Results: Participants who worried more about their health and were younger, not employed, and without a spouse or partner reported higher levels of loneliness compared to their counterparts. More time spent on social media was associated with more loneliness (β = 0.12, p < 0.001). Three profile groups emerged for social media use motives: 1) social media use motive ratings on avoiding difficult feelings higher or the same as for maintaining contact; 2) slightly higher ratings for maintaining contact; and 3) substantially higher ratings for maintaining contact. Time spent on social media was significant only in motive profile groups 2 and 3 (β = 0.12 and β = 0.14, both p < 0.01). Conclusions: Our findings suggest that people who use social media for the motive of maintaining their relationships feel lonelier than those who spend the same amount of time on social media for other reasons. While social media may facilitate social contact to a degree, they may not facilitate the type of contact sought by those who use social media primarily for this reason.

• Stea, Tonje Holte; Steigen, Anne Mari; Dangmann, Cecilie Ruud; Granrud, Marie Dahlen & Bonsaksen, Tore (2023). Associations between exposure to sexual abuse, substance use, adverse health outcomes, and use of youth health services among Norwegian adolescents. BMC Public Health. 23(1). doi: 10.1186/s12889-023-16261-y. Full text in Research Archive Show summary

  Background A strong association between sexual abuse and adverse health outcomes has been reported among adolescents. The present study aimed to provide more information about adverse health outcomes associated with sexual abuse and substance use, and to examine the use of youth health services among Norwegian adolescents. Methods National representative cross-sectional study among 16–19-year-old Norwegian adolescents (n = 9784). Multivariable regression analyses, adjusted for socioeconomic status and age, were used to examine the association between exposure to sexual abuse, substance use and health risk factors, and the use of youth health services. Results Adolescents exposed to sexual abuse had higher odds of depressive symptoms (males: OR:3.8; 95% CI:2.5–5.8, females: 2.9;2.4–3.5), daily headache (males: 5.3;2.8–10.1, females:1.9; 1.5–2.4), high medication use (males: 3.2;1.7-6.0, females: 2.0;1.6–2.6), self-harm (males: 3.8;2.4-6.0, females:3.2; 2.6–3.9), suicidal thoughts (males: 3.3; 2.2-5.0, females:3.0; 2.5–3.6) and suicide attempts (males: 9.5;5.6–16.0, females:3.6;2.7–4.9). Furthermore, exposure to sexual abuse was associated with higher odds of using school health services (males: 3.9;2.6–5.9, females: 1.6;1.3–1.9) and health services for youth (males: 4.8;3.1–7.6, females: 2.1;1.7–2.5). In general, substance use was associated with increased odds of adverse health related outcomes and use of youth health services, but the strength of the relationships varied according to sex. Finally, results indicated a significant interaction between sexual abuse and smoking that was associated with increased odds of having suicidal thoughts for males (2.6;1.1–6.5) but a decreased odds of having suicidal thoughts and have conducted suicide attempts once or more for females (0.6;0.4-1.0 and 0.5;0.3–0.9, respectively). Conclusions The present study confirmed a strong relationship between exposure to sexual abuse and health risks, especially among males. Moreover, males exposed to sexual abuse were much more likely to use youth health services compared to sexually abused females. Substance use was also associated with adverse health outcomes and use of youth health services, and interactions between sexual abuse and smoking seemed to influence risk of suicidal thoughts and attempts differently according to sex. Results from this study increase knowledge about possible health related effects of sexual abuse which should be used to identify victims and provide targeted treatment by youth health services.

• Schoultz, Mariyana; Lamph, Gary; Thygesen, Hilde; Leung, Janni; Bonsaksen, Tore & Ruffolo, Mary [Show all 11 contributors for this article] (2023). Perceptions of social media challenges and benefits during the Covid-19 pandemic: Qualitative findings from a cross sectional international survey. PLOS Global Public Health. 3(1). doi: 10.1371/journal.pgph.0001463. Full text in Research Archive Show summary

  Since the beginning of the Covid-19 pandemic in January 2020 the need for rapid information spread grew and social media became the ultimate platform for information exchange as well as a tool for connection and entertainment. With the rapid information spread along came the various public misconceptions and misinformation which consequently influenced perceptions and behaviors of the public towards the coronavirus pandemic. Thus, there was a need for identification and collation of public perceptions information to address future public health initiatives. This cross-national study aimed to examine the challenges and benefits of using social media during the Covid-19 pandemic outbreak. This study was a content analysis of the open-ended questions from a wider cross-sectional online survey conducted in Norway, UK, USA, and Australia during October/November 2020. 2368 participants out of 3474 respondents to the survey provided the open text responses included in the qualitative analysis. Thematic analysis was conducted independently by two researchers. All statements were coded to positive and negative sentiments. Three overarching themes were identified: 1. Mental health and emotional exhaustion 2. Information and misinformation; 3. Learning and inspiration.While providing a powerful mode of connection during the pandemic, social media also led to negative impact on public perceptions, including mistrust and confusion. Clarity in communications by institutions and education about credible information sources should be considered in the future. Further research is required in exploring and documenting social media narratives around COVID-19 in this and any subsequent incidents of pandemic restrictions. Understanding the public perceptions and their social narratives can support the designing of appropriate support and services for people in the future, while acknowledging the uncertainty and overwhelming impact of the pandemic that may have skewed the experiences of social media.

• Lien, Lars; Bonsaksen, Tore; Stea, Tonje Holte; Kleppang, Annette Løvheim; Steigen, Anne Mari & Leonhardt, Marja (2023). Time trends in self-reported depressive symptoms, prescription of antidepressants, sedatives and hypnotics and the emergence of social media among Norwegian adolescents. PLOS ONE. 18(12). doi: 10.1371/journal.pone.0295384. Full text in Research Archive Show summary

  Background Research has shown increased mental health problems and use of prescription drugs among adolescents in recent years and social media use has been linked to poorer mental health. However, trend studies concerning these topics are scarce. The purpose of this study was to analyze gender-specific trends in a) symptoms of depression and loneliness, and b) prescription of antidepressants, hypnotics and sedatives, in relation to the emergence of social media among adolescents in Norway. Methods This is an ecological study using data from the ‘Young in Oslo’ surveys from 1996 to 2021. The surveys included approximately 110 000 students, 14–17 years of age, and yielded a response rate varying from 95% in 1996 to 64% in 2021. A self-report questionnaire was used to collect information on symptoms of depression and loneliness. Information on antidepressant and sleep medication prescription was retrieved from the Norwegian Prescription Database for the age group 15 to 19 years. A graphical approach and logistic regression models were used to examine gender-specific time-trends between 1996 to 2021. Results We found a doubling in self-reported symptoms of depression and loneliness among girls between 1996 and 2021, with the steepest increase in the period from 2006 to 2012, when Facebook and other social media were introduced. A similar trend was observed in the prescription of antidepressants among girls, with the steepest increase between 2011 and 2013. Among both boys and girls, ‘worried too much about things’ and ‘had sleep problems’ were the two symptoms with the greatest changes. Conclusion A significant upward trend in self-reported depressive symptoms and medication use was observed over the past 25 years, with variations in the rate of increase, including a steeper trajectory during certain periods immediately after the introduction of social media platforms in Norway.

• Redzovic, Skender Elez; Vereijken, Beatrix & Bonsaksen, Tore (2023). Aging at home: factors associated with independence in activities of daily living among older adults in Norway—a HUNT study. Frontiers in Public Health. 11. doi: 10.3389/fpubh.2023.1215417. Full text in Research Archive Show summary

  Background: Maintaining independence in activities of daily living (ADL) is essential for the well-being of older adults. This study examined the relationship between demographic and living situation factors and ADL independence among community-dwelling older adults in Norway. Methods: Data was collected in Norway between 2017 and 2019 as part of the fourth wave of the ongoing Trøndelag Health Study (HUNT) survey, sent to all citizens in Trøndelag county over 20  years of age, which is considered representative of the Norwegian population. Included in the current crosssectional study were 22,504 community-living individuals aged 70  years or older who completed the survey and responded to all items constituting the ADL outcome measure. Group differences in ADL independence were examined with Chi Square tests, while crude and adjusted associations with ADL independence were examined with logistic regression analyses. Statistical significance was set at p  <  0.05. Results: The participants reported a high degree of independence in primary ADL and slightly lower in instrumental ADL. In the fully adjusted analyses, ADL independence was associated with lower age, female gender, higher levels of education and income, higher subjective well-being, having no chronic or disabling disease, and having someone to talk to in confidence. Surprisingly, women who were married had higher likelihood of ADL independence than unmarried women, whereas married men had lower likelihood of ADL independence than unmarried men. Conclusion: In addition to known demographic and disease-related factors, the social context affects independence in ADL even in a society that offers advanced health and homecare services to all older adults equally. Furthermore, the same social setting can have differential effects on men and women. Despite the healthcare system in Norway being well-developed, it does not completely address this issue. Further improvements are necessary to address potential challenges that older adults encounter regarding their social connections and feelings of inclusion. Individuals with limited education and income are especially susceptible to ADL dependency as they age, necessitating healthcare services to specifically cater to this disadvantaged demographic.

• Mygland, Jenny Solveig; Mørk, Gry; Stigen, Linda; Gramstad, Astrid; Magne, Trine A & Bonsaksen, Tore (2023). Stable or unstable associations between learning environment factors, study approaches and exam grades: cross-sectional analyses across two consecutive program years. Journal of Occupational Therapy Education. 7(1), p. 1–15. doi: 10.26681/jote.2023.070112. Full text in Research Archive Show summary

  Studies into the relationships between learning environment perceptions, approaches to studying, and academic outcomes have largely followed cross-sectional designs. As a result, knowledge is sparse with regards to whether, or to what degree, the established associations are consistent across years of study. This study aimed to (i) examine associations between occupational therapy students’ academic performance, their approaches to studying and perceptions of the learning environment, while in their second and third years of study, and (ii) evaluate the consistency of the results across years of study. Occupational therapy students in Norway were assessed annually with regards to their perceptions of the learning environment, study approaches, and academic performance. Associations between variables, measured within each study year, were analyzed with linear regression analyses, and then compared year-overyear. In the second study year (n=162), better academic performance was associated with lower student autonomy, and higher scores on strategic approach. In the third study year (n=189), better academic performance was associated with being female and lower scores on surface approach. Having occupational therapy as the preferred line of education at enrollment was associated with better grades in both study years. Associations between grades and gender, perceptions of student autonomy, and study approaches were somewhat different between the two years. Implications for educational practice is discussed and various contents and emphasis in educational programs are proposed.

• Bonsaksen, Tore; Brunes, Audun & Heir, Trond (2023). Quality of Life In People With Visual Impairment Compared With the General Population. Journal of Public Health (Berlin). ISSN 2198-1833. p. 1–9. doi: 10.1007/s10389-023-01995-1. Full text in Research Archive Show summary

  Aim The aim of the present study was to examine quality of life and its associated factors among adults with visual impairment in Norway. Subject and methods Of the 1216 adults contacted, 736 (61% response rate) participated in a cross-sectional survey. A general population probability sample served as reference (n=1792, 36% response rate). Differences between the populations were examined with independent t-tests for continuous variables and with Chi-square tests for categorical variables. Quality of life covariates were investigated with linear regression analysis. Results People with visual impairment had lower quality of life than the general Norwegian population, across all age groups (mean QOL: 6.8 versus 7.6, p<0.001) and within all age groups (all p<0.01). Compared with the general population, people with visual impairment were less likely to report the highest levels and more likely to report intermediate levels of quality of life. Higher quality of life was associated with lower onset-age of impaired vision (B=-0.11, p<0.001), having employment (B=0.36, p=0.02), lower levels of loneliness (B=-0.28, p<0.001) and higher levels of social support (B=0.40, p<0.001) and general self-efficacy (B=0.07, p<0.001). Conclusion Quality of life was lower among people with visual impairment and may be increased by promoting work participation, social inclusion, connectedness, and coping.

• Lerdal, Anners; Gay, Caryl; Bonsaksen, Tore; Ekeberg, Øivind; Grimholt, Tine Kristin & Heir, Trond [Show all 10 contributors for this article] (2023). Validation of a short version of the Lee fatigue scale in adults living in Norway: a cross-sectional population survey. BMC Public Health. 23(1). doi: 10.1186/s12889-023-17036-1. Full text in Research Archive Show summary

  Background Due to the nature of fatigue, a brief reliable measure of fatigue severity is needed. Thus, the aim of our study was to evaluate a short version of the Lee Fatigue Scale (LFS) in the Norwegian general population. Methods This cross-sectional survey consists of a representative sample from the Norwegian population drawn by The National Population Register in Norway. The study is part of a larger study (NORPOP) aimed at collecting normative data from several questionnaires focused on health in adults living in Norway. Registered citizens between 18 and 94 years of age were randomly selected stratified by age, sex and geographic region. Of the 4971 respondents eligible for the study, 1792 (36%) responded to the survey. In addition to age and sex, we collected responses on a 5-item version of the LFS measuring current fatige severity. The psychometric properties focusing on internal structure and precision of the LFS items were analyzed by a Rasch rating scale model. Results Complete LFS scores for analyses were available for 1767 adults. Women had higher LFS-scores than men, and adults < 55 years old had higher scores than older respondents. Our analysis of the LFS showed that the average category on each item advanced monotonically. Two of the five items demonstrated misfit, while the three other items demonstrated goodness-of-fit to the model and uni-dimensionality. Items #1 and #4 (tired and fatigue respectively) showed differential item functioning (DIF) by sex, but no items showed DIFs in relation to age. The separation index of the LFS 3-item scale showed that the sample could be separated into three different groups according to the respondents’ fatigue levels. The LFS-3 raw scores correlated strongly with the Rasch measure from the three items. The core dimensions in these individual items were very similarly expressed in the Norwegian language version and this may be a threat to the cultural-related or language validity of a short version of the LFS using these particular items. Conclusions The study provides validation of a short LFS 3-item version for estimating fatigue in the general population.

• Tannoubi, Amayra; Quansah, Frank; Magouri, Iteb; Chalghaf, Nasr; Bonsaksen, Tore & Srem-Sai, Medina [Show all 10 contributors for this article] (2023). Modelling the associations between academic engagement, study process and grit on academic achievement of physical education and sport university students. BMC Psychology. 11(1). doi: 10.1186/s40359-023-01454-2. Full text in Research Archive Show summary

  Objective The present study examined the impact of academic engagement, study processes, and grit on the academic achievement of physical education and sport university students. Methods An internet-based survey recruited 459 university students aged 19–25 years (M = 21 ± 1.3) in physical education and sports (PES) to fill out questionnaires on Physical Education-Study Process Questionnaire (PE-SPQ), Physical Education-Grit (PE-Grit), academic engagement (A-USEI), and Grade Point Average (GPA). A path analysis was carried out to understand variable relationships. Results Data from each variable exhibited symmetrical and normal distribution, as indicated by the skewness and kurtosis values. The model’s fit indices showed sufficient Comparative Fit Index (CFI = 0.92), Tucker-Lewis Index (TLI = 0.90), Goodness of Fit Index (GFI = 0.99) and Normed Fit Index (NFI = 0.90) and showed acceptable levels. The results indicated a statistically significant positive impact of engagement (β = 0.299, p < 0.001) and study processes (β = 0.397, p < 0.001) on academic achievement. However, the effect of grit on achievement was non-significant. Conclusions Academic engagement as well as study processes are two important factors predicting academic achievement while grit seems to be not a major predictor. Hence, physical education and sport faculty and university administrators should prioritize student engagement as a determinant of academic outcomes by reforming or redesigning physical education and sport curriculum modules that can facilitate engagement.

• Lie, Silje Stangeland; Helle, Nikolina; Sletteland, Nina Vahl; Vikman, Miriam Dubland & Bonsaksen, Tore (2023). Implementation of Virtual Reality in Health Professions Education: Scoping Review. JMIR Medical Education. 9, p. 1–15. doi: 10.2196/41589. Full text in Research Archive Show summary

  Methods Results Discussion References Abbreviations Copyright Abstract Background: Virtual reality has been gaining ground in health professions education and may offer students a platform to experience and master situations without endangering patients or themselves. When implemented effectively, virtual reality technologies may enable highly engaging learning activities and interactive simulations. However, implementation processes present challenges, and the key to successful implementation is identifying barriers and facilitators as well as finding strategies to address them. Objective: This scoping review aimed to identify the literature on virtual reality implementation in health professions education, identify barriers to and facilitators of implementation, and highlight gaps in the literature in this area. Methods: The scoping review was conducted based on the Joanna Briggs Institute Evidence Synthesis methodologies. Electronic searches were conducted in the Academic Search Elite, Education Source, and CINAHL databases on January 5, 2022, in Google Scholar on February 2 and November 18, 2022, and in PubMed database on November 18, 2022. We conducted hand searches of key items, reference tracking, and citation tracking and searches on government webpages on February 2, 2022. At least 2 reviewers screened the identified literature. Eligible studies were considered based on predefined inclusion criteria. The results of the identified items were analyzed and synthesized using qualitative content analysis. Results: We included 7 papers and identified 7 categories related to facilitators of and barriers to implementation—collaborative participation, availability, expenses, guidelines, technology, careful design and evaluation, and training—and developed a model that links the categories to the 4 constructs from Carl May’s general theory of implementation. All the included reports provided recommendations for implementation, including recommendations for careful design and evaluation, training of faculty and students, and faculty presence during use. Conclusions: Virtual reality implementation in health professions education appears to be a new and underexplored research field. This scoping review has several limitations, including definitions and search words, language, and that we did not assess the included papers’ quality. Important implications from our findings are that ensuring faculty’s and students’ competence in using virtual reality technology is necessary for the implementation processes. Collaborative participation by including end users in the development process is another factor that may ensure successful implementation in higher education contexts. To ensure stakeholders’ motivation and potential to use virtual reality, faculty and students could be invited to participate in the development process to ensure that the educational content is valued. Moreover, technological challenges and usability issues should be resolved before implementation to ensure that pedagogical content is the focus. This accentuates the importance of piloting, sufficient time resources, basic testing, and sharing of experiences before implementation.

• Geirdal, Amy Østertun; Leung, Janni; Price, Daicia; Kabelenga, Isaac; Lamph, Gary & Thygesen, Hilde [Show all 8 contributors for this article] (2023). Associations Between Demographic Variables, Psychosocial Health, Quality of Life, and Happiness in the Context of COVID-19. Applied Research in Quality of Life. ISSN 1871-2584. 19(2), p. 1–15. doi: 10.1007/s11482-023-10255-z. Full text in Research Archive Show summary

  Purpose The purpose was to examine the association between demographic vari- ables, psychosocial health, quality of life, and happiness in the context of COVID. The hypothesis was that psychosocial health variables have mediating roles between demographic variables and experienced quality of life (QoL) and happiness. Methods Cross-sectional surveys were conducted across four countries: Norway, USA, UK, and Australia among 1649 individuals. Multiple regression analysis iden- tified those variables that made independent statistically contributions onto the QoL and happiness outcome variables, and the analysis of psychological distress, fatigue and loneliness as mediational variables was performed. Results Not having a spouse/ partner was associated with poorer QoL, and older age was associated with lower happiness. The psychosocial health variables made the highest variance in QoL (R2 change = 0.51) and happiness (R2 change = 0.46) and poorer psychosocial health had a mediating role between civil status and QoL (p < 0.001) and between age and happiness outcomes (p < 0.001). Conclusion Psychosocial health is of considerable importance in individuals in the time of COVID-19

• Leung, Janni; Price, Daicia; Bonsaksen, Tore; Ruffolo, Mary; Thygesen, Hilde & McClure-Thomas, Caitlin [Show all 8 contributors for this article] (2023). Schooling-at-Home and Extra Child-Caring Responsibilities were Associated with Parental Mental Health, Psychosocial Well-Being, and Loneliness. Social Education Research (SER). ISSN 2717-5723. 5(1), p. 1–14. doi: 10.37256/ser.5120243332. Full text in Research Archive Show summary

  Schooling-at-home and educating children at home have received increased attention since the COVID-19 pandemic which resulted in abrupt social changes, including stay-at-home protocols and school closures to prevent the spread of infection during the period. We examined the mental health, psychosocial well-being, and loneliness of parents according to whether they had been taking on extra schooling-at-home and child-care responsibilities. We conducted a multi-country cross-sectional online survey nine months into the COVID-19 pandemic in Norway, the UK, the USA, and Australia with a sample size of 1,722. Outcome measures included the General Health Questionnaire 12 (GHQ-12) mental health scale, the Psychosocial well-being (PSW) scale, and the De Jong Gierveld Loneliness Scale (LS). The key explanatory factor was parental and child-care status, which categorised participants based on how many extra child-care or schooling-at-home responsibilities were taken up. Moderator variables included working-from-home status, living arrangements, and demographic covariates. Our sample had 20.0% of parents who reported taking on some or half of the extra child-care responsibilities, and 11.7% reported that they were taking on most of the extra child-care responsibilities. Parents who were taking on most of the extra child-care or schooling-at-home responsibilities had poorer mental health (M = 17.34, SE = 0.40 vs M = 15.47, SE = 0.37, p = 0.002), psychosocial well-being (M = 2.92, SE = 0.05 vs M = 2.72, SE = 0.05, p = 0.011), and loneliness (M = 11.29, SE = 0.31 vs M = 10.33, SE = 0.28, p = 0.019), compared to parents who did not have extra responsibilities. Younger parents and those not living with a spouse reported poorer outcomes. Parents who reported that they were taking on most of the child-caring responsibilities reported the poorest mental health, psychosocial well-being, and highest levels of loneliness. Psychosocial and community support for parents who take on schooling-at-home and education responsibilities is important for the well-being of the parents as well as for their children.

• Thørrisen, Mikkel Magnus; Sadeghi, Talieh; Bonsaksen, Tore; Graham, Ian D. & Aas, Randi Wågø (2022). Working with alcohol prevention in occupational health services: “knowing how” is more important than “knowing that” – the WIRUS OHS study. Addiction science & clinical practice. ISSN 1940-0632. 17(1). doi: 10.1186/s13722-022-00335-0. Full text in Research Archive Show summary

  Background Alcohol consumption is a major public health challenge; the majority of employees consume alcohol regularly and a considerable proportion of employees can be characterized as risky drinkers in need of interventions. Occupational health services (OHS) are uniquely positioned for implementing alcohol prevention interventions targeting employees, but rarely do so. Studies have shown that lack of knowledge among OHS personnel is a barrier to alcohol prevention activity. This study aimed to explore OHS personnels’ levels of theoretical and practical alcohol knowledge, and whether these two ways of knowing were differentially associated with alcohol prevention activity. Methods In this cross-sectional study, survey data were collected from 322 OHS personnel in Norway in 2018 (response rate = 53.6%). The survey included variables of two ways of knowing (theoretical and practical) and three types of doing (intervention frequency, conducting individual interventions, and conducting group interventions). Data were analyzed with descriptive statistics, paired sample t-tests, bivariate correlations, and adjusted linear and logistic regression analyses. Results OHS personnel rated their theoretical alcohol knowledge higher than their practical knowledge (η2 = 0.33, p < 0.001). Higher reported levels of practical knowledge were associated with higher intervention frequency (b = 0.39, β = 0.60, p < 0.001) and greater likelihood of conducting individual interventions (OR = 1.60, p < .001) as well as group interventions (OR = 1.84, p < 0.001). Theoretical knowledge was not associated with conducting interventions, and there was no evidence of an interaction between the two ways of knowing in their association with doing. Sensitivity analyses did not indicate clustering effects of OHS personnel being employed within different units. Conclusions Different ways of knowing about alcohol among OHS personnel were dissimilarly associated with conducting alcohol prevention interventions in occupational health settings. For doing, knowing how seems to be more important than knowing that. Training programs for OHS personnel should emphasize knowledge about how to deal with alcohol-related issues and how to conduct prevention interventions, rather than focus on detrimental effects of alcohol.

• Bonsaksen, Tore & Breen-Franklin, Adele (2022). Intrinsic relationships between learning conceptions, preferences for teaching and approaches to studying among occupational therapy students in the United States. Occupational Therapy in Health Care. ISSN 0738-0577. doi: 10.1080/07380577.2022.2025512. Full text in Research Archive
• Gramstad, Astrid; Stigen, Linda; Maass, Ruca Elisa Katrin; Sveen, Unni; Horghagen, Sissel & Arntzen, Cathrine [Show all 7 contributors for this article] (2022). Er det regionale skilnader når det gjeld kommuneergoterapeutane i Noreg? Ergoterapeuten. ISSN 0800-3475. 65(5), p. 36–45. Full text in Research Archive Show summary

  The aim of this study was to identify similarities and differences between the four health regions in Norway, with regards to the characteristics of occupational therapy staff working in the municipal health services. A cross-sectional study was performed where occupational therapists working in the municipalities were invited to fill out an online survey about the context of their work, work relationships within and outside the profession, competence level, participation in research, development projects and demographic characteristics. A total of 561 occupational therapists participated in the study. The data were analyzed with descriptive statistics, and differences between groups were analyzed with Chi-Square tests and one-way analysis of variance. The results showed unexpectedly that overall, the differences between health regions were small and not statistically significant regarding age, gender composition and competence level of the occupational therapists. However, we found differences between the health regions regarding the professional background of the occupational therapists’ line manager; the number of occupational therapists in the same work unit; the proportion having served as fieldwork supervisor during the preceding year; and perceived influence on the service goals of the unit. More research is needed to explore how such differences may influence occupational therapists’ practice and perceptions of their practice. Keywords: Geografisk ulikheit, kommunale tenester, spørjeundersøking

• Leonhardt, Marja; Granrud, Marie Dahlen; Bonsaksen, Tore & Lien, Lars (2022). Associations between Mental Health, Lifestyle Factors and Worries about Climate Change in Norwegian Adolescents. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 19(19). doi: 10.3390/ijerph191912826. Full text in Research Archive Show summary

  Climate change is a serious global health threat that has an impact on young people’s lives and may influence their mental health. Since the global climate strike movement, many adolescents have expressed worries about climate change. Thus, the aim of this study is to examine the prevalence of worries about climate change, and factors associated with worries about climate change, in a representative sample of Norwegian adolescents. Data were retrieved from Ungdata, an annual nationwide online youth survey. Adolescents (n = 128,484) from lower and upper secondary school participated in the study. Data were analysed descriptively and with logistic regression. Most of the adolescents were not worried or a little worried about climate change. Girls, pupils who had at least one parent with higher education and pupils from urban areas were more inclined to worry about the climate. Adolescents who worried about the climate had more symptoms of depression than those who were less worried. While worry about climate change may constitute an additional burden for adolescents experiencing depressive symptoms, such worry can also be seen to reflect climate-friendly values.

• Thørrisen, Mikkel Magnus; Skogen, Jens Christoffer; Bonsaksen, Tore; Skarpaas, Lisebet Skeie & Aas, Randi Wågø (2022). Are workplace factors associated with employee alcohol use? The WIRUS cross-sectional study. BMJ Open. 12(10). doi: 10.1136/bmjopen-2022-064352. Full text in Research Archive Show summary

  OBJECTIVES: Sociodemographic predictors of employee alcohol use are well established in the literature, but knowledge about associations between workplace factors and alcohol use is less explored. The aim of this study was to explore whether workplace factors were associated with employee alcohol use (consumption and alcohol-related problems). DESIGN: Cross-sectional study. Linear and binary logistic regression analyses. SETTING: Heterogeneous sample of employees (workers and supervisors) from 22 companies across geographical locations and work divisions in Norway. PARTICIPANTS: Employees (N=5388) responded on survey items measuring workplace factors and alcohol use. OUTCOMES: Data on alcohol use were collected with the Alcohol Use Disorders Identification Test (AUDIT). Consumption was measured with the AUDIT-C (the first three items), and alcohol-related problems were operationalised as a sum score of eight or higher on the full ten-item AUDIT. RESULTS: Higher levels of alcohol consumption were associated with more liberal workplace drinking social norms (b=1.37, p<.001), working full-time (b=.18, p<.001), working from holiday home (b=.40, p<.01), being a supervisor (b=.25, p<.001), having supervisors with less desired leadership qualities (b=-.10, p<.01), shorter working hours (b=-.03, p<.05), higher workplace social support (b=.13, p<.05), and higher income (b=.02, p<.001). Alcohol-related problems were associated with more liberal drinking social norms (OR=3.52, p<.001) and shorter working hours (OR=0.94, p<.05). CONCLUSIONS: Workplace drinking social norms was the supremely most dominant predictor of both consumption and alcohol-related problems. Results suggest that some workplace factors may play a role in explaining employee alcohol consumption, although the predictive ability of these factors was limited. This study points to the importance of drinking social norms, workplace drinking culture and leadership for understanding employee alcohol use.

• Kaddech, Nabil; Guelmami, Noomen; Bonsaksen, Tore; Doggui, Radhouane; Beji, Chiraz & Elati, Jalila (2022). Adaptation and Psychometric Evidence of the ARABIC Version of the Diabetes Self-Management Questionnaire (A-DSMQ). Healthcare. 10(5), p. 1051–1051. doi: 10.3390/healthcare10050951. Full text in Research Archive Show summary

  1) Background: Diabetic patients must engage in self-care practices in order to maintain optimal glycemic control, hence reducing the likelihood of developing complications, and enhance the overall quality of their lives. The Diabetes Self-care Management Questionnaire (DSMQ) is a tool for assessing self-management habits that may be used to predict glycemic control in people with diabetes. However, no Arabic language version of the instrument has been found. Therefore, we adapted an Arabic language version of the instrument in Tunisia. The purpose of the current research aimed to assess the psychometric features of the Tunisian version of the DSMQ in patients with type 2 diabetes. (2) Method: Two samples including both genders, one exploratory (n = 208, mean age 53.2 ± 8.3) and one confirmatory (n = 441, mean age 53.4 ± 7.4), completed an adapted Arabic language version of the DSMQ, a sociodemographic questionnaire and information about their HbA1C levels. (3) Results: The exploratory factor analysis revealed that the 15 items of the A-DSMQ fit well with the data. Likewise, the alpha coefficients for the A-DSMQ factors were above 0.80: for “Glucose Management” (GM), “Dietary Control” (DC), “Physical Activity” (PA), and “Heath-Care Use” (HU). The fit indices for the CFA were good, and the four-factor solution was confirmed. The Average Variance Extracted values and Fornell–Larcker criterion established the convergent and discriminant validity, respectively. The concurrent validity of the tool was established through the statistically significant negative relationships between the A-DSMQ factors and HbA1C, in addition to its positive association with the practice of physical activity measured by the IPAQ. (4) Conclusions: Given the high EFA factor loadings, the CFA fit indices, the correlation matrix, the sensitivity analysis, the convergent validity, and the excellent internal consistency of the A-DSMQ, it can be concluded that the A-DSMQ is an effective psychometric tool for diabetes self-management in Tunisia

• Stigen, Linda; Mørk, Gry; Carstensen, Tove; Magne, Trine A; Gramstad, Astrid & Johnson, Susanne Grødem [Show all 8 contributors for this article] (2022). Perceptions of the academic learning environment among occupational therapy students – changes across a three-year undergraduate study program. BMC Medical Education. 22(1). doi: 10.1186/s12909-022-03291-0. Full text in Research Archive Show summary

  Introduction: Although the learning environment influences students’ motivation, learning outcomes, and satisfaction with the study program, less is known about how these factors change as the students’ progress through the study program. Aim: The aim of this study was to examine changes in occupational therapy students’ perceptions of the academic learning environment during their three-year study program and to examine factors associated with the students’ perceptions of the learning environment. Materials and methods: A longitudinal cohort study was conducted throughout the three-year study program. Data were collected annually using the Course Experience Questionnaire (CEQ). In total, 263 students from six occupational therapy programs participated in at least one data gathering point. The number of participants was 186 in the first year, 168 in the second year and 200 in the third year. Of the 263 students who participated in the study, 87 participated in only one point of data collection, 58 at two points and 118 at all three points of the data collection. Data were analyzed with linear mixed models. Results: The results showed statistically significant temporal changes on the “Emphasis on independence”, “Good teaching” and “Generic skills” scales. There was a significant decrease in scores from the first to the second year of study and the scores remained at this level in the third study year on both the “Emphasis on independence” and “Good teaching” scales. In addition, associations were found between study effort and educational institution related to the “Appropriate workload” scale, as well as between age and the “Generic skills” scale. Conclusion: The temporal changes of the students’ perceptions of the “Emphasis on independence” as well as “Good teaching” scales are noteworthy. Both scales indicated a significant decrease in scores, indicating that the students perceived that they were less independent from first to second and third year, as well as a perceived decline in the quality of teaching from first to second and third year. The results of this study are central when planning to facilitate learning, especially related to independence and perceptions of good teaching for students in occupational therapy programs.

• Baklouti, Souad; Fekih-Romdhane, Feten; Guelmami, Noomen; Bonsaksen, Tore; Baklouti, Hana & Aloui, Asma [Show all 9 contributors for this article] (2022). The effect of web-based Hatha yoga on psychological distress and sleep quality in older adults: a randomized controlled trial. Complementary Therapies in Clinical Practice. ISSN 1744-3881. doi: 10.1016/j.ctcp.2022.101715. Full text in Research Archive Show summary

  Background: To date, there has been very limited experimental research on the impact of Yoga on older adults' mental health during the COVID-19 crisis. We aimed to explore the effect of a web-based Hatha yoga program on psychological and quality of sleep in older adults who self-isolated at home during the initial stage of the COVID-19 outbreak. Methods: Two hundred volunteers of both sexes were split into experimental (Yoga group, YG) and control (Control group, CG) groups, in a web-based randomized controlled study. All participants were administered the Depression, Anxiety and Stress Scales (DASS-21) and the Pittsburgh sleep quality index (PSQI); at baseline and following an eight-week online Hatha yoga intervention. Results: The YG showed significant reductions in depression (-56.1%; Z = 5.67, p < 0.01, r = 0.70) anxiety (-64.3%; Z = 5.27, p < 0.01, r = 0.65) and stress (-68.2%; Z = 5.86, r = 0.73) scores, while the CG showed a significant increase in depression. In addition, the total PSQI score of the YG was considerably lower during follow-up (3.38 ± 2.02, p < 0.05) than at baseline (4.8 ± 32, p < 0.05), which indicates an improvement of the quality of sleep. The proportion of individuals experiencing good sleep from the YG increased from 63% to 85% after the Hatha yoga intervention. Conclusion: The use of a web-based Hatha Yoga intervention program was associated with a beneficial effect on the mental health and quality of sleep in older adults. Keywords: COVID-19; Distress; Older adults; Quality of sleep; Yoga.

• DaLomba, Elaina; Bonsaksen, Tore; Greer, Mary Jan & Mansur, Saji (2022). Changes in study approaches, self-efficacy, and mental health in allied healthcare students during the COVID-19 crisis. Journal of Occupational Therapy Education. 6(2), p. 1–13. Full text in Research Archive Show summary

  There is growing concern about student mental health, particularly during the COVID-19 crisis. Mental health factors impact self-efficacy and study behaviors, thus there is a need to explore changes in these factors during the pandemic. The aim of this study was to explore changes in allied healthcare students’ approaches to studying, self-efficacy and positive mental health before and during the COVID-19 crisis. The Approaches and Study Skills Inventory for Students, General Self-efficacy scale, Mental Health Continuum – Short Form were given to graduate students (n=26) prior to, and one year into the pandemic. Repeated measures analyses of variance were performed. General self-efficacy scores increased with large effect size, while no significant change pattern was observed for mental health scores. The decrease in strategic study approach scores had a large effect size. The changes in deep and surface study approach scores across time were not statistically significant. While students sustained their mental health and increased their self-efficacy, students may benefit from assistance in organizing daily academic routines and fostering community support during times of crisis.

• Bonsaksen, Tore; Thørrisen, Mikkel Magnus; Hashemi, Neda; Porras, David Gimeno Ruiz de & Aas, Randi Wågø (2022). Do health professionals’ attitudes towards alcohol use matter for alcohol prevention efforts? Results from the WIRUS-OHS study. BMC Health Services Research. 22(1), p. 1004–1004. doi: 10.1186/s12913-022-08400-9. Full text in Research Archive Show summary

  BACKGROUND: Use of alcohol is a major public health issue, representing the 7th largest burden of disease in the world. Workplaces offer a unique arena for health initiatives addressing alcohol use, where occupational health services (OHS) personnel play an important role. However, we do not know if the extent of such initiatives may be influenced by personal drinking attitudes among OHS personnel. Thus, the aim of the study was to explore how drinking attitudes among OHS personnel were associated wit their frequency of working with alcohol-related cases and with their views on alcohol prevention activities in the OHS. METHODS: The WIRUS project included a cross-sectional survey of attitudes and practices among OHS personnel (n=325) employed by Norwegian OHS services (n=69), who informed about sociodemographics and professional characteristics, drinking attitudes, frequency of cases with alcohol-related issues, and perceptions toward the role of the OHS in primary, secondary, and tertiary prevention activities. Measures of associations were examined with linear and logistic regression models. RESULTS: Drinking attitudes were unrelated to the frequency of working with alcohol-related cases. Physicians, psychologists, and nurses had higher frequency of working with alcohol-related cases, compared to those with other professional backgrounds (β=0.46, p=0.01). Drinking attitudes were also unrelated to attitudes towards primary/secondary/tertiary prevention activities in OHS, while female OHS personnel were more positive towards increased primary alcohol prevention in the OHS (OR:1.82, p<0.05). Only marginal portions (1%-3%) of the variance in attitudes towards alcohol prevention activities in the OHS were accounted for by the models. CONCLUSION: This study did not find evidence of associations between OHS personnel's drinking attitudes and their practices towards alcohol prevention activities. The lack of association between OHS personnel's attitudes towards alcohol use and their attitudes and practices relating to alcohol prevention in the workplace might point towards professionalism, as personal attitudes appear not to interfere with their priorities and professional mission. Given the small amount of outcome variance explained by the tested models, other variables should be used in future studies.

• Bonsaksen, Tore; Chiu, Vivian; Leung, Janni; Schoultz, Mariyana; Thygesen, Hilde & Price, Daicia [Show all 8 contributors for this article] (2022). Students’ Mental Health, Well-Being, and Loneliness during the COVID-19 Pandemic: A Cross-National Study. Healthcare. 10(6), p. 996–996. doi: 10.3390/healthcare10060996. Full text in Research Archive Show summary

  During the COVID-19 pandemic, much research has been devoted to assessing mental health in a variety of populations. Students in higher education appear to be particularly vulnerable to experiencing reduced mental health. The purpose of the study was to assess whether higher education students experienced poorer mental health compared to the general population and examine the factors associated with students’ mental health during the COVID-19 pandemic. A cross-national sample of students (n = 354) and non-students (n = 3120) participated in a survey in October/November 2020. Mental health outcomes among students and non-students were compared with independent t-tests. Multiple linear regression analysis and general linear estimation were used to assess the impact of student status on mental health outcomes while adjusting for sociodemographic factors. Students reported poorer mental health than non-students. The difference in mental health between students and non-students was bigger for participants aged 30 years or older. More social media use was associated with poorer mental health outcomes. In conclusion, students had poorer mental health than the wider population. Aspects of life as a student, beyond what can be attributed to life stage, appears to increase mental health problems.

• Thygesen, Hilde; Bonsaksen, Tore; Schoultz, Mariyana; Mary, Ruffolo; Leung, Janni & Price, Daicia [Show all 7 contributors for this article] (2022). Social Media Use and Its Associations With Mental Health Nine Months After the COVID-19 Outbreak: A Cross-National Study. Frontiers in Public Health. 9. doi: 10.3389/fpubh.2021.752004. Full text in Research Archive Show summary

  Background: The covid-19 pandemic has impacted the health and well-being of millions across the globe. Strict social distancing policies and periodic lockdowns has led to an increased reliance on alternative online means of communication, including social media. Objectives: to examine (i) social media use and mental health in the general population 9 months after the COVID-19 pandemic outbreak and (ii) mental health in relation to motives for and extent of social media use, while adjusting for sociodemographic variables. Methods: A cross-national online survey was conducted in Norway, UK, USA and Australia. Participants (n = 3,474) reported extent of and motives for social media use and completed the 12-item General Health Questionnaire. The data were analyzed by chi-square tests, one-way analyses of variance, and multiple linear regression analysis. Results: Poorer mental health was associated with using social media to decrease loneliness and for entertainment motives, while better mental health was associated with using social media for personal contact and maintaining relationships. Overall increased daily time on social media was associated with poorer mental health. The social media use variables were responsible for a substantial proportion of the outcome variance explained. These findings were consistent across the four countries, with only minor variations. Conclusions: Motives for using, and time spent using, social media were associated with the participants' mental health. Guidance and recommendations for social media usage to the general public for prevention and intervention for behavioral health may be beneficial.

• Aas, Maren H. & Bonsaksen, Tore (2022). Exploring occupation-based practice among occupational therapists in hospitals and rehabilitation institutions. Scandinavian Journal of Occupational Therapy. ISSN 1103-8128. doi: 10.1080/11038128.2022.2059564. Full text in Research Archive Show summary

  Background While occupational therapists value occupation-based practice, they appear to spend less time on this approach and more time on impairment-based practices. Several barriers are reported for the occupation-based approach. Aim To explore different aspects of occupation-based practice among occupational therapists working in hospitals and rehabilitation institutions, and to examine associations between sociodemographic factors, barriers, and occupation-based practice. Materials and methods A cross-sectional survey was conducted. Participants were occupational therapists working in hospitals and rehabilitation institutions in Norway. The data were analysed with descriptive statistics and logistic regression. Results The therapists (n = 124) valued occupation-based practice and reported using it frequently and to a large extent. Relatively small proportions of their practice (26% assessments and 38% interventions) were classified as occupation-based. Lack of time, space and equipment were reported as large barriers. Lack of time and lack of equipment were associated with low self-reported level of occupation-based practice. Conclusions The participants valued occupation-based practice, while the reported assessment and intervention methods were mainly not occupation-based. Several barriers were reported, and some were associated with less use of occupation-based practice.

• Bonsaksen, Tore; Leung, Janni; Price, Daicia; Ruffolo, Mary; Lamph, Gary & Kabelenga, Isaac [Show all 8 contributors for this article] (2022). Self-Reported Long COVID in the General Population: Sociodemographic and Health Correlates in a Cross-National Sample. Life. 12(6), p. 901–901. doi: 10.3390/life12060901. Full text in Research Archive Show summary

  We aimed to gain knowledge of possible sociodemographic predictors of long COVID and whether long COVID was associated with health outcomes almost two years after the pandemic outbreak. There were 1649 adults who participated in the study by completing a cross-sectional online survey disseminated openly in Norway, the UK, the USA, and Australia between November 2021 and January 2022. Participants were defined as having long COVID based on self-reports that they had been infected by COVID-19 and were experiencing long-lasting COVID symptoms. Logistic regression analyses were used to examine possible sociodemographic predictors, and multivariate analysis of variance was used to examine whether long COVID status was associated with health outcomes. None of the sociodemographic variables was significantly associated with reporting long COVID. Having long COVID was associated with higher levels of psychological distress, fatigue, and perceived stress. The effect of long COVID on health outcomes was greater among men than among women. In conclusion, long COVID appeared across sociodemographic groups. People with long COVID reported worsened health outcomes compared to those who had had COVID-19 but without long-term symptoms. Men experiencing long COVID appear to be particularly vulnerable to experiencing poorer health outcomes; health services may pay extra attention to potentially unnoticed needs for support among men experiencing long COVID.

• Bredal, Inger Schou; Bonsaksen, Tore; Ekeberg, Øivind; Skogstad, Laila; Grimholt, Tine Kristin & Heir, Trond (2022). A comparison between healthcare workers and non-healthcare workers’ anxiety, depression and PTSD during the initial COVID -19 lockdown. Public Health in Practice. 3. doi: 10.1016/j.puhip.2022.100267. Full text in Research Archive Show summary

  Objective: Several studies have found that Healthcare workers are vulnerable to mental health problems during the COVID-19 pandemic. However, few studies have made comparisons of healthcare workers (HCWs) and nonHCWs. The current study aimed to compare mental health problems among HCWs with non-HCWs during the initial lockdown of COVID 19.<p> <p>Study design: A population-based cross-sectional survey. Methods: The survey was conducted by means of an open web link between April and May 2020. Data were collected by self-report. The PTSD Checklist for DSM-5 (PCL-5) was used to assess posttraumatic stress.<p> <p>Results: A total of 4527 citizens answered the questionnaire and 32.1% were HCWs. The majority were female, under 60 years of age, and lived in urban areas. Among the HCWs, the majority were registered nurses working in hospitals. The prevalence were 12.8% vs 19.1% for anxiety, 8.5% vs 14.5% for depression and 13.6% vs 20.9% for PTSD among HCWs and non-HCWs respectively. The highest prevalence’s for anxiety and PTSD among HCWs were found for those under 40 years of age and having low education level (<12 years).<p> <p>Conclusion: Mental health problems was significantly lower among HCWs compared to non-HCWs. However, the COVID-19 poses a challenge for HCWs, especially young HCWs and those with low level of education. Providing support, appropriate education, training, and authoritative information to the different members of the HCWs could be effective ways to minimize the psychological effect.

• Mørk, Gry; Stigen, Linda; Gramstad, Astrid; Magne, Trine A; Carstensen, Tove & Bonsaksen, Tore (2022). Stable and unstable associations between learning environment factors and study approaches: two consecutive cross-sectional analyses of Norwegian occupational therapy students. Learning Environments Research. ISSN 1387-1579. doi: 10.1007/s10984-022-09445-7. Full text in Research Archive Show summary

  Relationships between learning environment variables and students' approaches to studying have been investigated from many points of view over the last decades. However, few studies have explored whether such relationships are stable over time. In the two consecutive cross-sectional analyses performed in this study, Norwegian occupational therapy students' perceptions of their learning environment and their approaches to studying were assessed in the second (162 students) and third (193 students) year of their study program. Aside from sociodemographic information, the students completed the Course Experience Questionnaire and the Approaches and Study Skills Inventory for Students, with the aim of exploring whether associations between learning environment variables and study approaches were stable across time. The data were analyzed with hierarchical linear regression analyses. Relatively stable associations with students' study approaches were found for the learning environment variables of 'generic skills' and 'appropriate workload'. The learning environment variables of 'clear goals and standards' and 'student autonomy' were directly associated with study approaches in both study years, but the nature of the associations shifted during the study period. Thus, knowledge of stability and change in these relationships could assist faculty in promoting a well-functioning learning environment throughout the study program. Keywords: Approaches to learning; Entwistle model; Generic skills; Higher education; Learning environment; Occupational therapy.

• Geirdal, Amy Østertun; Nerdrum, Per; Høglend, Per Andreas & Bonsaksen, Tore (2022). Changes in Psychological Distress in Five Groups of Welfare State Service Workers over a Nine-Year Period. Healthcare. 10(4). doi: 10.3390/healthcare10040592. Full text in Research Archive Show summary

  Health and social care workers are exposed to varying degrees of stress in their work, which may be reflected in their trajectories of psychological distress during the education program and the first years in the job. The aim of this study was to add to the knowledge concerned with the long-term development of psychological distress in five groups of welfare state service workers in Norway. The study included 1612 individuals. Psychological distress was measured with General Health Questionnaire-12 at four occasions from the start of the education program to 6 years post-graduation (nine year follow-up period). Results of linear mixed models (LMM) for repeated measures showed that psychological distress changed significantly over time in the social work professional groups. At the start of the education program, the lowest and highest levels of psychological distress were found among the child welfare and social workers, respectively. Six years post-graduation, social workers had become less distressed and child welfare workers had become more distressed. No significant change pattern for psychological distress was found among any of the health care professional groups.

• Bonsaksen, Tore; Brunes, Audun & Heir, Trond (2022). Post-traumatic stress disorder in people with visual impairment compared with the general population. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 19(2), p. 619–619. doi: 10.3390/ijerph19020619. Full text in Research Archive Show summary

  Background: People with a visual impairment appear to have an increased risk of experiencing potentially traumatizing life events and possibly also subsequently developing post-traumatic stress disorder (PTSD). This study investigated the point prevalence of PTSD in people with a visual impairment compared with the general population of Norway and examined factors associated with PTSD among people with a visual impairment. Methods: A telephone-based survey was administered to a probability sample of 1216 adults with a visual impairment. Of these, 736 (61% response rate) participated. A probability sample from the general population served as a reference (n = 1792, 36% response rate). PTSD was measured with the PTSD Checklist for the DSM-5 (PCL-5), based on the currently most bothersome event reported from the Life Events Checklist for DSM-5 (LEC-5). We used the DSM-5 diagnostic guidelines to categorize participants as fulfilling the PTSD symptom criteria or not. Results: The prevalence of PTSD was higher among people with a visual impairment than in the general population, both for men (9.0% vs. 3.8%) and women (13.9% vs. 8.5%). The prevalence rates of PTSD from the illness or injury that had caused the vision loss (men 3.9%, women 2.2%) accounted for a considerable part of the difference between the populations. For women, PTSD related to sexual assaults also contributed significantly to a higher PTSD prevalence in the visually impaired versus the general population (5.2% vs. 2.2%), while for men there were no other event categories which resulted in significant differences. Among people with a visual impairment, the higher risk of PTSD was associated with lower age, female gender, having acquired the vision loss, and having other impairments in addition to the vision loss. Conclusion: The higher prevalence of PTSD in people with a visual impairment suggests that vulnerability to mental health problems is associated with serious life events. The higher incidence than in the general population is partly due to the illness or injury that had led to the vision loss and partly due to people with vision loss appearing to be more vulnerable through exposure to other types of potentially traumatizing events, such as sexual abuse.

• Helgøy, Kjersti Velde; Bonsaksen, Tore & Røykenes, Kari (2022). Research-based education in undergraduate occupational therapy and physiotherapy education programmes: a scoping review. BMC Medical Education. 22(1), p. 1–23. doi: 10.1186/s12909-022-03354-2. Full text in Research Archive Show summary

  Background In a research-based learning environment, students learn how to become critical thinkers and lifelong learners, and to generate discipline-enriching knowledge. Research training is important for all healthcare professionals and the integration of research in education can be one approach to improve evidence-based practice among future professionals. The purpose of this scoping review was to identify studies reporting on research-based education in undergraduate occupational therapy and physiotherapy curricula to document the current state of knowledge and to map factors that reflect and support the implementation of research-based education in undergraduate occupational therapy and physiotherapy programmes. Methods A scoping review was used to systematically select and summarize existing literature. The search was conducted using a combination of keywords and MeSH terms in the following databases: EBSCO (Academic Search Elite, CINAHL, ERIC), MEDLINE, Embase, Education Source and grey literature. A thematic analysis identified strategies used to implement and promote research-based education in occupational therapy and physiotherapy bachelor programmes. Results The database search identified 3068 records. 75 were eligible for full-text assessment and 27 studies were included. The studies were published between 1999 and 2021 and were conducted in Norway, Canada, South Africa, Australia, the United Kingdom, the United States, New Zealand, Ireland, Taiwan, Italy, and Iran. The study designs were mainly quantitative and qualitative, and studies included primarily occupational therapy and physiotherapy students. We identified the following four strategies: ‘student engagement in research’, ‘curriculum improvement regarding EBP’, ‘EBP teaching’ and ‘journal club’, where ‘EBP teaching’ was most frequently identified. Conclusions Findings from this scoping review suggest that ensuring students’ competence in research methods is necessary for students to be able to read and understand research articles, which are important as foundational skills in undergraduate research training. Journal clubs can be a foundation for student engagement with research literature, and students’ basic research skills may be facilitated through their involvement in research projects and by conducting systematic reviews. Further, cooperation with clinical practice is important, and the awareness of research-based education should be increased among both faculty members and students.

• Asbjørnslett, Mona; Bull, Helen; Mørk, Gry & Bonsaksen, Tore (2022). First year occupational therapy students’ engagement in learning activities - a qualitative study. Journal of Occupational Therapy Education. 6(4). doi: 10.26681/jote.2022.060401. Full text in Research Archive Show summary

  When students enter a bachelor program in occupational therapy, they engage in a variety of learning activities. To explore students’ perceptions of learning activities, this qualitative study investigated the experiences of six first year students participating in an occupational therapy study program at a Norwegian university. The students took part in two focus group interviews. The interview analysis focused on meaning and ended up with three main themes: 1. Getting to know each other through collaborative learning activities, 2. Engaging in classroom learning activities, and 3. Approaching the syllabus and doing assignments. The study concludes that early engagement in social and collaborative learning activities can be a meaningful prerequisite to future learning focused on meaning and feeling safe in the learning environment. Teaching styles also influence students’ engagement in the occupation of studying, with the change from one teaching style to another being particularly challenging for the students.

• Mørk, Gry; Gramstad, Astrid; Åsli, Lene Angel; Stigen, Linda; Johnson, Susanne Grødem & Magne, Trine A [Show all 9 contributors for this article] (2022). Approaches to studying: changes during a three-year undergraduate study program. Scandinavian Journal of Educational Research. ISSN 0031-3831. doi: 10.1080/00313831.2022.2148274. Full text in Research Archive Show summary

  Whether higher education students’ approaches to studying are amenable to change, is disputed. In this study, Norwegian occupational therapy students’ (n = 263) approaches to studying were assessed annually across the three-year course, with the aim of exploring changes during the undergraduate study program. Sociodemographic information and the Approaches and Study Skills Inventory for Students were completed. Changes during the follow-up period were analyzed using linear mixed models for repeated measures. A significant increase in deep approach scores and a decrease in surface approach scores during the study program was revealed. The strategic approach remained unchanged, but with a difference between education institutions. Overall, the study suggests that the students’ approaches to studying changed in a positive direction during the study program. Attention should be given to students at risk of adopting a surface approach to studying and to the individual and contextual elements influencing study behaviors.

• Rosenberg, Marte Kimo & Bonsaksen, Tore (2022). Job satisfaction among psychomotor physiotherapists in Norway. INQUIRY (INQ). ISSN 0046-9580. 59, p. 1–8. doi: 10.1177/00469580221126763. Full text in Research Archive Show summary

  The objective of the study was to investigate (i) levels of job satisfaction among employed and self-employed psychomotor physiotherapists in Norway and (ii) factors associated with job satisfaction. Although there are several studies on job satisfaction among physiotherapists, there is limited knowledge about job satisfaction among psychomotor physiotherapists in Norway. A cross-sectional survey was distributed to Norwegian psychomotor physiotherapists (n=64) via a weblink. Job satisfaction was measured with 2 different scales (Warr’s and Speakman’s Job Satisfaction Scales). Group differences were analyzed with chi-squared tests and independent sample t-tests. Adjusted associations with job satisfaction were analyzed with multivariate linear regression. Fifty-eight women (90.6%) and 6 men (9.4%) were included in the study. The results revealed an overall high level of job satisfaction among the participants. None of the independent variables were associated with ratings on Warr’s Job Satisfaction Scale. When using Speakman’s Job Satisfaction Scale as outcome, employed practitioners had a higher level of job satisfaction, compared to their self-employed counterparts (P<.01). Being employed was associated with a higher level of job satisfaction, compared to being self-employed. Self-employed physiotherapists also felt more overworked and experienced the job to be more physically demanding than their counterparts.

• Tannoubi, Amayra; Guelmami, Noomen; Bonsaksen, Tore; Chalghaf, Nasr; Fairouz, Azaiez & Bragazzi, Nicola Luigi (2022). Development and Preliminary Validation of the Physical Education-Study Process Questionnaire (PE-SPQ): Insights for Physical Education university students. Frontiers in Public Health. 10. doi: 10.3389/fpubh.2022.856167. Full text in Research Archive Show summary

  Background: The Revised Two Factor Study Process Questionnaire (R-SPQ-2F) is used to examine students' study approaches in higher education. The questionnaire is designed to measure two factors: deep and surface approaches. In order to measure these approaches for students in physical education and sport, a new measurement instrument should take into consideration the practical context of this field of education that makes it specific to other fields. Objective: The present study aims (a) to develop and empirical test of a new instrument for measuring the study process in physical education and sports students, and (b) to test psychometric properties of the tool. Methods: Two exploratory and confirmatory samples of physical education students enrolled in a bachelor's degree program in physical education at the High Institute of Physical Education and Sports of Kef-Tunisia, aged 19–26 years, were recruited online among female students (n = 414) and male students (n = 393). The participants filled in Google Form survey including Physical Education-Study Process Questionnaire (PE-SPQ) and the Arabic version of the Revised Study Process Questionnaire-2 Factors (R-SPQ-2F). Results: Exploratory factor analysis showed a suitable four factors solution, which is approved by confirmatory factor analysis indices [χ2 = 466.47, TLI = 0.94, CFI = 0.95; RMSEA = 0.56 IC 90% (0.050–0.062)]. Internal consistency of the PE-SPQ simultaneously checked by McDonald's ω, Cronbach's α and Gutmann's λ6 showed good reliability of the PE-SPQ. Convergent validity examined by Average variance extracted (AVE) was good. The comparison between the AVE root mean square and Pearson correlation coefficients of each factor with his indicators reveals the discriminant validity of the PE-SPQ. Furthermore, Pearson's correlation between the PE-SPQ factors and the R-SPQ-2F establishes the concurrent validity of the new scale. Conclusion: The PE-SPQ scale is valid and reliable and can be used to assess study process factors in physical education students.

• DaLomba, Elaina; Bonsaksen, Tore & Mansur, Saji (2022). Healthcare Students’ Approaches to Studying in Association With Self-Efficacy and Mental Health: Repeated Cross-Sectional Analysis. Occupational Therapy in Mental Health. ISSN 0164-212X. doi: 10.1080/0164212X.2022.2078757. Full text in Research Archive Show summary

  There has been increasing concern about student mental health, self-efficacy, and their impact on approaches to learning. Little is known about how these three constructs relate and change over time. This is a second study exploring graduate occupational and physical therapy students’ approaches to studying, mental health factors, self-efficacy, and changes in relationships between these factors over time. We found that higher self-efficacy was related to higher deep approach ratings, while higher mental health ratings were related to higher strategic approach ratings and lower surface approach ratings. Self-efficacy and mental health show relatively consistent associations over time with student approaches to learning.

• Edvardsen, Even Elias; Dalseth, Eline Fjærestad; Johnson, Susanne Grødem; Stigen, Linda; Mørk, Gry & Magne, Trine A [Show all 9 contributors for this article] (2022). Occupational therapy students’ preferences for teaching and course design across a three-year undergraduate education program. Irish Journal of Occupational Therapy (IJOT). ISSN 0791-8437. 50(1), p. 51–57. doi: 10.1108/IJOT-03-2022-0012. Full text in Research Archive Show summary

  Purpose - Understanding students’ preferences for teaching and course design is important for educators in higher education when planning courses and teaching activities. The purpose of this study was to explore changes in occupational therapy students’ preferences for teaching and courses across the three-year study program. <p> <p>Design/methodology/approach - A total of 263 students participated in a longitudinal study, where preferences were measured with the Approaches and Study Skills Inventory for Students. The data were analyzed with linear mixed effect models for repeated measures. <p> <p>Findings - The results indicated no significant changes in preferences for courses and teaching over the three-year period. Also, there were no significant differences between the six involved study programs. Preferences for the courses and teaching type “supporting understanding” were associated with higher age and higher study effort. Preferences for the courses and teaching type “transmitting information” were associated with lower age and female gender. <p> <p>Originality/value - In summary, the findings of this study suggest that preferences for teaching and courses are stable and may be challenging to alter during a three-year undergraduate study program.

• Thygesen, Hilde; Bonsaksen, Tore; Schoultz, Mariyana; Ruffolo, Mary; Leung, Janni & Price, Daicia [Show all 7 contributors for this article] (2021). Use and self‑perceived effects of social media before and after the COVID‑19 outbreak: a cross‑national study. Health and Technology. ISSN 2190-7188. doi: 10.1007/s12553-021-00595-x. Full text in Research Archive Show summary

  To (i) examine the use of social media before and after the COVID-19 outbreak; (ii) examine the self-perceived impact of social media before and after the outbreak; and (iii) examine whether the self-perceived impacts of social media after the outbreak varied by levels of mental health. A cross-national online survey was conducted in Norway, UK, USA and Australia. Participants (n = 3810) reported which social media they used, how frequently they used them before and after the COVID-19 outbreak, and the degree to which they felt social media contributed to a range of outcomes. The participants also completed the 12-item General Health Questionnaire. The data were analyzed by chi-square tests and multiple linear regression analysis. Social media were used more frequently after the pandemic outbreak than compared to before the outbreak. Self-perceived effects from using social media increased after the COVID-19 outbreak, and in particular stress and concern for own and others’ health. Emotional distress was associated with being more affected from using social media, in particular in terms of stress and concern for own or others’ health. The use of social media has increased during the coronavirus outbreak, as well as its impacts on people. In particular, the participants reported more stress and health concerns attributed to social media use after the COVID-19 outbreak. People with poor mental health appear to be particularly vulnerable to experiencing more stress and concern related to their use of social media.

• Bonsaksen, Tore; Nerdrum, Per & Geirdal, Amy Østertun (2021). Psychological distress and its associations with psychosocial work environment factors in four professional groups: A cross-sectional study. Nursing and Health Sciences. ISSN 1441-0745. 23(3), p. 698–707. doi: 10.1111/nhs.12856. Full text in Research Archive Show summary

  This study aimed to explore associations between psychosocial work environment factors and psychological distress in four groups of professionals in Norway. Eight hundred fifty-six professionals participated in this cross-sectional study 6 years after graduation. Data were analyzed with linear and logistic regression analyses. For the sample as a whole, higher psychological distress was associated with higher demands, lower support, lower job satisfaction, more work-home interaction problems, and lower coping in the job. Work-home interaction problems increased the likelihood of having case-level psychological distress. The strength of associations between psychological distress and other factors, such as demands, support, and coping in the job, varied by professional group. In conclusion, problems concerned with work-home interaction were generally associated with higher psychological distress. Between professional groups, other independent variables were differently associated with psychological distress. Work environment factors should receive continued attention in efforts to promote mental health.

• Bonsaksen, Tore; Ruffolo, Mary; Leung, Janni; Price, Daicia; Thygesen, Hilde & Schoultz, Mariyana [Show all 7 contributors for this article] (2021). Loneliness and its association with social media use during the COVID-19 outbreak. Social Media + Society. 7(3), p. 1–10. doi: 10.1177/20563051211033821. Full text in Research Archive Show summary

  Social distancing rules during the COVID-19 pandemic changed social interaction for many and increased the risk of loneliness in the general population. Social media use has been ambiguously related to loneliness, and associations may differ by age. The study aimed to examine loneliness and its association with social media use within different age groups during the COVID-19 pandemic. A cross-sectional online survey was conducted in Norway, the United Kingdom, the United States, and Australia during April/May 2020, and 3,810 participants aged 18 years or above were recruited. Multiple regression analyses were conducted to examine associations between social media use and social and emotional loneliness within separate age groups. Emotional loneliness was higher among young adults and among those who used social media several times daily. Adjusting by sociodemographic variables, using more types of social media was associated with lower social loneliness among the oldest participants, and with higher emotional loneliness among the youngest participants. Among middle-aged participants, using social media more frequently was associated with lower social loneliness. We found that the associations between social media use and loneliness varied by age. Older people’s engagement on social media may be a resource to reduce loneliness during the COVID-19 pandemic. We observed higher levels of loneliness among high-frequent social media users of younger age.

• Bonsaksen, Tore; Skogstad, Laila; Heir, Trond; Ekeberg, Øivind; Bredal, Inger Schou & Grimholt, Tine Kristin (2021). Suicide Thoughts and Attempts in the Norwegian General Population during the Early Stage of the COVID-19 Outbreak. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 18(8), p. 1–9. doi: 10.3390/ijerph18084102. Full text in Research Archive Show summary

  The aim of the study was to examine the prevalence of suicide thoughts and attempts during the early stage of the COVID-19 outbreak and examine pandemic-related factors associated with suicide thoughts in the general Norwegian population. A sample of 4527 adults living in Norway were recruited via social media. Data related to suicide thoughts and attempts, alcohol use, pandemic-related concerns, and sociodemographic variables were collected. Associations with suicide thoughts were analyzed with logistic regression analysis. In the sample, 3.6% reported suicide thoughts during the last month, while 0.2% had attempted suicide during the same period. Previous suicide attempts (OR: 11.93, p < 0.001), lower age (OR: 0.69, p < 0.001), daily alcohol use (OR: 3.31, p < 0.001), being in the risk group for COVID-19 complications (OR: 2.15, p < 0.001), and having economic concerns related to the pandemic (OR: 2.28, p < 0.001) were associated with having current suicide thoughts. In addition to known risk factors, the study suggests that aspects specific to COVID-19 may be important for suicidal behaviors during the pandemic.

• Price, Daicia; Bonsaksen, Tore; Ruffolo, Mary; Leung, Janni; Chiu, Vivian & Thygesen, Hilde [Show all 8 contributors for this article] (2021). Perceived Trust in Public Authorities Nine Months after the COVID-19 Outbreak: A Cross-National Study. Social Sciences. 10(9), p. 349–349. doi: 10.3390/socsci10090349. Full text in Research Archive Show summary

  This study aimed to examine the perceived trust in information provided by public authorities and financial measures put in place to address the impact of COVID-19. Using a cross-national approach among four Western countries—the United States of America, Norway, Australia, and the United Kingdom—provides an analysis of responses related to trust and how they were associated with age group, gender, education level, employment status, size of place of residence, infection status, and social media use. When controlling for all included variables in logistic regression analyses, the likelihood of having trust in the public authorities’ information was higher for women, those with higher levels of education, and those living in urban areas. Being infected with the coronavirus, and spending more time daily on social media, were both associated with lower likelihood of reporting trust in information. Although policies implemented to respond to economic concerns varied cross-nationally, higher age, identifying as female, being employed, living in a city, no COVID-19 infection experience and lower levels of social media usage were associated with a higher likelihood of trusting in the financial measures put in place to counteract the economic effects of COVID-19.

• Helgøy, Kjersti Velde; Smeby, Jens-Christian & Bonsaksen, Tore (2021). Practice educators’ emphasis on research in supervision of occupational therapy students. Scandinavian Journal of Occupational Therapy. ISSN 1103-8128. p. 1–15. doi: 10.1080/11038128.2021.1968948. Full text in Research Archive Show summary

  Background: One approach to promote students’ use of research in future practice involves integrating students’ research use in supervision during practice placements. Studies examining this aspect of supervision in practice placements are lacking. Aim: To explore how practice educators perceive and emphasize research in their supervision of occupational therapy students during practice placements. Materials and methods: A qualitative study was conducted. A purposive sample was recruited, consisting of participants from community-based health services and hospitals in Norway. We conducted three focus groups and one individual interview with occupational therapists (n = 9). The qualitative data analysis was based on interpretive description. Results: We identified four integrative themes: ‘emphasis on research in supervision of students’; ‘practice educators’ research competence and awareness of research’; ‘institutionalization of research use in everyday practice’; and ‘communication and cooperation between education and practice regarding research’. Despite highlighting several benefits of research use, the practice educators focus rarely on students’ research use in practice placements. Conclusions and significance: Cooperation between practice educators and faculty members regarding students’ training in research use seems essential. Practice educators may need additional training in how research should be emphasized in supervision.

• Schou-Bredal, Inger; Grimholt, Tine; Bonsaksen, Tore; Skogstad, Laila; Heir, Trond & Ekeberg, Øivind (2021). Optimists' and pessimists' self-reported mental and global health during the COVID-19 pandemic in Norway. Health Psychology Report. ISSN 2353-4184. 9(2), p. 1–9. doi: 10.5114/hpr.2021.102394. Full text in Research Archive Show summary

  background The COVID-19 pandemic represents a global health crisis. How well people cope with this situation depends on many factors, including one’s personality, such as dispositional optimism. The aim of the study was to investigate: 1) optimists’ and pessimists’ concerns during lockdown, and mental and global health; 2) whether pessimists without known risk factors more often than optimists report being at risk for COVID-19. participants and procedure A snowball sampling strategy was used; 4,527 people, 18 years or older, participated in a survey on a variety of mental health conditions and COVID-19 worries. In addition, they completed the Life Orientation Test-Revised (LOT-R). Optimism was defined by LOT-R f ≥ 17. results Fewer optimists than pessimists reported that they were worried about COVID-19, respectively 51.2% vs. 66.8%, p < .001. Among those reporting none of the known somatic risk factors, more pessimists than optimists (14.3% vs. 9.1%, p < .001) considered themselves at risk of a fatal outcome from COVID-19. Significantly fewer optimists reported that they had anxiety (5.1%), depression (3.4%), suicidal ideation (0.7%) and insomnia (19.3%) during the COVID-19 outbreak than pessimists (24.7% anxiety, 18.4% depression, 5.4% suicidal ideation, 39.8% insomnia, all p < .001). Optimists reported better global health than pessimists (87.2 vs. 84.6, p < .001). conclusions Optimists were generally less worried about the COVID-19 pandemic than pessimists and reported better mental and global health during lockdown. Pessimists more often than optimists reported being at risk for COVID-19 without reporting known risk factors. key words anxiety; COVID-19; depression; dispositional optimism; insomnia

• Bonsaksen, Tore; Magne, Trine A; Stigen, Linda; Gramstad, Astrid; Åsli, Lene Angel & Mørk, Gry [Show all 8 contributors for this article] (2021). Associations between occupational therapy students’ academic performance and their study approaches and perceptions of the learning environment. BMC Medical Education. 21. doi: 10.1186/s12909-021-02940-0. Full text in Research Archive Show summary

  Background Relationships between students’ academic performance and their employed study approaches have been studied extensively. However, research using study approaches and learning environment factors as concurrent predictors of academic performance is sparse. There is a need to disentangle the potentially interrelated influences of individual and contextual factors on students’ academic performance. Objective This study aimed to increase the understanding of the associations between occupational therapy students’ academic performance, and their approaches to studying, perceptions of the learning environment, and sociodemographic characteristics. Method A cross-sectional study was designed, and 174 first-year students completed the Approaches and Study Skills Inventory for Students and the Course Experience Questionnaire, in addition to background information. Data on grades were collected from the data registries of each education institution, and associations were analyzed by multiple linear regression. Results None of the learning environment scales were associated with grades. Adjusting for all variables, better exam results were associated with being female (β = 0.22, p < 0.01) and having higher scores on strategic approach (β = 0.31, p < 0.001) and lower scores on surface approach (β = -0.20, p < 0.01). Conclusion The study suggests that students with a desire for obtaining good grades ought to use strategic study behaviors and avoid using surface approach behaviors. While it is important to ensure good quality of the learning environment for a variety of reasons, the learning environment did not contribute significantly to explain the students’ academic performance.

• DaLomba, Elaina; Mansur, Saji; Bonsaksen, Tore & Greer, Jan (2021). Exploring graduate occupational and physiotherapy students’ approaches to studying, self-efficacy, and positive mental health. BMC Medical Education. 21, p. 124–124. doi: 10.1186/s12909-021-02550-w. Full text in Research Archive Show summary

  Background Occupational and physical therapy academic programs are rigorous. Increased rates of student anxiety and depression may impact learning. Data on student study skills, self-efficacy, and mental health is limited. This study explored relationships between students’ self-efficacy, mental health factors, and approaches to studying. Method A cross-sectional study was designed. Seventy-three students completed the Approaches and Study Skills Inventory for Students-Short Form, General Self-Efficacy Scale, and Mental Health Continuum-Short Form. Associations between predictors (education program, general self-efficacy and mental health) and ratings on the study approach scales were analyzed with multiple linear regression. Results Multiple regression models revealed associations between higher self-efficacy and higher ratings on the deep (β = 0.49, p <  0.01) and strategic (β = 0.34, p <  0.05) scales, and lower ratings on the surface scale (β = − 0.29, p <  0.01). Compared to OT students, PT students had higher surface approach ratings (β = − 0.36, p <  0.001). Poorer mental health scores were associated with higher surface approach ratings (β = − 0.41, p < 0.001). Conclusions To support productive study strategies among occupational and physical therapy students it may be useful to promote their general self-efficacy and positive mental health.

• Bredal, Inger Schou; Skogstad, Laila; Grimholt, Tine K.; Bonsaksen, Tore; Ekeberg, Øivind & Heir, Trond (2021). Concerns in the norwegian population during the initial lockdown due to the covid-19 pandemic. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 18(11). doi: 10.3390/ijerph18116119. Full text in Research Archive Show summary

  Abstract: Although concern affects one’s welfare or happiness, few studies to date have focused on peoples’ concerns during the initial COVID-19 lockdown. The aim of the study was to explore concerns in the Norwegian populations according to gender and age, and identify which concerns were most prominent during the lockdown. A population-based cross-sectional online survey using snowball-sampling strategies was conducted, to which 4527 adults (≥18 years) responded. Questions related to concerns had response alternatives yes or no. In addition, they were asked which concern was most prominent. Nearly all the 4527 respondents (92%) reported that they were concerned: 60.9% were generally concerned about the pandemic, 83.9% were concerned about family and friends, 21.8% had financial concerns, and 25.3% expected financial loss. More women were concerned about family and friends than males, (85.2% vs. 76.2%, p < 0.001), whereas more men expected financial loss (30.4% vs. 24.4%y, p = 0.001). Younger adults (<50 years) had more financial concerns than older adults (25.9% vs. 10.5%, p < 0.001). Being concerned about family and friends was the most prominent concern and was associated with; lower age (OR 0.79), female gender (OR 1.59), and being next of kin (2.42). The most prominent concern for adults 70 years or older was being infected by COVID-19. In conclusion, women and younger individuals were most concerned. While adults under 70 years of age were most concerned about family and friends and adults 70 years or older were most concerned about being infected by COVID-19.

• Price, Daicia; Bonsaksen, Tore; Ruffolo, Mary; Leung, Janni; Thygesen, Hilde & Schoultz, Mariyana [Show all 7 contributors for this article] (2021). Willingness to take the COVID-19 vaccine as reported nine months after the pandemic outbreak: A cross-national study. Social Sciences. 10(11). doi: 10.3390/socsci10110442. Full text in Research Archive Show summary

  Although vaccination has been identified as an effective measure of reducing the spread of COVID-19, hesitancy to obtain a vaccine for COVID-19 has been shared. The aim of this cross-national study was to examine (i) the willingness in the general population to take the COVID-19 vaccine nine months after the pandemic outbreak and (ii) the willingness to take the vaccine in relation to sociodemographic variables, whether one has experienced COVID-19 infection, concerns about health and family, and trust in the authorities’ information about the pandemic. A cross-sectional survey design was used to collect data online in Norway, the UK, the USA, and Australia. Chi-Square tests or Fisher’s Exact test were used to analyze the data. Logistic regression analysis was used to assess direct associations between the independent variables and the outcome. Within the total sample (n = 3474), living in a city, having a college education, being concerned about your own health and the health of next of kin, and trusting information provided by authorities increased the likelihood of reporting willingness to take the COVID-19 vaccine. Across all countries, participants who reported trust in the authorities' information about COVID-19 demonstrated a significantly higher plausibility of taking the COVID-19 vaccine.

• Bonsaksen, Tore; Leung, Janni; Schoultz, Mariyana; Thygesen, Hilde; Price, Daicia & Ruffolo, Mary [Show all 7 contributors for this article] (2021). Cross-national study of worrying, loneliness, and mental health during the COVID-19 pandemic: a comparison between individuals with and without infection in the family. Healthcare. 9(7), p. 903–903. doi: 10.3390/healthcare9070903. Full text in Research Archive Show summary

  Objective: The objective of this study was to examine differences in worry, loneliness, and mental health between those individuals infected by COVID-19 or having someone their family infected, and the rest of the population. Methods: A cross-sectional online survey was conducted in Norway, UK, USA, and Australia during April/May 2020. Participants (n = 3810) were recruited via social media postings by the researchers and the involved universities. Differences between those with and without infection in the family were investigated with chi-square tests and independent t-tests. Multiple regression analyses were used to assess associations between sociodemographic variables and psychological outcomes (worry, loneliness, and mental health) in both groups. Results: Compared to their counterparts, participants with infection in the family reported higher levels of worries about themselves (p < 0.05) and their family members (p < 0.001) and had poorer mental health (p < 0.05). However, the effect sizes related to the differences were small. The largest effect (d = 0.24) concerned worries about their immediate family. Poorer psychological outcomes were observed in those who were younger, female, unemployed, living alone and had lower levels of education, yet with small effect sizes. Conclusions: In view of the small differences between those with and without infection, we generally conclude that the mental health effects of the COVID-19 situation are not limited to those who have been infected or have had an infection within the family but extend to the wider population.

• DaLomba, Elaina; Gramstad, Astrid; Johnson, Susanne Grødem; Carstensen, Tove; Stigen, Linda & Mørk, Gry [Show all 8 contributors for this article] (2021). Predictors of students’ participation in a learning environment survey with annual follow-ups. PLOS ONE. 16(6), p. e0253773–e0253773. doi: 10.1371/journal.pone.0253773. Full text in Research Archive Show summary

  Background Longitudinal research is one effective way to gauge changes in a student cohort over time, however attrition in these studies is typically high, which can result in study bias. This study explored learning environment factors, approaches to studying, and academic performance as predictors of occupational therapy students’ consistent participation in data collection conducted over three years of their professional program. Method A longitudinal study of Norwegian occupational therapy students (analyzed n = 240) was conducted. Logistic regression analysis was used to explore occupational therapy students’ perceptions of the learning environment, their approaches to studying, and exam grades as they related to the likelihood of consistent participation at three annual surveys. Results Annual response rates varied between 55.1%, and 65.6%, and consistent participation was observed among 49.2%. The fully adjusted regression models showed that higher strategic approach scores increased the odds of consistent participation (adjusted OR: 1.04, p < 0.01), whereas higher surface approach scores decreased the odds of consistent participation (adjusted OR: 0.95, p < 0.05). Neither sociodemographic factors, learning environment factors nor academic performance predicted participation over time. Conclusions Researchers can anticipate relatively high levels of attrition in longitudinal studies of occupational therapy students, but attrition seems to be largely proportional between groups. However, completers in longitudinal studies may be somewhat more well-organized and academically oriented than drop-outs.

• Bonsaksen, Tore; Thørrisen, Mikkel Magnus; Skogen, Jens Christoffer; Hesse, Morten & Aas, Randi Wågø (2021). Are Demanding Job Situations Associated with Alcohol-Related Presenteeism? The WIRUS-Screening Study. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 18(11). doi: 10.3390/ijerph18116169. Full text in Research Archive Show summary

  Abstract: Alcohol-related presenteeism (impaired work performance caused by alcohol use) is an important but under-researched topic. The aim of this study was to explore whether psychosocial work environment factors were associated with alcohol-related presenteeism. A cross sectional study of Norwegian employees (n = 6620) was conducted. Logistic regression analyses were used for estimating associations with alcohol-related presenteeism, which was reported among 473 (7.1%) of the employees. Adjusted by age, gender, education level and managerial level, higher levels of overcommitment to work were associated with alcohol-related presenteeism. Higher age, male gender and higher education were also associated with alcohol-related presenteeism. Occupational health services and employers should especially focus on overcommitted employees when designing workplace health promotion programs. Modifying attitudes towards alcohol-related presenteeism among overcommitted employees may be of importance for safety at work.

• Geirdal, Amy Østertun; Price, Daicia; Schoultz, Mariyana; Thygesen, Hilde; Ruffolo, Mary & Leung, Janni [Show all 7 contributors for this article] (2021). The Significance of Demographic Variables on Psychosocial Health from the Early Stage and Nine Months after the COVID-19 Pandemic Outbreak. A Cross-National Study. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 18(8). doi: 10.3390/ijerph18084345. Full text in Research Archive Show summary

  Abstract: This cross-national study explored stability and change in mental health, quality of life, wellbeing and loneliness during the early stage and nine months after the implementation of COVID-19 pandemic social distancing measures and periodic lockdowns as adjusted by demographic variables. In the USA, the UK, Australia and Norway, 7284 individuals responded to the invitation to take part in two cross-sectional web-based surveys (April and November 2020), including questions about sociodemographic variables and psychosocial outcomes. Independent t-tests and generalized linear models (GLM) and estimated marginal means were used to analyze differences between subgroups and countries, multiple linear regression analyses were conducted on the psychosocial outcome measures by demographic variables and time in each country and mean responses presented by time after adjusting for all demographic variables in the model. Age, gender, civil status, education, employment, place of work and living area were all significant factors for psychosocial health across the countries. Differences in mental health, quality of life, well-being and loneliness were found between the countries in both April and November 2020, while time did not contribute to reducing the toll in any of the four countries over the nine-month period.

• Ruffolo, Mary; Price, Daicia; Bonsaksen, Tore; Leung, Janni; Schoultz, Mariyana & Thygesen, Hilde [Show all 7 contributors for this article] (2021). Cross-National Study of Mental Health and Employment Status Nine Months Post Social Distancing Implementation Practices. The British Journal of Social Work. ISSN 0045-3102. 52(4), p. 2105–2124. doi: 10.1093/bjsw/bcab177. Full text in Research Archive Show summary

  This cross-national study examined the mental health between those individuals working and those not working nine months post initial COVID-19 social distancing implementation. Respondents (N = 3,474) were recruited through social media (e.g. Facebook, Twitter) and completed an online survey in October/November 2020. The respondents were from Norway, the UK, the USA and Australia. The mental health of those working and not working were analysed using t tests and socio-demographics were compared using one-way analysis of variance. Respondents who were working were significantly more likely to experience better mental health, were younger, report higher levels of education, and significantly less likely to worry about their own situation, health or financial situation than respondents who were not employed. Respondents who were retired reported better mental health than respondents who were not working for other reasons (laid off/dismissed, receiving benefits, studying, other). These findings raise the importance for social workers and other health service providers to monitor the overall mental health of individuals especially when social distancing protocols are in place and as countries begin to recover from the pandemic.

• Thørrisen, Mikkel Magnus; Bonsaksen, Tore; Skogen, Jens Christoffer; Skarpaas, Lisebet Skeie; Sevic, Aleksandra & Mechelen, Willem van [Show all 7 contributors for this article] (2021). Willingness to participate in alcohol prevention interventions targeting risky drinking employees. The WIRUS project. Frontiers in Public Health. 9. doi: 10.3389/fpubh.2021.692605. Full text in Research Archive Show summary

  Background: The extent to which eligible individuals in a target population are willing to participate in interventions is important when evaluating the efficacy of public health interventions. Objectives: As part of a process evaluation of an ongoing randomized controlled trial, this study aimed to identify the proportion of risky drinkers who were willing to participate in an alcohol prevention intervention in an occupational health setting, and correlates for such willingness. Methods: Risky drinking employees from 22 companies in Norway were identified through an alcohol screening survey. Risky drinkers' (N = 779) willingness to complete a health examination and to be randomized into an alcohol prevention intervention (digital or face-to-face intervention, or control) was recorded by personnel from occupational health services. The proportion of employees who were willing to participate was assessed on 31 potential correlates (sociodemographic, alcohol-related, work-related, and lifestyle/daily activity). Adjusted (multiple logistic regression) analyses were utilized to explore associations between potential correlates and willingness to participate. Results: Altogether, 38.1% of employees were willing to participate in prevention interventions. In the adjusted analysis, only 5 out of 31 potential correlates were significantly associated with willingness to participate. Managers were more than twice as willing to participate than workers (OR = 2.17, p < 0.01). Willing employees had less workplace decision latitude (perceived control over workplace decisions and less possibility of utilizing personal skills in the job) (OR = 0.62, p < 0.05), and were more overcommitted with exorbitant work ambition and need for approval (OR = 1.49, p < 0.05). Willing employees had to some extent less alcohol-related impaired work performance (presenteeism, OR = 0.78, p < 0.05), and they spent less time on care activities (OR = 0.84, p < 0.05). Conclusions: Reaching four out of ten with risky drinking habits for prevention interventions strengthens the rationale for targeting this public health problem in occupational health care settings. In particular, this study suggests the importance of ensuring secure commitment among workers, who were less willing til participate than managers. Nevertheless, tailoring recruitment and implementation strategies based on easily identifiable correlates may be onerous.

• Schoultz, Mariyana; Leung, Janni; Bonsaksen, Tore; Ruffolo, Mary; Thygesen, Hilde & Price, Daicia [Show all 7 contributors for this article] (2021). Mental health, information and being connected: Qualitative experiences of social media use during the COVID-19 pandemic from a trans-national sample. Healthcare. 9(6), p. 1–14. doi: 10.3390/healthcare9060735. Full text in Research Archive Show summary

  Abstract: Background: Due to the COVID-19 pandemic and the strict national policies regarding social distancing behavior in Europe, America and Australia, people became reliant on social media as a means for gathering information and as a tool for staying connected to family, friends and work. This is the first trans-national study exploring the qualitative experiences and challenges of using social media while in lockdown or shelter-in-place during the current pandemic. Methods: This study was part of a wider cross-sectional online survey conducted in Norway, the UK, USA and Australia during April/May 2020. The manuscript reports on the qualitative free-text component of the study asking about the challenges of social media users during the COVID-19 pandemic in the UK, USA and Australia. A total of 1991 responses were included in the analysis. Thematic analysis was conducted independently by two researchers. Results: Three overarching themes identified were: Emotional/Mental Health, Information and Being Connected. Participants experienced that using social media during the pandemic amplified anxiety, depression, fear, panic, anger, frustration and loneliness. They felt that there was information overload and social media was full of misleading or polarized opinions which were difficult to switch off. Nonetheless, participants also thought that there was an urge for connection and learning, which was positive and stressful at the same time. Conclusion: Using social media while in a shelter-in-place or lockdown could have a negative impact on the emotional and mental health of some of the population. To support policy and practice in strengthening mental health care in the community, social media could be used to deliver practical advice on coping and stress management. Communication with the public should be strengthened by unambiguous and clear messages and clear communication pathways. We should be looking at alternative ways of staying connected.

• Yazdani, Farzaneh; Bonsaksen, Tore; Roberts, Dave; Hess, Ka Yan & Karamali, Esmaili Samaneh (2021). The Self-Efficacy for Therapeutic Use of Self Questionnaire (SETUS): psychometric properties of the English version. Irish Journal of Occupational Therapy (IJOT). ISSN 0791-8437. doi: 10.1108/IJOT-10-2020-0015. Full text in Research Archive Show summary

  Purpose The purpose of this paper is to investigate psychometric properties of the Self-Efficacy for Therapeutic Use of Self (SETUS) scales, a questionnaire based on the Intentional Relationship model, and to investigate the factor structure and internal consistency of the English version of three-part SETUS questionnaire in occupational therapy students. Design/methodology/approach The sample of this cross-sectional study included 155 students with age range 18–30 years, of which 95% were women. Principal Components Analysis (PCA) was performed on the questionnaire scales, including the Self-Efficacy for Therapeutic Mode Use (SETMU), Self-Efficacy for Recognizing Interpersonal Characteristics (SERIC) and Self-Efficacy for Managing Interpersonal Events (SEMIE). The internal consistencies were calculated. Pearson correlation analysis was used to evaluate the strength of correlation among the scales. Findings The PCA confirmed that the items of each of the three proposed scales loaded strongly on one factor (self-efficacy for three factors of therapeutic mode use, recognizing interpersonal characteristics and managing interpersonal events). The Cronbach’s alpha for the SETMU, SERIC and SEMIE was 0.85, 0.95 and 0.96, respectively. The three scales significantly inter-correlated strongly (r ranging 0.74–0.83, all p < 0.001). Originality/value The SETUS questionnaire comprises three valid and reliable scales. It can be used by occupational therapy supervisors as a means to reflect on students’ self-efficacy in components of therapeutic use of self.

• Bonsaksen, Tore; Thygesen, Hilde; Leung, Janni; Ruffolo, Mary; Schoultz, Mariyana & Price, Daicia [Show all 7 contributors for this article] (2021). Video-based communication and its association with loneliness, mental health and quality of life among older people during the COVID-19 outbreak. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 18(12), p. 1–10. doi: 10.3390/ijerph18126284. Full text in Research Archive Show summary

  The aim of the study was to examine the use of video-based communication and its association with loneliness, mental health and quality of life in older adults (60–69 years versus 70+ years) during the COVID-19 pandemic. A cross-sectional online survey was conducted in Norway, UK, USA and Australia during April/May 2020, and 836 participants in the relevant age groups were included in the analysis. Multiple regression analyses were conducted to examine associations between the use of video-based communication tools and loneliness, mental health and quality of life within age groups, while adjusting by sociodemographic variables. Video-based communication tools were found to be more often used among participants aged 60–69 years (60.1%), compared to participants aged 70 or above (51.8%, p < 0.05). Adjusting for all variables, the use of video-based communication was associated with less loneliness (β = −0.12, p < 0.01) and higher quality of life (β = 0.14, p < 0.01) among participants aged 60–69 years, while no associations were observed for participants in the oldest age group. The use of video-based communication tools was therefore associated with favorable psychological outcomes among participants in their sixties, but not among participants in the oldest age group. The study results support the notion that age may influence the association between the use of video-based communication tools and psychological outcomes amongst older people

• Bonsaksen, Tore; Lindstad, Marte Ørud; Håkansson, Carita; Wagman, Petra & Cordier, Reinie (2021). Rasch analysis of the Norwegian version of the Occupational Balance Questionnaire in a sample of occupational therapy students. Occupational Therapy International. ISSN 0966-7903. 2021. doi: 10.1155/2021/8863453. Full text in Research Archive Show summary

  Background. Recently, the Occupational Balance Questionnaire developed in Sweden was translated into Norwegian. No studies to date have examined the measurement properties of the Norwegian version of this questionnaire. Aim. The study is aimed at examining the psychometric properties of the Norwegian version of the Occupational Balance Questionnaire, the OBQ11-N. Methods. Along with sociodemographic data, 180 occupational therapy students enrolled at two Norwegian universities completed the OBQ11-N as well as one question each related to health and quality of life and some sociodemographic variables. Rasch analysis was employed for examining rating scale functioning, item and person validity, dimensionality, and differential item functioning. Results. Item categories were ordered, but there were potential gaps in the measurement of the construct. Person reliability was fair, whereas item reliability was low. Point biserial correlations were positive, indicating that all items contributed to the construct. Factor loadings were low for two items, and there were indices of a second underlying dimension and item redundancy. Many people were not aligned with the items, and some items functioned differently across various demographic variables. Conclusion and Significance. The OBQ11-N did not function as an adequate measure of occupational balance in a sample of students. Potentially, the detected measurement problems may be solved by adding more relevant items to a larger item pool, from which the best fitting items should be selected.

• Maass, Ruca Elisa Katrin; Bonsaksen, Tore; Gramstad, Astrid; Sveen, Unni; Stigen, Linda & Arntzen, Cathrine [Show all 7 contributors for this article] (2021). Factors associated with the establishment of new occupational therapist positions in Norwegian municipalities after the Coordination reform. Health Services Insights (HSI Journal). 14, p. 1–8. doi: 10.1177/1178632921994908. Full text in Research Archive Show summary

  Community-based occupational therapy is an increasingly important domain of work for occupational therapists. In Norway, this has been emphasized by the Coordination reform (2012), which assigned municipalities increased responsibility to protect and promote the health of their inhabitants. However, even if approximately 400 positions have been established between 2012 and 2017, little is known whether they have contributed to increased and/or more equal coverage across municipalities. To explore this matter, survey data was gathered among members of the Norwegian Occupational Therapy Association during 2017. Data was analyzed statistically (descriptive, comparative and associative) with SPSS 25. Results suggest large regional variations in the establishment of new positions. Moreover, most new positions were established in medium-sized municipalities that already had (an) occupational therapist(s) in the community. Number of prior positions, as well as being in the process of merging with another municipality were the only significant predictors for the establishment of new positions during regression analysis. Findings suggest that no levelling-out of geographical distributions of OT-coverage has occurred, even if new positions might have contributed to level-out workload (number-of-patients-per-therapist). Further, we discuss implications of our findings for policy-making and recruitment of Occupational Therapists for rural positions.

• Breen-Franklin, Adele & Bonsaksen, Tore (2021). Associations between study approaches and exam grades among occupational therapy students in the United States. Irish Journal of Occupational Therapy (IJOT). ISSN 0791-8437. doi: 10.1108/IJOT-09-2020-0013. Full text in Research Archive Show summary

  Purpose – Previous studies on the associations between approaches to studying and outcomes have been conducted largely in Europe, where participants have been largely undergraduate-level students. The purpose of this study is to examine the associations between study approaches and academic outcomes of graduate occupational therapy students in the USA. Design/methodology/approach – In this study, 120 masters- and doctoral-level occupational therapy students in their first and second study year in a large metropolitan city completed the short version of the Approaches and Study Skills Inventory for Students (ASSIST). A total of 18 items from the full 52-items version comprise the short version of the ASSIST, with 6 items belonging to each of the deep, strategic and surface scales. Associations between the study approach scales and exam grades were analyzed with single and multiple logistic regression analyses. Findings – There was a direct association between the use of strategic studying and higher grade point average. Thus, students who want to perform well academically are encouraged to use study behaviors comprised by the strategic approach to studying. Originality/value – This study appears to be the first to examine associations between study approaches and academic performance among occupational therapy students in the US context. More research on the study approaches of US American students is warranted.

• Schou-Bredal, Inger; Grimholt, Tine K.; Bonsaksen, Tore; Skogstad, Laila; Heir, Trond & Ekeberg, Øivind (2021). Psychological responses and associated factors during the initial lockdown due to the corona disease epidemic (COVID-19) among Norwegian citizens. Journal of Mental Health. ISSN 0963-8237. p. 1–9. doi: 10.1080/09638237.2021.1952949. Full text in Research Archive Show summary

  BACKGROUND Ongoing COVID-19 studies pay little attention to the risk or protective factors related to psychological stress. AIMS This study aims to estimate the prevalence of anxiety, depression and insomnia during the initial phase of the COVID-19 outbreak, and explore factors that might be associated with these outcomes. METHODS A population-based cross-sectional survey was conducted using snowball-sampling strategy. Participants from 18 years or older filled out an anonymous online questionnaire. RESULTS A total of 4527 citizens filled out the questionnaire. Prevalence rates were; insomnia 31.8%, anxiety 17.1% and depression 12.5%. Risk factors associated with anxiety, depression and insomnia were being single (OR = 0.75, OR = 0.57, OR = 0.59), unemployed (OR = 0.47, OR = 0.53, OR = 0.73), financial concerns (OR = 1.66, OR = 2.09, OR = 1.80) at risk for complication from COVID-19 (OR = 1.63, OR = 1.68, OR = 1.60), and being generally worried due to the COVID-19 (OR 0 3.06, OR = 1.41, OR = 1.74). CONCLUSION Being single, unemployed, at risk of health complications, or having concerns because of financial or other consequences of the pandemic are associated with mental health adversities such as anxiety, depression and insomnia during a pandemic lockdown.

• Bonsaksen, Tore; Ekeberg, Øivind; Bredal, Inger Schou; Skogstad, Laila; Heir, Trond & Grimholt, Tine Kristin (2021). Use of alcohol and addictive drugs during the COVID-19 outbreak in Norway: associations with mental health and pandemic-related problems. Frontiers in Public Health. 9:667729(429), p. 1–9. doi: 10.3389/fpubh.2021.667729. Full text in Research Archive Show summary

  Background: The outbreak of COVID-19 has had a major impact on people's daily life. This study aimed to examine use of alcohol and addictive drugs during the COVID-19 outbreak in Norway and examine their association with mental health problems and problems related to the pandemic. Methods: A sample of 4,527 persons responded to the survey. Use of alcohol and addictive drugs were cross-tabulated with sociodemographic variables, mental health problems, and problems related to COVID-19. Logistic regression analyses were used to examine the strength of the associations. Results: Daily use of alcohol was associated with depression and expecting financial loss in relation to the COVID-19 outbreak. Use of cannabis was associated with expecting financial loss in relation to COVID-19. Use of sedatives was associated with anxiety, depression, and insomnia. Use of painkillers was associated with insomnia and self-reported risk of complications if contracting the coronavirus. Conclusion: The occurrence of mental health problems is more important for an understanding of the use of alcohol and addictive drugs during the COVID-19 outbreak in Norway, compared to specific pandemic-related worries.

• Geirdal, Amy Østertun; Ruffolo, Mary; Leung, Janni; Thygesen, Hilde; Price, Daicia & Bonsaksen, Tore [Show all 7 contributors for this article] (2021). Mental health, quality of life, wellbeing, loneliness and use of social media in a time of social distancing during the COVID-19 outbreak. A cross-country comparative study. Journal of Mental Health. ISSN 0963-8237. 30(2), p. 148–155. doi: 10.1080/09638237.2021.1875413. Full text in Research Archive Show summary

  Background The COVID-19 outbreak raised questions about how people experience their mental health, quality of life (QoL), wellbeing and loneliness in the context of social distancing, and the use of social media during this time Aims To examine the experience of mental health, QoL, wellbeing and loneliness and use of social media among people living in Norway, USA, UK and Australia. Methods A cross-country comparative survey of people living in Norway, USA, UK and Australia. Relevant statistical analyses were used to examine differences between the countries and to explore associations between demographic, mental health and psychosocial variables and use of social media. Results There were 3810 respondents from four countries, of which 50 − 74% showed a high level of emotional distress. The Norwegian population reported significantly better mental health, QoL and wellbeing and lower levels of loneliness compared to the other countries. High-frequent use of social media after the COVID-19 outbreak was associated with poorer mental- and psychosocial health. Conclusions The results suggest that the COVID-19 outbreak took a toll on people’s experience of mental health, QoL, wellbeing and experienced loneliness, and high-frequent use of social media was associated with these factors.

• Skogstad, Laila; Bredal, Inger Schou; Bonsaksen, Tore; Heir, Trond; Ekeberg, Øivind & Grimholt, Tine Kristin (2021). Concerns related to the COVID-19 in adult Norwegians during the first outbreak in 2020: A qualitative approach. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 18(8). doi: 10.3390/ijerph18084312. Full text in Research Archive Show summary

  Concerns related to the first outbreak of the COVID-19 pandemic in the Norwegian population are studied in a cross-sectional web-survey conducted between 8 April and 20 May 2020. The qualitative thematic analysis of the open-ended question “Do you have other concerns related to the pandemic?”, followed a six-step process. Concerns from 1491 informants were analyzed, 34% of women and 30% of men (p = 0.05) provided concerns. Respondents with higher educational level reported concerns more often (86% vs. 83%, p = 0.022). The qualitative analysis revealed five themes—society, health, social activities, personal economy and duration—and 13 sub-themes, mostly related to the themes “society” and “health” (724 and 704, respectively). Empathy for others was prominent, for society (nationally and globally), but also concerns related to infecting others and family members at risk for developing serious illness if infected. The responses to the open-ended question yielded additional information, beyond the information obtained from questions with pre-categorized response options, especially related to concerns about society and health. Themes arising from the qualitative analysis shed light on what are important concerns for people during the pandemic and this may serve as targeted measures for the authorities.

• Bonsaksen, Tore; Schoultz, Mariyana; Thygesen, Hilde; Ruffolo, Mary; Price, Daicia & Leung, Janni [Show all 7 contributors for this article] (2021). Loneliness and its associated factors nine months after the COVID-19 outbreak: a cross-national study. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 18(6), p. 1–11. doi: 10.3390/ijerph18062841. Full text in Research Archive Show summary

  COVID-19 has been a global healthcare concern impacting multiple aspects of individual and community wellness. As one moves forward with different methods to reduce the infection and mortality rates, it is critical to continue to study the impact that national and local “social distancing” policies have on the daily lives of individuals. The aim of this study was to examine loneliness in relation to risk assessment, measures taken against risks, concerns, and social media use, while adjusting for sociodemographic variables. The cross-sectional study collected data from 3474 individuals from the USA, the UK, Norway, and Australia. Loneliness was measured with the de Jong Gierveld Loneliness Scale. Multiple linear regression was used in the analysis of associations between variables. The results showed that concerns about finances were more strongly associated with social loneliness, while concerns about the future was more strongly associated with emotional loneliness. Longer daily time spent on social media was associated with higher emotional loneliness. In conclusion, pandemic-related concerns seem to affect perceptions of loneliness. While social media can be used productively to maintain relationships, and thereby prevent loneliness, excessive use may be counterproductive.

• Ruffolo, Mary; Price, Daicia; Schoultz, Mariyana; Leung, Janni; Bonsaksen, Tore & Thygesen, Hilde [Show all 7 contributors for this article] (2021). Employment Uncertainty and Mental Health during the COVID-19 Pandemic Initial Social Distancing Implementation: A Cross-national study. Global Social Welfare: Research, Policy, & Practice. 8, p. 141–150. doi: 10.1007/s40609-020-00201-4. Full text in Research Archive Show summary

  Background Social distancing during the COVID-19 pandemic has resulted in changes in the work environment and employment uncertainty. This paper reports on a cross-national comparison of four countries (Norway, UK, USA and Australia) and examines the differences in mental health between those individuals employed and those not employed during the social distancing implementation. Methods Participants (N = 3,810) were recruited through social media in April/May 2020 and were invited to complete a self-administered electronic survey over a 3-week period. Differences between those employed and those not employed with regard to their sociodemographic characteristics and mental health were investigated with chi-square tests, independent t tests, and one-way analysis of variances (ANOVAs). Results Compared with their counterparts, participants who were employed reported lower levels of mental health distress (p < 0.001), higher levels of psychosocial well-being (p < 0.001), better overall quality of life (p < 0.001), and lower levels of overall loneliness, social loneliness, and emotional loneliness (p < 0.001). Small to medium but consistent differences (Cohen’s d = 0.23–0.67) in mental health favor those with employment or those who were retired. Conclusion Further study is needed to assess mental health over time as the COVID-19 pandemic and employment uncertainty continues.

• Horghagen, Sissel; Bonsaksen, Tore; Sveen, Unni; Dolva, Anne-Stine & Arntzen, Cathrine (2021). Erfaringer med ulike rolleforståelser og -praksiser blant ergoterapeuter i kommunehelsetjenesten; generalist, spesialist eller generisk rolle? Ergoterapeuten. ISSN 0800-3475. 64(1), p. 38–41. Full text in Research Archive
• DaLomba, Elaina; Stigen, Linda; Johnson, Susanne Grødem; Mørk, Gry; Gramstad, Astrid & Magne, Trine A [Show all 9 contributors for this article] (2020). Psychometric properties and associations between subscales of a study approach measure. Nursing and Health Sciences. ISSN 1441-0745. doi: 10.1111/nhs.12750. Full text in Research Archive Show summary

  The purpose of this study was to (i) confirm the factor structure of the Approaches and Study Skills Inventory for Students (ASSIST) in the current sample of undergraduate occupational therapy students and (ii) explore the pattern of associations between the 13 ASSIST subscales. Occupational therapy students (n = 171) across Norway completed the ASSIST. A three‐factor structure was confirmed. Several positive associations were found between the deep and strategic approach subscales, whereas several surface approach subscales were negatively associated with the deep and strategic approach subscales. In conclusion, the study showed that the Norwegian ASSIST has a well‐functioning three‐factor structure in line with its theoretical underpinnings, and it can therefore readily be adopted as a study process measure in Norwegian occupational therapy education programs. In view of the associations between subscales, there is support for a higher‐order concept of “productive” study approaches that encompasses both deep and strategic behaviors. The analysis of associations also suggests that students demonstrating unproductive study behaviors may need guidance and intervention that extends beyond the first detected problematic behavior.

• Bonsaksen, Tore; Heir, Trond; Skogstad, Laila; Grimholt, Tine K.; Ekeberg, Øivind & Lerdal, Anners [Show all 7 contributors for this article] (2020). Daily use of alcohol in the Norwegian general population: Prevalence and associated factors. Drugs and alcohol today. ISSN 1745-9265. doi: 10.1108/DAT-02-2020-0010. Full text in Research Archive Show summary

  Purpose: Harmful use of alcohol is a major public health problem. While harm is often researched in the context of heavy drinking episodes, high-frequency drinking, even when drinking moderate quantities, constitutes a health risk in a longer perspective. The aim of this study was to examine the prevalence of daily use of alcohol in the Norwegian general population, and to assess sociodemographic, mental health-related and personal resource variables associated with daily use of alcohol. Methodology: A cross-sectional survey concerned with health, illness and serious life events was distributed to 5,500 persons in the general population in Norway (response rate 36 %). Sociodemographic variables, personal resource variables (general self-efficacy, optimism, and extraversion) and psychological distress (current anxiety and/or depression) were assessed with regards to their associations with daily drinking in unadjusted and adjusted regression models. Findings: Daily use of alcohol was reported by 39 persons (2.2 %) in the sample (3.1 % of men and 1.4 % of women). While general self-efficacy, optimism and extraversion were unrelated to daily drinking, the adjusted model revealed that male sex (OR: 2.18, p < 0.05), being unemployed/not in education (OR: 3.10, p < 0.05) and reporting current anxiety and/or depression (OR: 3.12, p < 0.01) were associated with daily use of alcohol. Value: The study has contributed to the knowledge about daily drinkers in a representative sample of the Norwegian population. A proportion of 2.2 % was found to drink alcohol on a daily basis. Compared to their counterparts, the odds of daily drinking were higher for men, unemployed persons and persons reporting current psychological distress. Public health initiatives aiming at reducing harmful use of alcohol may pay particular attention to these subsets of the population.

• Yazdani, Farzaneh; Stringer, Amy; Nobakht, Laya; Bonsaksen, Tore & Tune, Kellie (2020). Qualitative analysis of occupational therapists’ reflective notes on practicing their skills in building and maintaining therapeutic relationships. Journal of Occupational Therapy Education. 4(4). doi: 10.26681/jote.2020.040414. Full text in Research Archive Show summary

  Previous research has shown that occupational therapists have increased their self-efficacy for using self intentionally in therapeutic encounters. However, experiences related to such changes have not yet been explored. The authors developed a therapeutic use-of-self training workshop to support the confidence and competence of practicing occupational therapists in using the Intentional Relationship Model and possibly enhancing their self-efficacy for therapeutic use-of-self. The purpose of the study was to explore the experiences of practicing occupational therapists in transferring learning from a training workshop focused on the therapeutic use-of-self into real world practice. Thirteen occupational therapists participated in the workshop and subsequently completed between one and four reflection notes. These notes were subjected to qualitative thematic analysis. The findings were organized into four themes: therapeutic relationship reasoning, engrained previous learning, reflection on/in action, and level of skills in conducting reflection. Reflection skills seemed to be essential for establishing and developing therapeutic relationships; practicing such skills needs to be facilitated by the work environment through emphasis on reflective practice and mentoring.

• Thordardottir, Björg; Stigen, Linda; Magne, Trine A; Johnson, Susanne Grødem; Gramstad, Astrid & Gran, Adrian Wetlesen [Show all 9 contributors for this article] (2020). Student perceptions of the learning environment in Norwegian occupational therapy education programs. Scandinavian Journal of Occupational Therapy. ISSN 1103-8128. doi: 10.1080/11038128.2020.1831058. Full text in Research Archive Show summary

  Background To support students’ motivation towards constructive and persistent study efforts, their learning environment needs attention. Aim To develop knowledge about occupational therapy students’ perceptions of the learning environment and assess whether identified differences between education programs were stable or changed across the 3 years of study. Methods Norwegian occupational therapy students completed the Course Experience Questionnaire (CEQ) while in their first, second, and third years of study. Differences between programs were analysed with multivariate and univariate analysis of variance. Results Among the first-year students, perceptions of the learning environment differed significantly between the six programs on five out of six scales. Apart from a continued difference on overall study satisfaction, the initial differences were no longer significant 1 year later. Differences on three scales (emphasis on independence, appropriate workload, and generic skills) were present in the third year of study. Conclusions and significance Students’ perceptions of the learning environment became more similar over time, during the first 2 years of study, possibly reflecting that the students have become more accustomed to the student role and to the culture and requirements of the education programs. However, differences between study sites re-occurring in the third year suggest that group-based comparisons of learning environment perceptions across time may be inconclusive.

• Helgøy, Kjersti Velde; Smeby, Jens-Christian; Bonsaksen, Tore & Olsen, Nina Rydland (2020). Research-based occupational therapy education: An exploration of students’ and faculty members’ experiences and perceptions. PLOS ONE. p. 1–19. doi: 10.1371/journal.pone.0243544. Full text in Research Archive Show summary

  Introduction One argument for introducing research in bachelor`s degree in health care is to ensure the quality of future health care delivery. The requirements for research-based education have increased, and research on how research-based education is experienced is limited, especially in bachelor health care education programmes. The aim of this study was to explore how occupational therapy students and faculty members experienced and perceived research-based education. Methods This qualitative, interpretative description consisted of three focus group interviews with occupational therapy students in their final year (n = 8, 6 and 4), and three focus group interviews with faculty members affiliated with occupational therapy programmes in Norway (n = 5, 2 and 5). Interviewing both students and faculty members enabled us to explore the differences in their experiences and perceptions. Results Five integrative themes emerged from the analysis: “introducing research early”, “setting higher expectations”, “ensuring competence in research methods”, “having role models” and “providing future best practice”. Research was described as an important aspect of the occupational therapy bachelor program as it helps ensure that students achieve the necessary competence for offering future best practice. Students expressed a need to be introduced to research early in the program, and they preferred to have higher expectations regarding use of research. Competence in research methods and the importance of role models were also highlighted. Conclusions Undergraduate health care students are expected to be competent in using research. Findings from our study demonstrated that the participants perceived the use of research during training as important to ensure future best practice. Increasing the focus on research in the programme’s curricula and efforts to improve students’ formal training in research-specific skills could be a starting point towards increased use of research in the occupational therapy profession.

• Thygesen, Hilde; Gramstad, Astrid; Åsli, Lene Angel; Stigen, Linda; Magne, Trine A & Carstensen, Tove [Show all 7 contributors for this article] (2020). Associations between learning environment factors and student satisfaction among occupational therapy students. Irish Journal of Occupational Therapy (IJOT). ISSN 0791-8437. 48(2), p. 91–100. doi: 10.1108/IJOT-10-2019-0015. Full text in Research Archive Show summary

  Purpose – Student satisfaction is an important indicator of educational quality in higher education institutions. Learning environment factors are assumed to play a role in determining student satisfaction. The purpose of this study is to examine the intrinsic relationships between five learning environment scales embedded within one measure; and examine the associations between each of these scales and an overall measure of education program satisfaction. Design/methodology/approach – In this cross-sectional study, 175 first-year occupational therapy students in Norway completed sociodemographic information and the Course Experience Questionnaire. The data were analyzed with Pearson’s correlation coefficientr and with linear regression. Findings – All intrinsic associations between the learning environment scales were positive. In the adjusted analysis, higher education program satisfaction was significantly associated with higher scores on “clear goals and standards,” “emphasis on independence” and “good teaching.” The final model accounted for 45.0% of the outcome variance, of which the scores on the learning environment scales contributed 41.8%. Originality/value – The learning environment is vital for student satisfaction. More specifically, efforts to improve student satisfaction may include strengthening student-focused teaching, strengthening the autonomy of the students, and ensuring that the goals and standards of courses are clear and easy to understand.

• Bonsaksen, Tore; Skogstad, Laila; Grimholt, Tine Kristin; Heir, Trond; Ekeberg, Øivind & Lerdal, Anners [Show all 7 contributors for this article] (2020). Substance use in the Norwegian general population: Prevalence and associations with disease. Journal of Substance Use. ISSN 1465-9891. 26(2). doi: 10.1080/14659891.2020.1784303. Full text in Research Archive Show summary

  Objective: This study aimed to estimate the prevalence of substance use in the Norwegian general population and examine whether the risk of various psychiatric or somatic diseases varied according to alcohol- and substance use. Methods: A survey was distributed to 5500 persons in Norway, and a sample of 1792 persons responded (36% response rate). Data concerned with the use of substances were cross-tabulated with disease occurrence, and relative ratios (RR) of diseases in groups of lifetime substance users versus abstainers/ low frequent users were calculated. Results: Lifetime prevalence estimates were 83.5% for alcohol, 7.9% for cannabis, 8.5% for sedatives, 33.8% for strong analgesics and 2.4% for opioids and for stimulants. Drinking alcohol weekly or daily was associated with lower risk of several diseases, whereas lifetime use of sedatives, strong analgesics and opioids was associated with higher risk. Lifetime use of cannabis was associated with higher risk of depression and lower risk of diabetes and arthrosis. Conclusions: While frequent alcohol use was associated with reduced risk of several diseases, lifetime use of other substances was generally associated with higher risk of disease. The study provides evidence of increased risk of disease among users of illicit substances and prescription drugs.

• Bonsaksen, Tore; Heir, Trond; Bredal, Inger Schou; Ekeberg, Øivind; Skogstad, Laila & Grimholt, Tine K. (2020). Post-traumatic stress disorder and associated factors during the early stage of the COVID-19 pandemic in Norway. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 17(24), p. 1–10. doi: 10.3390/ijerph17249210. Full text in Research Archive Show summary

  The COVID-19 outbreak and the sudden lockdown of society in March 2020 had a large impact on people’s daily life and gave rise to concerns for the mental health in the general population. The aim of the study was to examine post-traumatic stress reactions related to the COVID-19 pandemic, the prevalence of symptom-defined post-traumatic stress disorder (PTSD), and factors associated with post-traumatic stress in the Norwegian population during the early stages of the COVID-19 outbreak. A survey was administered via social media channels, to which a sample of 4527 adults (≥18 years) responded. Symptom-defined PTSD was measured with the PTSD Checklist for the DSM-5. The items were specifically linked to the COVID-19 pandemic. We used the DSM-5 diagnostic guidelines to categorize participants as fulfilling the PTSD symptom criteria or not. Associations with PTSD were examined with single and multiple logistic regression analyses. The prevalence of symptom-defined PTSD was 12.5% for men and 19.5% for women. PTSD was associated with lower age, female gender, lack of social support, and a range of pandemic-related variables such as economic concerns, expecting economic loss, having been in quarantine or isolation, being at high risk for complications from COVID-19 infection, and having concern for family and close friends. In conclusion, post-traumatic stress reactions appear to be common in the Norwegian population in the early stages of the COVID-19 outbreak. Concerns about finances, health, and family and friends seem to matter.

• Thørrisen, Mikkel Magnus; Mørk, Gry; Åsli, Lene Angel; Gramstad, Astrid; Stigen, Linda & Magne, Trine A [Show all 12 contributors for this article] (2020). Student characteristics associated with dominant approaches to studying: Comparing a national and an international sample. Scandinavian Journal of Occupational Therapy. ISSN 1103-8128. doi: 10.1080/11038128.2020.1831056. Full text in Research Archive Show summary

  BACKGROUND: Productive approaches to studying (deep and strategic learning) are associated with a variety of favourable academic outcomes, and may be of particular importance for students in multifaceted and complex disciplines such as occupational therapy. AIM: To explore associations between student characteristics and their dominant approaches to studying in two samples of occupational therapy students: a national sample of Norwegian first-year students, and an international sample of students in different year cohorts (Australia, Hong Kong, Singapore and Norway). MATERIALS AND METHODS: A total of 180 (national sample) and 665 (international sample) students were included in the study. Approaches to studying were measured with the Approaches to Study Skills Inventory for Students (ASSIST). Data were analyzed with adjusted multinomial regression analyses. RESULTS: Age, gender and prior higher education were not associated with the dominant study approach. More time spent on independent study (international sample: OR = 1.07/1.08, p < 0.01/<0.001) and having current study program as the top priority line of education at enrolment (national sample: OR = 2.89, p < 0.05) predicted productive study approaches. CONCLUSIONS AND SIGNIFICANCE: Factors such as age, gender and prior higher education seem to be of limited importance for understanding students’ dominant approaches to studying.

• Fan, Chia-Wei; Yazdani, Farzaneh; Carstensen, Tove & Bonsaksen, Tore (2020). Rasch analysis of the Self-Efficacy for Therapeutic Use of Self questionnaire in Norwegian occupational therapy students. Scandinavian Journal of Occupational Therapy. ISSN 1103-8128. doi: 10.1080/11038128.2020.1726453. Full text in Research Archive Show summary

  Background: Research suggested combining modern test theory with classical test theory to achieve comprehensive evaluation of an assessment tool. However, the Norwegian Self-Efficacy for Therapeutic Use of Self questionnaire has not yet been examined by the modern test theory. Aims/objective: This study aims to examine psychometric properties of the Norwegian Self-Efficacy for Therapeutic Use of Self questionnaire by using Rasch analysis. Material and methods: One hundred and eleven occupational therapy students from two universities in Norway completed the questionnaire across four time points. Rasch analysis was used to examine the appropriateness of the rating scales, unidimensionality, person response validity, item/person separation, and the Wright map. Results: The ten-point rating scale did not fully maximise the measurement potentials. Unidimensionality was confirmed except for two items. Person response validity needs further investigation. Excellent person/item separation and Wright map were found. Conclusion: This study supports the psychometric properties of the Norwegian Self-Efficacy for Therapeutic Use of Self questionnaire in assessing self-efficacy in therapeutic encounters. Further research is needed to address the misfit items and the rating scale issue. Significance: Rasch analysis showed that the Norwegian Self-Efficacy for Therapeutic Use of Self questionnaire is promising to be used as a reliable and valid tool.

• Bonsaksen, Tore; Brown, Ted; Lim, Hua Beng; Fong, Kenneth & Småstuen, Milada Cvancarova (2020). Associations Between Occupational Therapy Students’ Approaches to Studying and Their Academic Grade Results: A Cross-Sectional and Cross-Cultural Study. Journal of Occupational Therapy Education. 4(1), p. 1–15. doi: 10.26681/jote.2020.040105. Full text in Research Archive Show summary

  Students’ approaches to studying are generally viewed as essential for their learning outcomes and are often described as being either deep, strategic or surface. However, research on associations between study approaches and academic outcomes among occupational therapy students are rare, as are studies that include cross-cultural comparisons. The objective of this study was to assess the degree to which the deep, strategic, and surface approaches to studying were associated with occupational therapy students’ grade point average, in the total sample and when stratified by country, while controlling for age, gender and time spent on independent study. Seven hundred and twelve students from four countries (Australia, Norway, Hong Kong, and Singapore) completed the Approaches and Study Skills Inventory for Students, and sum scores were calculated for the deep, strategic, and surface scales. Linear regression analyses were used to investigate associations between scale scores and grade point average, in the total sample and within each of the four sub-samples. The results showed that in the total sample, and in the Australia and Singapore sub-samples, none of the scales was associated with grade point average. In Hong Kong, lower deep approach scores and higher strategic approach scores were associated with higher grade point average. In Norway, higher strategic approach scores and lower surface approach scores were associated with higher grade point average. The study found that the approaches to studying scales were relevant for understanding academic performance among occupational therapy students in Norway and Hong Kong, but appeared less useful in the Australian and Singapore contexts.

• Aas, Maren H.; Austad, Vilde Mittet; Lindstad, Marte Ørud & Bonsaksen, Tore (2020). Occupational Balance and Quality of Life in Nursing Home Residents. Physical & Occupational Therapy in Geriatrics. ISSN 0270-3181. doi: 10.1080/02703181.2020.1750530. Full text in Research Archive Show summary

  Introduction: Nursing home residents may have difficulty maintaining occupational balance. The study aimed to explore occupational balance in nursing home residents, and examine the association between occupational balance and quality of life in this group. Methods: Forty-six nursing home residents (age range 69-101 years) in Norway were recruited to participate. The data were analyzed descriptively and with independent t-tests and Spearman’s correlation coefficient rho (rs). Results: The participants’ occupational balance (M = 20.7) was in the higher end of the scale. In the total sample, occupational balance and quality of life were not significantly associated (rs = 0.18, p = 0.23). However, splitting the sample by gender revealed a positive association for men (rs = 0.61, p = 0.01), while it was absent for women (rs = −0.00, p = 0.99). Conclusion: When assessing occupational balance and its correlates in elderly nursing home residents, gender appears important to consider.

• Bonsaksen, Tore & Breen-Franklin, Adele (2020). An Evaluation of the Factor Structure and Internal Consistency of the ‘Conceptions of Learning’ and ‘Preferences for Teaching’ Measures in American Occupational Therapy Students. Journal of Occupational Therapy Education. 4(1), p. 1–13. doi: 10.26681/jote.2020.040104. Full text in Research Archive Show summary

  When planning to use measurement scales in new samples and contexts, examining the scales’ psychometric properties is an important initial step. This study examined the factor structure and internal consistency of two measures that are part of the Approaches and Study Skills Inv entor y for Students (ASSIST) – the Conceptions of learning and Preferences for teaching and courses – in a sample of American occupational therapy students. The students ( n = 115) completed the measures and provided basic sociodemographic information. Scale structure was examined with Principal Components Analysis (PCA), while consistency between scale items was assessed with mean inter-item correlations. For the Conceptions of learning measure, one item was removed due to cross-loading between factors. The subsequent analysis revealed two factors, representing deep and surface conceptions of learning, on which the items – with one exception – loaded in line with theory. For the Preferences for teaching and courses measure, two factors were found, representing preferences denoted in theory as supporting understanding and transmitting information, respectively. The items showed good fit with the two theoretically proposed factors. The scales’ mean inter-item correlations were satisfactory, ranging 0.27-0.36. One item on the Conceptions of learning measure appears to be problematic due to crossloading, and another may be interpreted in a different way than originally proposed. After removing the problematic item, all scales showed satisfactory psychometric properties for assessing conceptions of learning and preferences for teaching.

• Horghagen, Sissel; Bonsaksen, Tore; Sveen, Unni; Dolva, Anne-Stine & Arntzen, Cathrine (2020). Generalist, specialist and generic positions experienced by occupational therapists in Norwegian municipalities. Irish Journal of Occupational Therapy (IJOT). ISSN 0791-8437. 48(2), p. 133–146. doi: 10.1108/IJOT-03-2020-0006. Full text in Research Archive Show summary

  Purpose: Reforms in the health-care system may impact how health-care professionals perceive and enact their roles. This study aims to examine the way in which occupational therapists experience and describe their roles in municipalities after the implementation of a health reform (the Coordination Act) in Norway. Design/methodology/approach: This qualitative study was designed within the perspectives of social constructivism. Data was collected through focus group interviews with 10 community-working occupational therapists. A thematic framework analysis was used to examine the participants’ experiences. Findings: The following four themes emerged: external factors that framed and shaped the occupational therapists’ roles in municipalities; the strengths and dilemmas of the generalist; the problematic generic position and the strengths; and dilemmas of the specialist. Originality/value: The study suggests that occupational therapy practitioners should identify new opportunities and adapt to health reform changes. They also need to renegotiate their roles as the health reforms require more specialized competences. Greater emphasis must be placed on the core knowledge and competences of occupational therapists to strengthen their professional identity in the municipalities.

• Fan, Chia-Wei; Carstensen, Tove; Småstuen, Milada Cvancarova; Yazdani, Farzaneh; Ellingham, Brian & Bonsaksen, Tore (2020). Occupational therapy students’ self-efficacy for therapeutic use of self: Development and associated factors. Journal of Occupational Therapy Education. 4(1), p. 1–15. doi: 10.26681/jote.2020.040103. Full text in Research Archive Show summary

  Occupational therapy students need to develop self-efficacy for therapeutic use of self in practice. This longitudinal study examined Norwegian occupational therapy students’ self-efficacy for therapeutic use of self over a 16-month period and investigated predictors of their end-point self-efficacy. One hundred and eleven students from two universities completed a self-efficacy questionnaire related to the use of self after a workshop, and at 3-month, 10-month, and 16-month follow-up. The students’ self-efficacy development was analyzed with linear mixed effect models, while factors associated with self-efficacy were investigated with linear regressions. The students from both universities showed a linear increase in self-efficacy for therapeutic mode use (p < 0.001), recognizing clients’ interpersonal characteristics (p < 0.001), and managing interpersonal events (p < 0.001). However, for the students from University 1 the largest increase occurred in an early phase, whereas for the students from University 2 the largest increase occurred in a late phase. Only baseline scores were associated with the end-point measure at 16-month follow-up. The study indicates that students’ self-efficacy for therapeutic use of self increased during the follow-up period and adds to the knowledge about occupational therapy students’ self-efficacy development related to understanding and managing client-therapist interactions.

• Gramstad, Astrid; Åsli, Lene Angel; Johnson, Susanne Grødem; Magne, Trine A; Carstensen, Tove & Mørk, Gry [Show all 8 contributors for this article] (2020). Approaches to Studying: A Cross-Sectional Comparison of Occupational Therapy Students in Six Education Programs in Norway. The Open Journal of Occupational Therapy. 8(2). doi: 10.15453/2168-6408.1683. Full text in Research Archive Show summary

  Students’ approaches to studying have been associated with their academic performance. Although previous research suggests that the cultural and educational context may influence approaches to studying, few studies have investigated differences in study approaches across education programs. The aim of this study was to examine whether approaches to studying differed among occupational therapy students enrolled in six different educational programs in Norway. From a population of 308 students, 187 first-year occupational therapy students in six educational programs in Norway were recruited. The students provided their sociodemographic information and completed the Approaches and Study Skills Inventory for Students (ASSIST), and group differences were analyzed with Chi-square tests and one-way analyses of variance. Scores on the deep and surface approach scales did not differ significantly among the students in the six educational programs, while there was an overall difference in scores on the strategic approach scale. Group differences regarding the subscales were minor, and only a few of the pairwise differences reached statistical significance. Differences at the education program level appear not to be important for the interpretation of differences in study approaches among students.

• Bredal, Inger Schou; Bonsaksen, Tore; Ekeberg, Øivind; Skogstad, Laila; Grimholt, Tine Kristin & Lerdal, Anners [Show all 7 contributors for this article] (2020). Sexual assault and the association with health, quality of life and self-efficacy in the general Norwegian population. Journal of Interpersonal Violence. ISSN 0886-2605. doi: 10.1177/0886260520926307. Full text in Research Archive Show summary

  The lifetime prevalence of sexual assault was examined in a representative sample of the general Norwegian adult population (n¼1,792), in addition to the association between sexual assault and health, quality of life, and general self-efficacy. Respondents completed questionnaires assessing these factors. Overall, 6.7% (n¼120) of the respondents (10.9% of women and 1.9% of men) reported an experience of sexual assault. Respondents in the sexual assault group reported significantly worse mental and physical health as well as poorer quality of life and lower self-efficacy, compared with those without sexual assault experience. The most prevalent mental problems in the sexual assault group were depression (61.7%), sleep problems (58.3%), eating disorders (26.7%), and posttraumatic stress disorder symptoms at a clinical level (25.0%). The most prevalent physical problems were chronic pain (47.5%) and musculoskeletal disease (30.8%). The proportions of physical and mental health problems were not significantly different between male and female victims. Results indicated that having experienced sexual assault during one’s life appears to be associated with lifetime occurrence of multiple health problems for both genders and reduces a person’s perceived general selfefficacy and quality of life.

• Mørk, Gry; Magne, Trine A; Carstensen, Tove; Stigen, Linda; Åsli, Lene Angel & Gramstad, Astrid [Show all 8 contributors for this article] (2020). Associations between learning environment variables and students’ approaches to studying: a cross-sectional study. BMC Medical Education. 20(120), p. 1–8. doi: 10.1186/s12909-020-02033-4. Full text in Research Archive Show summary

  Background Aspects of the learning environment may be related to students` approaches to studying, but few studies have investigated these relationships in the context of occupational therapy education. Objective To examine associations between occupational therapy students’ perceptions of the learning environment and their approaches to studying. Method One hundred eighty-seven first-year occupational therapy students in Norway (response rate 61.3%) participated in this study. Aside from sociodemographic information, the students completed the Course Experience Questionnaire and the Approaches and Study Skills Inventory for Students. Associations between learning environment variables and study approaches were investigated with hierarchical linear regression analyses. Results Higher scores on Generic skills were associated with higher scores on the deep and strategic approach scales (β ranging 0.18–0.51), while lower scores were associated with higher surface approach scale scores (β = − 0.24). Lower scores on Clear goals and standards and Appropriate workload were associated with higher surface approach scores (β ranging − 0.16 - -0.42). Conclusion By improving aspects of the learning environment, there may be a potential for influencing occupational therapy students’ approaches to studying. Based on this study, emphasizing how generic skills developed in the study program may become useful in practising a profession, ensuring clarity of goals and standards, and maintaining an appropriate workload on students appear to be important.

• Thørrisen, Mikkel Magnus; Bonsaksen, Tore; Hashemi, Neda; Kjeken, Ingvild; Mechelen, Willem van & Aas, Randi Wågø (2019). Association between alcohol consumption and impaired work performance (presenteeism): A systematic review. BMJ Open. 9:e029184(7), p. 1–15. doi: 10.1136/bmjopen-2019-029184. Full text in Research Archive Show summary

  Objectives: The aim of this review was to explore the notion of alcohol-related presenteeism; that is, whether evidence in the research literature supports an association between employee alcohol consumption and impaired work performance. Design: Systematic review of observational studies. Data Sources: MEDLINE, Web of Science, PsycINFO, CINAHL, AMED, Embase and Swemed+ were searched through October 2018. Reference lists in included studies were hand searched for potential relevant studies. Eligibility criteria: We included observational studies, published 1990 or later as full-text empirical articles in peer-reviewed journals in English or a Scandinavian language, containing one or more statistical tests regarding a relationship between a measure of alcohol consumption and a measure of work performance. Data extraction and synthesis: Two independent reviewers extracted data. Tested associations between alcohol consumption and work performance within the included studies were quality assessed and analysed with frequency tables, cross-tabulations and χ2 tests of independence. Results: Twenty-six studies were included, containing 132 tested associations. The vast majority of associations (77%) indicated that higher levels of alcohol consumption were associated with higher levels of impaired work performance, and these positive associations were considerably more likely than negative associations to be statistically significant (OR=14.00, phi=0.37, p<0.001). Alcohol exposure measured by hangover episodes and composite instruments were over-represented among significant positive associations of moderate and high quality (15 of 17 associations). Overall, 61% of the associations were characterised by low quality. Conclusions: Evidence does provide some support for the notion of alcohol-related presenteeism. However, due to low research quality and lack of longitudinal designs, evidence should be characterised as somewhat inconclusive. More robust and less heterogeneous research is warranted. This review, however, does provide support for targeting alcohol consumption within the frame of workplace interventions aimed at improving employee health and productivity.

• Bonsaksen, Tore; Thørrisen, Mikkel Magnus; Skogen, Jens Christoffer & Aas, Randi Wågø (2019). Who reported having a high-strain job, low strain job, active job and passive job? The WIRUS screening study. PLOS ONE. 14(12). doi: 10.1371/journal.pone.0227336. Full text in Research Archive Show summary

  Objective. The Job Demands and Control model classifies job types as active, passive, low-strain or high-strain, based on a combination of job demands and control. While studies have shown high-strain jobs to have adverse consequences for health and work participation, prognostic factors for the four job types have been less explored. The aim of this study was to assess the associations between sociodemographic factors and job descriptors and being in high-strain, low-strain, active and passive jobs. Methods. The WIRUS Screening study targeted Norwegian employees in private and public enterprises. In this study, associations with job types among 4,487 employees were investigated with binary logistic regression analyses, adjusting for sociodemographic and job-related variables. Results. In fully adjusted models, high-strain job was associated with female gender; lower education; shift work; and doing work outside the workplace. Low-strain job was associated with opposite scores on the same variables, and with lower job position. Active job was associated with lower age; female gender; higher levels of education; higher job position level; shift work; and not doing work outside the workplace. Passive job was associated with opposite scores on the same variables. Conclusions. The study corroborates the role gender and education have for experiencing the job, and expands on existing knowledge on the role of job position and irregular working hours and spaces. By identifying factors associated with job types, the prevention of health problems and work disability may become be more targeted.

• Bredal, Inger Schou; Bonsaksen, Tore; Heir, Trond; Skogstad, Laila; Lerdal, Anners & Grimholt, Tine Kristin [Show all 7 contributors for this article] (2019). Optimists report fewer physical and mental health conditions than pessimists in the general Norwegian population. Health Psychology Report. ISSN 2353-4184. 7(1), p. 9–18. doi: 10.5114/hpr.2019.81003. Full text in Research Archive Show summary

  Background: Several studies have found that optimism is associated with better health. However, all those studies have investigated the subject in a specific context: gender, age group, diagnosis, situation, or population segment. Given the association found between optimism and physical health, mental health and well-being in previous studies, one would expect optimistic individuals in the general population to report fewer physical and mental health conditions during their lifetimes than pessimists. The aim of the present study was to test this hypothesis. Participants and procedure: A random sample of 1792 people participated in a survey on a broad variety of mental and physical health conditions. In addition they filled out the Life Orientation Test– Revised (LOT-R). Optimism was defined as a score of ≥ 17 on the LOT-R. Results: Optimists reported a lower prevalence of a wide range of mental and physical health conditions compared with pessimists. The associations between optimism and better health conditions persisted for the majority of health conditions investigated, even after adjustment for age, gender and education. Overall, pessimists had a greater estimated risk of disease in general. In addition 11.30% of the pessimists reported having had five or more different diseases during their lifetimes, compared with 3.90% of the optimists. Conclusions: Our results add to growing evidence that optimism plays an important role in health and support the view that fostering optimism is an appropriate strategy for promoting health.

• Ritter, Victoria Croke & Bonsaksen, Tore (2019). Improvement in Quality of Life Following a Multidisciplinary Rehabilitation Program for Patients with Parkinson’s Disease. Journal of Multidisciplinary Healthcare. 2019(12), p. 219–227. doi: 10.2147/JMDH.S202827. Full text in Research Archive Show summary

  Background: Parkinson’s disease follows a chronic course, and therefore quality of life is important to assess in relation to rehabilitation programs for persons with the disease. Aim: To examine whether a brief rehabilitation program can promote positive changes in functional status, general self-efficacy, and quality of life and to examine factors associated with changes in quality of life. Methods: Patients with Parkinson’s disease (n=83) completed the General Self-Efficacy Scale and the Parkinson’s Disease Questionnaire at the beginning of a rehabilitation program and at three weeks follow-up. Within-person changes were analyzed with paired t-tests. A hierarchical linear regression was conducted to assess the independent associations between the independent variables and changes in quality of life during the three weeks program, while adjusting for the covariance between the independent variables. Results: Patients reported higher functional status (d=0.37, p<0.001), general self-efficacy (d =0.28, p<0.01), and quality of life (d=0.32, p<0.001) at three weeks follow-up, compared to their baseline scores. The regression analysis showed that having a better initial functional status (β =−0.26, p<0.05) and lower quality of life (β =0.51, p<0.001) were associated with more improvements in quality of life. Conclusion: The study suggests that actual functioning in persons with Parkinson’s disease is a better predictor of improved quality of life than self-efficacy beliefs and that those who have lower levels of initial quality of life benefit more from rehabilitation.

• Bonsaksen, Tore & Breen-Franklin, Adele (2019). The short ASSIST scales: measurement properties in a sample of occupational therapy students in the USA. Journal of Occupational Therapy Education. 3(3), p. 1–16. doi: 10.26681/jote.2019.030311. Full text in Research Archive Show summary

  Shortening measurement scales can improve the scales’ feasibility, but at the same time, their measurement properties can be affected. This study investigated psychometric properties of the shortApproaches and Study Skills Inventory for Students(ASSIST) among occupational therapy students in the United States. The students (n= 120) completed the ASSIST and provided basic socio-demographic and education-related information. Scale structure was examined with Principal Components Analysis (PCA), while consistency between scale items was assessed with Cronbach’s α and inter-item correlations. Three factors were confirmed, but three items showed poor or ambiguous fit with the proposed scales. These items were subsequently removed from the scales, resulting in improved fit with the expected three-factor solution. Cronbach’s α for the amended scales ranged from 0.55-0.70 (mean inter-item correlation 0.20-0.34). In conclusion, the amended short ASSIST scales showed satisfactory psychometric properties for assessing study approaches in the sample. Given the variability in psychometric properties found for the short ASSIST scales across studies, the properties of the instrument should preferably be checked before using the scales with new populations.

• Skogen, Jens Christoffer; Thørrisen, Mikkel Magnus; Bonsaksen, Tore; Vahtera, Jussi; Sivertsen, Børge & Aas, Randi Wågø (2019). Effort-Reward Imbalance Is Associated With Alcohol-Related Problems. WIRUS-Screening Study. Frontiers in Psychology. 10. doi: 10.3389/fpsyg.2019.02079. Full text in Research Archive Show summary

  There is ample evidence of associations between a perceived stressful working environment and several health-related outcomes. To better understand potential mechanisms behind these observations some studies have focused on the relationship between effort-reward imbalance at work and alcohol consumption. So far, the findings have been inconsistent. One reason for this inconsistency might come from the focus on alcohol consumption per se, while disregarding other aspects such as adverse consequences related to the consumption of alcohol. The aim of the present study was to explore associations between perceived effort and reward, effort-reward imbalance and overcommitment, and alcohol-related problems. Using data from the alcohol screening component in the Norwegian WIRUS-project (N = 5,080), we ascertained the perceived effort, reward, effort-reward imbalance (ERI) and overcommitment using the effort-reward imbalance questionnaire. Alcohol-related problems was determined using a cut-off ≥8 on the Alcohol Use Disorder Identification Test (AUDIT). Associations were estimated using crude and adjusted logistic regression models. Covariates were age, gender and education. We found associations between different aspects of ERI and overcommitment, and alcohol-related problems. Specifically, the main analysis indicated that there was an increased odds for alcohol-related problems among those who reported high levels of ERI in conjunction with high overcommitment [adjusted OR: 1.40 (CI 95% 1.10–1.78)] compared to those with low levels of ERI and low overcommitment. Our findings suggest that ERI and overcommitment is associated with increased likelihood of alcohol-related problems. These findings indicate that individual and work-related factors should be taken into account collectively when aiming to determine the impact of psychosocial work environment on alcohol-related problems. Due to the cross-sectional nature of the present study, we are not able to determine the direction of the associations, and future studies should aim to investigate this.

• Heir, Trond; Bonsaksen, Tore; Grimholt, Tine Kristin; Ekeberg, Øivind; Skogstad, Laila & Lerdal, Anners [Show all 7 contributors for this article] (2019). Serious life events and post-traumatic stress disorder in the Norwegian population. BJPsych Open. 5(5), p. 1–7. doi: 10.1192/bjo.2019.62. Full text in Research Archive Show summary

  Background It has been suggested that countries with more resources and better healthcare have populations with a higher risk of posttraumatic stress disorder (PTSD). Norway is a high-income country with good public healthcare. Aims To examine lifetime trauma exposure and the point prevalence of PTSD in the general Norwegian population. Method A survey was administered to a national probability sample of 5500 adults (aged ≥18 years). Of 4961 eligible individuals, 1792 responded (36%). Responders and non-responders did not differ significantly in age, gender or urban versus rural residence. Trauma exposure was measured using the Life Events Checklist for the DSM-5. PTSD was measured with the PTSD Checklist for the DSM-5. We used the DSM-5 diagnostic guidelines to categorise participants as fulfilling the PTSD symptom criteria or not. Results At least one serious lifetime event was reported by 85% of men and 86% of women. The most common event categories were transportation accident and life-threatening illness or injury. The point prevalence of PTSD was 3.8% for men and 8.5% for women. The most common events causing PTSD were sexual and physical assaults, life-threatening illness or injury, and sudden violent deaths. Risk of PTSD increased proportionally with the number of event categories experienced. Conclusions High estimates of serious life events and correspondingly high rates of PTSD in the Norwegian population support the paradox that countries with more resources and better healthcare have higher risk of PTSD. Possible explanations are high expectations for a risk-free life and high attention to potential harmful mental health effects of serious life events.

• Grimholt, Tine Kristin; Bonsaksen, Tore; Bredal, Inger Schou; Heir, Trond; Lerdal, Anners & Skogstad, Laila [Show all 7 contributors for this article] (2019). Flight anxiety reported from 1986 to 2015. Aerospace Medicine and Human Performance. ISSN 2375-6314. 90(4), p. 384–388. doi: 10.3357/AMHP.5125.2019. Full text in Research Archive
• Geirdal, Amy Østertun; Nerdrum, Per & Bonsaksen, Tore (2019). The transition from university to work: what happens to mental health? A longitudinal study. BMC Psychology. 7(65), p. 1–10. doi: 10.1186/s40359-019-0340-x. Full text in Research Archive Show summary

  Background: When enrolled in university or college, students receive varying degrees of training in managing practical situations in the workplace. However, after graduation, the young professionals meet their responsibilities at work. The experience of the transition between education and work may connote a feeling of professional uncertainty and lack of coping, both of which are important factors related to young professionals’ mental health. The gap between the two areas of knowledge is frequently described as ‘practice shock’. Very few studies of mental health among students and young professional workers have used longitudinal designs. In the present study, we conducted a longitudinal investigation of change and stability in the levels of psychological distress among healthcare professionals, teachers, and social workers from the end of their study programs until 3years into their subsequent professional lives. We also assessed the extent to which psychological distress at the end of the study program, sociodemographic characteristics, coping with the professional role, the psychosocial workplace environment, and experience of overall quality of life can predict psychological distress 3years into their professional lives. Methods: Psychological distress was measured using the General Health Questionnaire 12 (GHQ-12). A total of 773 students/young professionals participated at both the end of their study programs and 3years into their professional lives. Group differences were examined by the chi-squared test, independent samples t-test, and oneway analysis of variance. McNemar’s test were applied to identify changes in the proportion of cases at the two time points. Linear and logistic regressions were employed to identify factors associated with GHQ-12 Likert scores and GHQ-12 case scores, respectively. Results: Psychological distress was significantly reduced at 3years for health professionals. Among the social workers and teachers, the change in psychological distress was not significant during the same period. Higher current quality of life contributed to lower psychological distress. Conclusions: Our findings support assumptions about higher levels of mental health problems as students, with mental health improving as health professionals and social workers move into professional work.

• Yazdani, Farzaneh & Bonsaksen, Tore (2019). Psychometric properties of the ‘self-efficacy for therapeutic mode use’ in a mixed sample of occupational therapists: a pilot study. International Journal of Therapy and Rehabilitation (IJTR). ISSN 1741-1645. 26(6), p. 1–8. doi: 10.12968/ijtr.2018.0035. Full text in Research Archive
• Brown, Ted & Bonsaksen, Tore (2019). An examination of the structural validity of the Physical Self-Description Questionnaire-Short Form (PSDQ–S) using the Rasch Measurement Model. Cogent Education. 6, p. 1–28. doi: 10.1080/2331186X.2019.1571146. Full text in Research Archive Show summary

  It is important for self-report scales and measures used by educators and health care professionals (such as the Physical Self-Description Questionnaire-Short Form [PSDQ–S]) to have documented reliability and validity. The aim of this study is to investigate the structural validity of the full PSDQ–S composite scale and 11 subscales using the Rasch Measurement Model. 117 healthy children (65 males and 52 females; M = 10 years, 2 months, SD = 1 year, 4 months) completed the PSDQ–S. The PSDQ–S’s rating scale functioning, dimensionality, hierarchical ordering, differential item functioning (DIF), and item and person separation reliability were examined. Results supported the scale functioning, dimensionality, hierarchical ordering, DIF, and reliability of the PSDQ–S composite scale and each of its 11 subscales. Therefore, the PSDQ–S composite scale and 11 subscales can be used with confidence to assess children’s self-reported physical self-concept.

• Bonsaksen, Tore; Opseth, Thea Moos; Misund, Aud R.; Geirdal, Amy Østertun; Fekete, Orsolya Reka & Nordli, Hege (2019). The de Jong Gierveld Loneliness Scale used with Norwegian clubhouse members: Psychometric properties and associated factors. International Journal of Psychosocial Rehabilitation. 22(2), p. 88–100. Full text in Research Archive Show summary

  Background: Loneliness is considered a common experience, but persistent loneliness can set the stage for depression and in other ways jeopardize psychological well-being. Loneliness appears to be particularly frequent among persons with mental health problems, and a short, feasible, and psychometrically sound measure of loneliness can assist in addressing loneliness in mental health practice and research. Aims: To contribute to the validation of a Norwegian version of the six-item de Jong Gierveld Loneliness Scale. We empirically investigated the factor structure and internal consistency of the scale, and explored factors associated with the resulting scales. Method: Ninety-four Norwegian clubhouse members completed the loneliness scale as part of a larger member survey in 2016. Factor structure was examined with Principal Components Analysis, in conjunction with Parallel Analysis, and internal consistency was examined with Cronbach’s coefficient alpha. Results: Two factors were extracted from the data, explaining 68.2 % of the total data variance. The structure matrix showed no cross-loadings, and all items loaded substantially (0.74-0.91) on the proposed factor. Internal consistency of the items belonging to factor 1 (social loneliness) and factor 2 (emotional loneliness) was α = 0.86 and 0.63, respectively. No variables showed a significant relationship with any of the scales. Conclusions: The scale demonstrated the theoretically proposed two-factor structure, with good measures of internal consistency. Thus, the de Jong Gierveld Loneliness Scale appears promising for future use in psychosocial settings in Norway.

• Arntzen, Cathrine; Sveen, Unni; Hagby, Cathrine; Bonsaksen, Tore; Dolva, Anne-Stine & Horghagen, Sissel (2019). Community-based occupational therapy in Norway: Content, dilemmas, and priorities. Scandinavian Journal of Occupational Therapy. ISSN 1103-8128. doi: 10.1080/11038128.2018.1548647. Full text in Research Archive Show summary

  Background: Profound changes in municipal health services, are calling for new models for community-based occupational therapy services. Objective: The aim of the study is to explore how Norwegian occupational therapists position themselves in relation to the tasks delivered. Method: Focus group interviews were conducted with ten community-based occupational therapists. Systematic text condensation was then used in the data analysis. Results: Norwegian occupational therapists description of professional practices can be constructed into four ideal types; being ‘the all-rounder’, ‘the provider of assistive device’, ‘the fire extinguisher’, or ‘the innovator’. The ideal types can help us understand more of the content and dilemmas that community-based occupational therapists encountered in their daily practice, and the priorities they make during these encounters. Conclusions and Significance: Community-based occupational therapists positioned themselves in different ways, and some of these positions were considered to be more favourable than others. The therapists struggled between ‘traditional’ occupational therapy tasks and new ways of delivering occupational therapy services. The study reveals similarities and differences between rural and urban occupational therapy practice. The ideal types can help community-based therapists to reflect on their own practice and empower them to be more in keeping with the OT’s objectives and preferences.

• Bjelland, Bente; Fagermoen, May Solveig; Lerdal, Anners & Bonsaksen, Tore (2019). Økt motivasjon for fysisk aktivitet blant personer med sykelig overvekt ett år etter deltakelse på lærings- og mestringskurs. Ergoterapeuten. ISSN 0800-3475. 62(2), p. 40–50. Full text in Research Archive Show summary

  Aims: The study aimed to describe the participants with regards to their motivation for physical activity, and to examine associations between sociodemographic variables and motivation for physical activity at the beginning of a patient education course and at one-year follow-up. Methods: The study had a longitudinal cohort design. Participants with morbid obesity attended a patient education course and comple­ted self-report questionnaires, including the Stages of Change-Exerci­se. The data were analyzed descriptively and with independent t-test, Chi Square test, Fisher's exact test, and logistic regression analysis. Results: Data from 69 participants were analyzed. Of these, 42 (60.9 percent) reported sustained high or increased motivation for physical activity between the beginning of the patient education course and the one-year follow-up, whereas 27 (39.1 percent) reported continuing low or decreased motivation. Higher education reduced the odds of being physically active at the beginning of the course, whereas employment increased the odds of being physically active at one-year follow-up. Conclusion: A majority of the participants showed a positive change in their motivation for physical activity, while a considerable minority remained physically inactive. Employment appears to be an important resource for promoting motivation for physical activity.

• Bonsaksen, Tore; Ekeberg, Øivind; Skogstad, Laila; Heir, Trond; Grimholt, Tine Kristin & Lerdal, Anners [Show all 7 contributors for this article] (2019). Self-rated global health in the Norwegian general population. Health and Quality of Life Outcomes. 17(1). doi: 10.1186/s12955-019-1258-y. Full text in Research Archive Show summary

  Background. Prevalence studies are needed to assess the distribution of diseases. However, in a contrasting health promotion perspective, self-rated health is in itself an important field of study. This study investigated self-rated global health in the general population in Norway. Methods. As part of a national survey, a two-item measure of global health (score range 0–100) was administered to a general population sample, and 1776 of 4961 eligible participants (response rate 36%) responded. Group comparisons were conducted using independent t-tests and one-way analyses of variance, whereas factors associated with global health was investigated with linear regression analysis. Results. In the adjusted analyses, better global health was associated with higher age (β = 0.13, p <  0.001), having higher education (β = 0.10, p <  0.001), being employed (β = 0.21, p <  0.001), and living with a spouse or partner (β = 0.05, p <  0.05). Conclusions. While global health was similar for men and women in the Norwegian general population, other sociodemographic variables were linked with global health. In particular, the link between employment and self-rated global health was strong. The findings are considered representative for the Norwegian population.

• Bonsaksen, Tore; Heir, Trond; Ekeberg, Øivind; Grimholt, Tine Kristin; Lerdal, Anners & Skogstad, Laila [Show all 7 contributors for this article] (2019). Self-evaluated anxiety in the Norwegian population: Prevalence and associated factors. Archives of Public Health. ISSN 0778-7367. 77(10). doi: 10.1186/s13690-019-0338-0. Full text in Research Archive Show summary

  Background: Self-evaluations of mental health problems may be a useful complement to diagnostic assessment, but are less frequently used. This study investigated the prevalence of self-evaluated current and lifetime anxiety in the general Norwegian population, and sociodemographic and psychological factors associated with current anxiety. Methods: A cross-sectional population survey was conducted, using anxiety stated by self-evaluation as outcome. Single and multivariate logistic regression analyses were conducted to examine associations between sociodemographic and psychological variables and anxiety. Results: One thousand six hundred eighty-four valid responses (34% of the eligible participants) were analysed in this study. One hundred and eleven participants (6.6%) reported current anxiety, while 365 (21.7%) reported lifetime anxiety. Adjusting for sociodemographic and psychological variables, higher age reduced the odds of current anxiety (OR=0.87, 95% CI=0.75–0.99), whereas higher levels of neuroticism increased the odds (OR=2.04, 95% CI=1.77–2.36). Conclusions: The study concludes that higher age appears to protect against anxiety, whereas neuroticism appears to increase the odds of experiencing anxiety.

• Bonsaksen, Tore; Dolva, Anne-Stine; Horghagen, Sissel; Sveen, Unni; Hagby, Cathrine & Arntzen, Cathrine (2019). Characteristics of community-based occupational therapy: Results of a Norwegian survey. Scandinavian Journal of Occupational Therapy. ISSN 1103-8128. 27(1), p. 39–46. doi: 10.1080/11038128.2019.1609085. Full text in Research Archive Show summary

  Background: Ongoing changes in healthcare delivery systems in Norway increasingly require community-based services, and the changes will likely affect the working conditions and opportunities for occupational therapists. Aim: To characterize occupational therapy in community-based practice in Norway. Material and methods: A cross-sectional, descriptive survey design was applied using a questionnaire related to personal and organizational characteristics. Participants (n = 561) were recruited among community-working occupational therapists in Norway registered as members of Ergoterapeutene. Data were analyzed with descriptive statistics. Results: The majority of the participants was female and had an average of 16.5 years of professional experience. They reported to spend about half of their working hours on direct work with clients. For many, work with assistive technology was a main task, accounting for approximately half their working hours. Only a small proportion worked in municipalities that had merged with others, but for a larger proportion (27%) a merger had been decided and was in preparation. Conclusion: This study established some basic information regarding Norwegian community-based occupational therapy and the municipalities where occupational therapists work. Significance: With this study serving as a baseline, we may be able to track how changes will affect community-based occupational therapy practice in the near future.

• Bonsaksen, Tore; Gramstad, Astrid; Mørk, Gry & Johnson, Susanne Grødem (2019). Perceptions of assessment in Norwegian occupational therapy students. Journal of Occupational Therapy Education. 3(3), p. 1–13. doi: 10.26681/jote.2019.030302. Full text in Research Archive Show summary

  In addition to securing minimum standards of learning among students, assessment is increasingly used as a tool to improve students’ learning. Assessment quality is measured as part of the Course Experience Questionnaire; however, the original ‘appropriate assessment’ scale has demonstrated ambiguous psychometric properties. The current study aimed to gain knowledge about occupational therapy students’ perceptions of assessment, and this was achieved by examining the factor structure and internal consistency of the six items on the ‘appropriate assessment’ scale. Students from six Norwegian universities (<i>n</i> = 187, response rate 61.3 %) completed the scale and reported demographic information. The factor structure of the scale was assessed with Principal Components Analysis and Parallel Analysis, and internal consistency was assessed with Cronbach’s <i>α</i> and mean inter-item correlations. Three factors were extracted from the data: Factor 1 (three items, <i>α</i> = 0.51) is concerned with the content of assessment. Factor 2 (two items, <i>α</i> = 0.62) is concerned with the context of assessment. Finally, Factor 3 (one item) is concerned with the feedback to students following assessment. In view of the item mean scores, feedback in particular appears to be an area of improvement for the occupational therapy programs, as well as a venue for further research.

• Bonsaksen, Tore; Dolva, Anne-Stine; Horghagen, Sissel; Sveen, Unni; Hagby, Cathrine & Arntzen, Cathrine (2019). Community-Working Occupational Therapists Serving as Fieldwork Supervisors: Characteristics and Associated Factors. The Open Journal of Occupational Therapy. 7(3), p. 1–9. doi: 10.15453/2168-6408.1627. Full text in Research Archive Show summary

  As enrollment numbers grow in occupational therapy academic programs in Norway, the need for more fieldwork placements and supervisors increases. More knowledge about factors of importance for occupational therapists’ decisions to take on the role of fieldwork supervisor may promote easier access to supervisors who are ready for the task, and it may assist in addressing the barriers for those who are not. We recruited a sample of 561 community-working occupational therapists for an electronic survey conducted in 2017. Quantitative survey responses were obtained and used in the current study. The differences between supervisors and non-supervisors were examined with independent t-tests and Chi Square tests. To assess factors associated with serving as a supervisor, a multivariate logistic regression analysis was conducted. One hundred fifty-six participants (27.8%) had served as a fieldwork supervisor during the preceding year. The adjusted analysis showed that having a job physically located together with other occupational therapists was significantly associated with increased odds for serving as supervisor (OR:1.79, 95% CI:1.17-2.74, p < 0.01). A minority of the participants had supervised occupational therapy students during the preceding year, suggesting that community-based services are an under-used arena for occupational therapy students’ fieldwork. In a long-term perspective, providing social and organizational support for occupational therapists who might take on student supervision may increase their willingness and opportunity to do so.

• Bonsaksen, Tore; Småstuen, Milada Cvancarova; Thørrisen, Mikkel Magnus; Fong, Kenneth; Lim, Hua Beng & Brown, Ted (2019). Factor analysis of the Approaches and Study Skills Inventory for Students (ASSIST) in a cross-cultural sample of undergraduate occupational therapy students. Australian Occupational Therapy Journal. ISSN 0045-0766. 66(1), p. 33–43. doi: 10.1111/1440-1630.12504. Full text in Research Archive Show summary

  Background/aim The Approaches and Study Skills Inventory for Students (ASSIST) has been used previously to assess the learning approaches among students in higher education, but reports of its use with occupational therapy students are rare. This study investigated the factor structure of the ASSIST in a cross‐cultural sample of undergraduate occupational therapy students, and examined whether the factor structure from specific participant groups from different cross‐cultural contexts was consistent. Methods Occupational therapy students (n = 712) from education programmes in Australia, Norway, Hong Kong and Singapore completed the ASSIST. To assess the factor structure of the instrument, a Principal Components Analysis (PCA) using a confirmatory approach, was completed. Cronbach's coefficient α and inter‐item correlations were used to assess the internal consistency of the ASSIST and its subscales. Results For the whole sample, the PCA confirmed the three primary factors as previously established. Five subscales loaded on the first factor (strategic approach). Four subscales loaded on the second factor (surface approach), whereas the remaining four subscales loaded on the third factor (deep approach). Repeating the analysis for each of the country‐specific samples produced slightly diverging factor structures for the samples from Australia and Hong Kong. Conclusion Considering all the data, the ASSIST subscales that emerged from the PCA used with a confirmatory approach in this study revealed a good degree of concordance with the established original factor, scale and subscale structure. The slightly deviating results obtained for the Hong Kong student group indicate that the established factor structure may not be the best fit across all settings, cultural contexts and sample groups.

• Uhrmann, Lisa S.; Nordli, Hege; Fekete, Orsolya Reka & Bonsaksen, Tore (2018). Perceptions of a Norwegian clubhouse among its members: A psychometric evaluation of a user satisfaction tool. International Journal of Psychosocial Rehabilitation. 21(2), p. 82–91. Full text in Research Archive
• Bonsaksen, Tore (2018). Psychometric properties of the short ASSIST scales. Uniped - Tidsskrift for universitets- og høgskolepedagogikk. ISSN 1500-4538. 41(2), p. 164–181. doi: 10.18261/ISSN.1893-8981-2018-02-07. Full text in Research Archive Show summary

  Background: The shortening of measurement scales may improve their feasibility, but may also affect the scales’ measurement properties. This study investigated the psychometric properties of the short Norwegian Approaches and Study Skills Inventory for Students (ASSIST) among occupational therapy students. Methods: The students (n = 148) completed the Norwegian ASSIST and provided sociodemographic data. Scale structure was examined with Principal Components Analysis (PCA). Scale consistency was assessed with Cronbach’s α. Bivariate associations between the full and short scales were examined with Pearson’s r. Linear regression analyses were used to assess associations between scale scores and the students’ average exam grade. Results: Three factors were confirmed, but one item did not fit within the deep approach scale. Cronbach’s α for the scales ranged 0.64–0.71. The full-length scales were strongly associated with the corresponding short scales, r ranging 0.85–0.87. For the surface scales, the full-length and short scale scores were both associated with the students’ average exam grade. For the strategic scale, only the full-length scale scores were associated with exam grade. Conclusions: The short scales of the Norwegian ASSIST have satisfactory psychometric properties and represent a feasible way of assessing students’ study approaches in Norwegian higher education.

• Meidert, Ursula; Bonsaksen, Tore & Scott, Patricia J. (2018). A study of measuring participation according to the International Classification of Functioning, Disability and Health with the Revised Role Checklist. Clinical Rehabilitation. ISSN 0269-2155. 32(11), p. 1530–1539. doi: 10.1177/0269215518782339. Full text in Research Archive Show summary

  Objective: To empirically test the hypothesis that the 10 roles on the Revised Role Checklist are represented in the International Classification of Functioning, Disability and Health participation areas. Design: Cross-sectional survey. Subjects: Investigators from Japan, Norway, Sweden, Switzerland, the United Kingdom and the United States recruited a total of 295 adults from the general population. There were 103 (34.9%) male and 191 (64.7%) female participants with one participant not indicating gender. The age distribution of participants was from <25 (n = 68) to 75+ with a mode of 25–34 years. Main measure: The Revised Role Checklist Part 1 was used to assess perceived incumbency in 10 roles. In addition, subjects were asked to provide role examples. Results: Of the 7087 examples provided by participants, 6578 (92.8%) fit the original hypothesis that the roles in the Revised Role Checklist were covered in participation areas. Fit was determined when the role example was either named in the associated International Classification of Functioning, Disability and Health participation area or when the criteria of: “does this example conceivably fit in the respective area as ‘a person’s involvement in life situations’ fit relative to each role.” Slight modification of the scope of three roles of the original hypothesis resulted in a 97.6% match. Conclusion: The roles in the Revised Role Checklist are well represented in the International Classification of Functioning, Disability and Health categories of participation.

• Carstensen, Tove & Bonsaksen, Tore (2018). Factors Associated with Therapeutic Approaches Among Norwegian Occupational Therapists: An Exploratory Study. Occupational Therapy in Mental Health. ISSN 0164-212X. 34(1), p. 75–85. doi: 10.1080/0164212X.2017.1383220. Full text in Research Archive Show summary

  According to the Intentional Relationship Model, the use of therapeutic approaches tailored to individual clients’ needs is essential for building therapeutic relationships. This study investigated factors associated with occupational therapists’ preferred therapeutic approaches. One hundred eight occupational therapists were recruited as a convenience sample, and the data were analyzed with linear regressions. Mental health as the field of practice was associated with a stronger preference for use of empathy. More job satisfaction was associated with stronger preference for the instructing mode. Empathy appears to be more commonly used in mental health practice, whereas instructing may be linked with job satisfaction.

• Nakamura-Thomas, Hiromi; Kyougoku, Makoto & Bonsaksen, Tore (2018). Japanese community-living older adults’ perceptions and solutions regarding their physical home environments. Home Health Care Management & Practice. ISSN 1084-8223. 31(1), p. 16–22. doi: 10.1177/1084822318800697. Full text in Research Archive Show summary

  This study examined perceived causes of accidental falls, the solutions implemented, and differences in scores on the Falls Efficacy Scale (FES) based on experiences of accidental falls, implementation of solutions, and experiences of problems in participants’ current environments. Data were collected individually from Japanese community-living older adults. Of the 41 participants, 71% experienced accidental falls, 41.5% implemented solutions, and 39.0% experienced problems in their current environments. Some solutions were implemented, including both appropriate and inappropriate ones. The FES scores differed significantly, based on experiences of problems in participants’ current environments, suggesting that a consultation-style intervention would contribute towards improved FES scores among clients experiencing problems in their current environments.

• Bonsaksen, Tore; Sveen, Unni; Dolva, Anne-Stine; Horghagen, Sissel; Thyness, Else Merete & Hagby, Cathrine [Show all 7 contributors for this article] (2018). Perceived influence on service goals among community-working occupational therapists in Norway. Journal of Primary Care & Community Health. ISSN 2150-1319. 9, p. 1–7. doi: 10.1177/2150132718813491. Full text in Research Archive Show summary

  Aim: This study aimed to assess the perceived influence that community-working occupational therapists in Norway have on the service goals of their respective organizations. In addition, we aimed to assess sociodemographic and work-related factors associated with the perceived level of influence. Methods: A cross-sectional survey was distributed to occupational therapists in community-based services in Norway (n = 1767), to which 561 (32%) responded. By multivariate regression analysis, factors associated with “self-perceived influence” were assessed. Results: After controlling for all variables, having a master’s degree (β = 0.09, P < .05), being involved in a research and development project (β = 0.25, P < .001), and not working with assistive technology (β = −0.19, P < .001) were associated with higher perceived influence. Conclusions: For occupational therapy to reach its potential in Norwegian community-based health care, the profession needs to establish itself more firmly and increase its influence within the health care services. To do so, it appears important to support occupational therapists’ educational aspirations, their participation in research and development projects, and their autonomous role in relation to the provision of assistive technology equipment.

• Bonsaksen, Tore (2018). Role participation – a comparison across age groups in a Norwegian general population sample. Occupational Therapy International. ISSN 0966-7903. 2018, p. 1–8. doi: 10.1155/2018/8680915. Full text in Research Archive Show summary

  Background: Life events, illness, and disability may alter a person’s role participation, in which case occupational therapy may be an appropriate intervention. However, role participation data derived from the general population, which is required for meaningful comparison, is largely missing. This study is aimed at describing past, present, and anticipated role participation in a general population sample from Norway and at examining differences in current role participation between age groups. Methods: In 2015, a sample of 140 persons (age range 19–94 years, 65% females) from the Norwegian general population completed the Role Checklist at one occasion. The data were analyzed descriptively and with chi-square tests and one-way analysis of variance. Results: The most frequent role was a home maintainer (93.6%), and the least frequent was a religious participant (7.1%). Participants aged 65 years and above had fewer roles compared with their younger counterparts and had to a larger extent experienced role loss over the course of their lives. Conclusions: Role continuity was the most prevalent role pattern in the total sample, whereas role loss appeared to be the most prevalent role pattern among those in the oldest age group. Rehabilitation services in general and participation-focused occupational therapy in particular may profit from assessing role participation in clients and potentially target roles through intervention.

• Hussain, Ratna; Carstensen, Tove; Yazdani, Farzaneh; Ellingham, Brian & Bonsaksen, Tore (2018). Short-term changes in occupational therapy students’ self-efficacy for therapeutic use of self. British Journal of Occupational Therapy. ISSN 0308-0226. 81(5), p. 276–284. doi: 10.1177/0308022617745007. Full text in Research Archive Show summary

  Introduction Self-efficacy concerned with the therapeutic use of self is important for occupational therapists, and students need to develop the skills and the self-efficacy required to meet interpersonal challenges in practice. This study examined short-term changes in occupational therapy students’ self-efficacy for using therapeutic modes, for recognizing clients’ interpersonal characteristics, and for managing interpersonal events. Factors associated with such changes were also examined. Method A sample of 89 Norwegian occupational therapy students from two universities was used, and the students completed three questionnaires 2–3 weeks after a workshop and at 3 months’ follow-up. Changes on the outcome measures were analyzed with t-tests for dependent samples, and factors associated with the outcome changes were analyzed with linear regression analyses. Results During the follow-up period, the students improved their self-efficacy scores on all three outcome measures. Higher age was associated with more improvement on two of the outcome measures. Conclusion The occupational therapy students improved their self-efficacy for therapeutic use of self during the brief follow-up period. Thus, the time in education, either university-based or practice-based, seems to add to students’ self-efficacy for clinical skills in this area. Higher age appears to be a resource for gaining more self-efficacy from attending educational courses.

• Ritter, Victoria Croke; Fekete, Orsolya Reka; Nordli, Hege & Bonsaksen, Tore (2018). Measuring perceived outcomes from participating at a clubhouse for persons with mental illness: psychometric properties and associated factors. Scandinavian Journal of Occupational Therapy. ISSN 1103-8128. 26(3), p. 219–225. doi: 10.1080/11038128.2018.1508496. Full text in Research Archive Show summary

  Background: The clubhouses are part of a growing international movement concerned with providing work-oriented psychosocial rehabilitation for people with a history of mental illness. Instruments used for measuring outcomes from clubhouse participation is in a developing phase. Aims: This study aimed to assess psychometric properties of an outcome survey tool used at a Norwegian clubhouse, and to explore factors associated with members’ perceived outcomes from participation at the clubhouse. Methods: A cross-sectional design was used. The instrument’s factor structure was examined with Principal Components Analysis (PCA), and internal consistency was assessed with Cronbach’s α. Associations with the derived outcome scale score were examined with linear regression analysis. Results: All scale items belonged to the same latent factor, and internal consistency of the items was α = 0.81. Members, who used the clubhouse more frequently perceived the outcomes from participating to be better, compared to their counterparts. Conclusion: The outcome scale was unidimensional and the items fit well together. Active members were likely to evaluate outcomes of clubhouse participation as more positive, compared to less active members. Significance: The scale can be useful for exploring clubhouse members’ perceptions of the outcomes they relate to their participation at the clubhouse.

• Bonsaksen, Tore & Yazdani, Farzaneh (2018). The Norwegian Occupational Wholeness Questionnaire (N-OWQ): Scale development and psychometric properties. Scandinavian Journal of Occupational Therapy. ISSN 1103-8128. p. 1–10. doi: 10.1080/11038128.2018.1426783. Full text in Research Archive Show summary

  Background: Occupational therapy has long emphasized the concepts doing, being, becoming and belonging, and a notion of balance between them. Measures of these concepts are in a developing stage. Aim: This study aimed to develop and examine the properties of the Norwegian version of the Occupational Wholeness Questionnaire (N-OWQ), which is proposed to measure being, becoming, and belonging, in addition to occupational wholeness as a higher-order concept. Methods: An anonymous sample of 248 persons over the age of 18 years completed the N-OWQ along with sociodemographic information. Principal Components Analysis (PCA) was performed on the scale items when examining factor structure. Item reduction was based on considerations of communalities, factor loadings, scale consistency if item deleted, and conceptual issues. Internal consistency was assessed with Cronbach’s α. Results: Following the PCA, the ‘Being’ and ‘Becoming’ scales merged into one five-item ‘Self’ scale (Cronbach’s α 0.77). The ‘Belonging’ scale items were split into two scales comprised by three items each: ‘Closeness’ (Cronbach’s α 0.70) and ‘Relatedness’ (Cronbach’s α 0.73). Conclusions: The revised N-OWQ merged the ‘Being’ and ‘Becoming’ items into one factor, whereas the ‘Belonging’ items were split into two distinct factors. Internal consistency for all scales were satisfactory.

• Bonsaksen, Tore; Grimholt, Tine Kristin; Skogstad, Laila; Lerdal, Anners; Ekeberg, Øivind & Heir, Trond [Show all 7 contributors for this article] (2018). Self-diagnosed depression in the Norwegian general population - associations with neuroticism, extraversion, optimism, and general self-efficacy. BMC Public Health. 18(1076). doi: 10.1186/s12889-018-5990-8. Full text in Research Archive Show summary

  Background: Multi-item rating scales for depression informs about the level of depression, but does not allow individuals to state by self-evaluation whether they feel depressed or not. The insider perspective on depression is rarely assessed. This study investigated the prevalence of self-diagnosed depression in the Norwegian general population, and associations with sociodemographic and psychological factors. Methods: As part of a national survey, the General Self-Efficacy Scale, the Life Orientation Test-Revised, a short version of the Eysenck Personality Questionnaire and a one-item measure of self-diagnosed depression was administered to 5. 500 persons in the general Norwegian population. Of the 4961 eligible participants ≥18 years of age, 1.787 (response rate 36%) participated in the survey, and 1.684 of these had valid scores on the relevant scales. The associations between sociodemographic factors and self-diagnosed depression were examined using univariate and multivariate logistic regression analyses. Results: One hundred and thirty-six participants (8.1%) reported depression during the preceding month. When adjusting for sociodemographic and psychological variables, higher age (OR=0.82), being in work (OR=0.57), and higher levels of general self-efficacy (OR=0.67) and optimism (OR=0.52) were associated with lower risk of self-diagnosed depression, whereas higher levels of neuroticism (OR=1.97) was associated with higher risk. Conclusions: The prevalence of self-diagnosed depression in the adult Norwegian population was higher for women than for men. Higher age, being in work and having higher levels of psychological resources appear to reduce the risk of selfdiagnosed depression, whereas neuroticism increases the risk.

• Carstensen, Tove; Ødegaard, Nina Bjerketveit & Bonsaksen, Tore (2018). Approaches to studying – associations with learning conceptions and preferences for teaching. Cogent Education. 5(1). doi: 10.1080/2331186X.2018.1480909. Full text in Research Archive Show summary

  Background: Research into occupational therapy students’ approaches to studying is growing, and research has shown approaches to studying to be associated with academic performance. However, learning conceptions and preferences for teaching among occupational therapy students have rarely been reported, and their relationships to study approaches need to be empirically investigated. Aim: This study aimed to investigate the sociodemographic and education-related factors associated with approaches to studying among occupational therapy students in Norway. Methods: Occupational therapy students (n = 149) from one education program in Norway completed questionnaires related to approaches to studying, learning conception, preferences for teaching, and sociodemographic factors. Hierarchical linear regression analyses were used to examine the independent variables’ associations with approaches to studying. Results: Higher age was associated with higher deep approach scores and lower surface approach scores, whereas being female was associated with higher surface approach scores. Higher scores on learning conception was associated with higher scores on the deep and the strategic approaches. Higher scores on supporting understanding was associated with higher scores on the deep and strategic approaches, whereas higher scores on transmitting information was associated with higher scores on the surface approach. Conclusions: This study provides increased understanding of the associations between students’ learning conceptions, preferences for teaching, and approaches to studying. The results contribute to educators’ knowledge base from which they can adapt their way of teaching according to student group characteristics.

• Bonsaksen, Tore; Yazdani, Farzaneh; Ellingham, Brian & Carstensen, Tove (2018). Psychometric properties of the Norwegian self-efficacy for managing interpersonal events (N-SEMIE). Ergoscience. ISSN 1861-6348. 13(3), p. 111–117. doi: 10.2443/skv-s-2018-54020180303. Full text in Research Archive Show summary

  Background: The Intentional Relationship Model addresses the use of different therapeutic approaches according to client needs, but also the therapist’s need to manage the relational challenges that inevitably arise in therapeutic encounters. However, measures of therapist self-efficacy related to managing such challenges have not been previously developed. Aim: This study aimed to examine the psychometric properties of a new measure, the Norwegian self-efficacy for managing interpersonal events (NSEMIE). Methods: Occupational therapy students (n = 106) completed the instrument along with sociodemographic information.  Factor analysis was performed using  Principal Components Analysis in combination with  Parallel Analysis, and internal consistency was assessed with Cronbach’s α and  inter-item correlations. Results: All scale items belonged to the same latent factor (factor loadings 0.72-0.84), and Cronbach’s α was 0.94 (mean inter-item correlation 0.60) for the scale items. Conclusion: The N-SEMIE scale is  unidimensional; the items have very high internal consistency; and the scale may be useful in research and audits related to therapist management of the interpersonal aspects of occupational therapy practice.

• Bonsaksen, Tore & Yazdani, Farzaneh (2018). Sociodemographic factors associated with the Norwegian occupational wholeness questionnaire scales. Ergoscience. ISSN 1861-6348. 13(1), p. 21-27–21-27. doi: 10.2443/skv-s-2018-54020180103. Full text in Research Archive Show summary

  Background: A new assessment purporting to measure the concepts being, becoming, belonging, and the higher order concept occupational wholeness, was recently subjected to factor analysis. The revised scales merged the being and becoming items into one scale related to the self, whereas the belonging items comprised two scales: belonging in terms of closeness and in terms of relatedness. To date, no studies have investigated sociodemographic factors related to these scales. Aim: This study aimed to examine sociodemographic factors associated with the scales encompassed by the Norwegian version of the Occupational Wholeness Questionnaire (N-OWQ). Methods: An anonymous sample of 248 persons over the age of 18 years completed the N-OWQ along with sociodemographic information. Linear regression analysis was used to investigate associations between sociodemographic variables and the N-OWQ scales. Results: None of the sociodemographic variables were significantly related to the self scale scores. Being female was related to higher scores on the closeness scale, whereas higher age and being employed were related to higher scores on the relatedness scale. None of the variables were associated with scores on the higher-order occupational wholeness scale. Conclusions: The factors associated with the closeness and relatedness scales are consistent with prior research on personal relationships and on participation in society. Future studies may aim to develop a measure of occupational wholeness that incorporates the person’s view of the relative importance of each of the comprised items.

• Bonsaksen, Tore (2018). Deep, surface, or both? A study of occupational therapy students’ learning concepts. Occupational Therapy International. ISSN 0966-7903. 2018. doi: 10.1155/2018/3439815. Full text in Research Archive Show summary

  Background: Students’ conceptualization of learning has been associated with their approaches to studying. However, whether students’ learning concepts are associated with their personal characteristics is unknown. Aim: To investigate whether sociodemographic, education-related, and personal factors were associated with the learning concepts of Norwegian occupational therapy students. Methods: One hundred and forty-nine students (mean age 23.9 years, 79.2% women) participated in the study. The employed self-report questionnaires included the Approaches and Study Skills Inventory for Students, the Rosenberg Self-Esteem Scale, and the General Self-Efficacy Scale. Differences between student cohorts were analyzed with oneway analyses of variance and χ2 tests, whereas factors associated with the students’ learning concepts were analyzed with bivariate correlation and linear regression models. Results: The students’ mean scores on the deep and surface learning concept scales were similar. Spending more time on the independent study was associated with having higher scores on the unidimensional learning concept measure. Conclusions: The students’ learning concept appears to encompass a surface concept as well as a deep concept of learning, and the two ways of conceptualizing learning were positively related to each other. Over time, a mature deep concept may add to, rather than replace, a basic surface concept of learning.

• Bonsaksen, Tore; Nordli, Hege & Fekete, Orsolya Reka (2018). Ønsker om jobb og utdanning blant medlemmer av et klubbhus for personer med psykisk sykdom. Tidsskrift for psykisk helsearbeid. ISSN 1503-6707. 15(2-3), p. 170–179. doi: 10.18261/issn.1504-3010-2018-02-03-08. Full text in Research Archive Show summary

  En stor andel personer med psykiske lidelser er uten arbeid, og fontenehusene, som er klubbhus for mennesker med psykiske plager, ønsker å bidra til at medlemmene kommer i arbeid. Hensikten med studien var å undersøke andelen personer blant klubbhusmedlemmer som var uten arbeid, andelen uten arbeid som ønsket arbeid, og faktorer som var assosiert med et ønske om arbeid. 94 medlemmer deltok i undersøkelsen, hvorav 79,8 prosent var uten arbeid. Av de uten arbeid ønsket 57,8 prosent å komme i arbeid. Høyere alder var assosiert med lavere sannsynlighet for å ønske arbeid. Det er et gap mellom den lave andelen i arbeid og den høye andelen som ønsker arbeid blant klubbhusmedlemmer.

• Ritter, Victoria Croke; Nordli, Hege; Fekete, Orsolya Reka & Bonsaksen, Tore (2018). User satisfaction and its associated factors among members of a Norwegian clubhouse for persons with mental illness. International Journal of Psychosocial Rehabilitation. 22(1), p. 5–14. doi: 10.37200/V22I1/8215. Full text in Research Archive
• Uhrmann, Lisa S.; Hovengen, Ida; Wagman, Petra; Håkansson, Carita & Bonsaksen, Tore (2018). The Norwegian Occupational Balance Questionnaire (OBQ11-N) – Development and pilot study. Scandinavian Journal of Occupational Therapy. ISSN 1103-8128. p. 1–7. doi: 10.1080/11038128.2018.1523458. Full text in Research Archive Show summary

  Background: The concept occupational balance has been linked with health and well-being, and it is therefore viewed as an important concept for occupational therapy practice, theory and research. To operationalize and measure occupational balance, the Occupational Balance Questionnaire (OBQ) was developed in Sweden. To date, no Norwegian translations of the OBQ exists. Aim: To describe the process of developing a Norwegian version of the 11-items Occupational Balance Questionnaire (OBQ11-N) and to evaluate its feasibility and face validity. Methods: The development process followed a predetermined series of steps, including forward and back translation and cognitive interviews with a pilot sample. Results: The pilot study sample (n = 8) varied with respect to age, gender and education level. There was high level of agreement between the participants with regard to their understanding of the content of the items. Three of the items were slightly modified in terms of words and phrasing. Conclusion: The OBQ11-N was developed according to established translation guidelines and appears to be feasible and have good face validity. Significance: The OBQ11-N may prove useful for assessing occupational balance and associated factors in Norwegian population groups. However, more research is needed to establish the Norwegian version of the questionnaire as psychometrically valid.

• Ritter, Victoria Croke; Yazdani, Farzaneh; Carstensen, Tove; Thørrisen, Mikkel Magnus & Bonsaksen, Tore (2018). Psychometric Properties of an Instrument Derived from the Intentional Relationship Model: the Self-Efficacy for Recognizing Clients’ Interpersonal Characteristics (N-SERIC). The Open Journal of Occupational Therapy. 6(2), p. 1–8. doi: 10.15453/2168-6408.1423. Full text in Research Archive Show summary

  Background: The Intentional Relationship Model conceptualizes the therapeutic use of self in occupational therapy. To increase motivation for and success in establishing therapeutic relationships, therapists need self-efficacy for using the self in therapeutic practice. However, attempts to combine this model with self-efficacy theory are rare, and instruments by which to measure self-efficacy for therapeutic use of self are in a developing stage. This study aimed to examine the factor structure and internal consistency of the Norwegian Self-Efficacy for Recognizing Interpersonal Characteristics (N-SERIC). Methods: Occupational therapy students (n = 100) from two education programs completed the instrument and sociodemographic information. The factor structure was examined with Principal Components Analysis (PCA), and internal consistency was assessed with Cronbach’s α and inter-item correlations. Results: The PCA revealed that all N-SERIC items belonged to the same latent factor, with factor loadings ranging between 0.75 and 0.89. The internal consistency of the scale items was high (Cronbach’s α = 0.96). Conclusions: The N-SERIC scale is unidimensional and the items have very high internal consistency. Thus, the scale sum score can be useful for occupational therapy research and audits focusing on interpersonal aspects of practice.

• Bonsaksen, Tore; Ellingham, Brian & Carstensen, Tove (2018). Factors Associated With Academic Performance Among Second-Year Undergraduate Occupational Therapy Students. The Open Journal of Occupational Therapy. 6(1), p. 1–8. doi: 10.15453/2168-6408.1403. Full text in Research Archive Show summary

  Background: Research into occupational therapy education and its outcomes for students is growing. More research is needed to determine the factors of importance for occupational therapy students’ academic outcomes. This study aimed to investigate factors associated with academic performance among second-year undergraduate occupational therapy students in Norway. Methods: Occupational therapy students (n = 111) from two education programs completed questionnaires asking for sociodemographic, work-related, and education-related information. Hierarchical linear regression analysis was used to examine factors independently associated with the students’ academic performance. Results: A higher age was associated with better average academic performance among the students, whereas having higher education experience before entering the occupational therapy program was associated with poorer average academic performance. Conclusions: Students of a higher age may have life experience that easily translates into good academic results, and they may represent an under-used resource for improving the academic climate and understanding subsequent exam results among undergraduate occupational therapy students. However, prior higher education experience from disciplines different from occupational therapy, and that hold different expectations toward students, may hinder good academic performance in occupational therapy coursework.

• Bonsaksen, Tore; Thørrisen, Mikkel Magnus; Sveen, Unni; Kjeken, Ingvild; Aas, Randi Wågø & Lund, Anne (2018). Grade correspondence between internal and external examiners of occupational therapy students’ bachelor theses. Uniped - Tidsskrift for universitets- og høgskolepedagogikk. ISSN 1500-4538. 41(3), p. 319–330. doi: 10.18261/issn.1893-8981-2018-03-11. Full text in Research Archive Show summary

  Students’ grades are increasingly important in defining their future employability, and therefore, securing a fair assessment of students’ theses is important. This study aimed to assess the level of grade correspondence between internal and external examiners of occupational therapy students’ bachelor theses, and to evaluate the overall level of grades initially set by examiners in the two groups. The grades initially suggested for 67 bachelor theses were analyzed. Absolute agreement between internal and external examiners was estimated as the proportion of theses on which the examiners suggested identical grades (percentage agreement), and consistency in agreement was estimated by the intraclass correlation coefficient (ICC). There was absolute agreement between the internal and the external examiners in 33 of the 67 cases (49.3 %), and also consistency in agreement was high (ICC = 0.81, 95 % CI [0.68, 0.88], p < 0.001). The results from this study demonstrate a high level of agreement between internal and external examiners of occupational therapy students’ bachelor theses. However, internal examiners as a group are more prone to give high grades compared to external examiners, and this may support the continued use of two examiners to ensure quality in grading.

• Bonsaksen, Tore (2018). Factors associated with occupational therapy students’ preferences for courses and teaching. Cogent Education. 5. doi: 10.1080/2331186X.2018.1431426. Full text in Research Archive Show summary

  Background: Students’ preferences for teaching have been associated with their own approaches to studying. However, whether teaching preferences are associated with a set of student characteristics is yet unknown. Aim: To investigate whether sociodemographic, education-related and personal factors were associated with preferences for teaching among Norwegian occupational therapy students. Methods: One hundred and forty-six students (mean age 23.7 years, 78.8% women) participated in the study. Self-report questionnaires were employed, including the Approaches and Study Skills Inventory for Students, the Rosenberg Self-Esteem Scale, and the General Self-Efficacy Scale. Differences between student cohorts were analyzed with one-way analyses of variance and χ 2 -tests, whereas factors associ- ated with the students’ teaching preferences were analyzed with linear regression models. Results: Overall, the students preferred teaching oriented toward “transmit- ting information” over teaching oriented toward “supporting understanding”. Higher age, higher levels of general self-efficacy and spending more time on independent study were associated with having a stronger preference for the “supporting un- derstanding” teaching type. Conclusions: Compared to their counterparts, students of higher age, who study more independently, and who have higher general self- efficacy are more inclined to prefer teaching that supports understanding, which is compatible with the expectations in higher education institutions.

• Bonsaksen, Tore; Dolva, Anne-Stine; Hagby, Cathrine; Sveen, Unni; Horghagen, Sissel & Thyness, Else Merete [Show all 7 contributors for this article] (2018). Involvement in research and development projects among community-working occupational therapists in Norway. Occupational Therapy in Health Care. ISSN 0738-0577. doi: 10.1080/07380577.2018.1526434. Full text in Research Archive Show summary

  A cross-sectional descriptive survey was conducted (n = 561). Almost half of the participants took part in research and development projects. Being involved in research and development was associated with lower age, having further education, and higher levels of work experience. The current and prioritized research topics were reablement and assistive technology. The study implies that community-working occupational therapists are largely involved in research and development, or eager to become involved.

• Bonsaksen, Tore; Lerdal, Anners; Heir, Trond; Ekeberg, Øivind; Skogstad, Laila & Grimholt, Tine Kristin [Show all 7 contributors for this article] (2018). General self-efficacy in the Norwegian population: Differences and similarities between sociodemographic groups. Scandinavian Journal of Public Health. ISSN 1403-4948. doi: 10.1177/1403494818756701. Full text in Research Archive Show summary

  Aims: General self-efficacy (GSE) refers to optimistic self-beliefs of being able to perform and control behaviors, and is linked with various physical and mental health outcomes. Measures of self-efficacy are commonly used in health research with clinical populations, but are less explored in relationship to sociodemographic characteristics in general populations. This study investigated GSE in relation to sociodemographic characteristics in the general population in Norway. Methods: As part of a larger national survey, the GSE scale was administered to a general population sample, and 1787 out of 4961 eligible participants (response rate 36%) completed the scale. Group comparisons were conducted using independent t-tests and one-way analyses of variance. Linear regression analysis was used to examine factors independently associated with GSE. Results: GSE was lower for older compared to younger participants (p < 0.001). It was higher for men compared to women (p < 0.001), higher for those with higher levels of education compared to those with lower levels (p < 0.001) and higher for those in work compared to their counterparts (p < 0.001). Controlling for all variables, male gender and employment were independently associated with higher GSE. Age moderated the associations between gender and employment on one hand, and GSE on the other. The association between being male and having higher GSE was more pronounced in younger age, as was the association between being employed and having higher GSE. Conclusions: Male gender and being employed were related to higher GSE among persons in the general population in Norway, and these associations were stronger among persons of younger age. The findings are considered fairly representative for the Norwegian population.

• Bonsaksen, Tore (2018). Age, gender, and approaches to studying predict academic performance among Norwegian occupational therapy students. Ergoterapeuten. ISSN 0800-3475. 61(2), p. 36–43. Full text in Research Archive Show summary

  Background: Students' academic outcomes may be a result of several factors including the students' personal characteristics, their study behaviors, and characteristics of the learning environment. This study examined the associations between age, gender, approaches to studying, and academic performance in Norwegian occupational therapy students. Methods: Occupational therapy students (n = 160) completed the Approaches and Study Skills Inventory for Students (ASSIST). Age, gender, and ASSIST subscale scores we~e used in a hierarchical linear regression analysis to predict the studer:i:ts' average academic performance. Results: Higher age and female gender were associated with higher academic performance among the students. In addition, three ASSIST subscales were associated with higher performance: higher scores on achieving and lack of purpose, and lower scores on fear of failure. The full model accounted for 27.3 percent of the outcome variance. Conclusions: To improve academic performance among occupational therapy students, it appears important to increase their motivation for achievement, and to reduce their fear of failure.

• Schwank, Kathrin; Carstensen, Tove; Yazdani, Farzaneh & Bonsaksen, Tore (2018). The Course of Self-Efficacy for Therapeutic Use of Self in Norwegian Occupational Therapy Students: A 10-Month Follow-Up Study. Occupational Therapy International. ISSN 0966-7903. 2018, p. 1–5. doi: 10.1155/2018/2962747. Full text in Research Archive Show summary

  Background. Occupational therapy students need to develop self-efficacy for managing the therapeutic relationship in practice. This study examined the 10-month trajectories of Norwegian students’ self-efficacy for use of self. Methods. Eighty-nine students completed self-efficacy questionnaires related to the use of self after a workshop and at 3- and 10-month follow-up. Changes on the three outcome measures (self-efficacy for therapeutic mode use, for recognizing clients’ interpersonal characteristics, and for managing interpersonal events) were analyzed with repeated measures ANOVA. Results. Across the follow-up period, the students improved their self-efficacy for therapeutic mode use (partial = 0.44, ), for recognizing clients’ interpersonal characteristics (partial = 0.81, ), and for managing interpersonal events (partial , ). Conclusion. The increased self-efficacy for use of self that was found at 3-month follow-up was maintained at 10-month follow-up. The results indicate that students may experience a boost in self-efficacy for therapeutic use of self after a brief workshop and that these changes can be sustained over time.

• Thørrisen, Mikkel Magnus; Nordli, Hege; Fekete, Orsolya Reka & Bonsaksen, Tore (2018). Systematisk måling av brukererfaringer blant medlemmer på klubbhus for psykososial rehabilitering. En psykometrisk vurdering. Tidsskrift for omsorgsforskning. ISSN 2387-5976. 4(1), p. 50–61. doi: 10.18261/issn.2387-5984-2018-01-07. Full text in Research Archive Show summary

  Brukerundersøkelser kan være et godt verktøy for instrumentell brukermedvirkning på systemnivå, forutsatt at de er valide og reliable. Formålet med denne studien var å undersøke psykometriske egenskaper ved Fontenehusets spørreundersøkelse av medlemserfaringer (FUME). Studien fant, ved hjelp av intern konsistensanalyse og faktoranalyse, at det opprinnelige spørreskjemaet, bestående av ti påstander, ikke har tilfredsstillende psykometriske egenskaper, men kan fungere i revidert versjon (FUME-R) dersom to av påstandene fjernes. Studien konkluderer med at det reviderte skjemaet kan anvendes i arbeidet med å evaluere og videreutvikle tjenestetilbudet ved klubbhus for psykososial rehabilitering.

• Ritter, Victoria Croke; Thørrisen, Mikkel Magnus; Yazdani, Farzaneh & Bonsaksen, Tore (2017). Further Validation of the Norwegian Self-Efficacy for Therapeutic Mode Use. Occupational Therapy International. ISSN 0966-7903. p. 1–5. doi: 10.1155/2017/9745373. Full text in Research Archive Show summary

  Background. The Intentional Relationship Model (IRM) proposes six therapeutic modes as ways of relating to clients. The Norwegian self-efficacy for therapeutic mode use (N-SETMU) was found to have a one-component structure. However, its items reflect abstract concepts rather than concrete behaviors. Aim. To validate further the N-SETMU by linking its items to the Norwegian client assessment of modes (N-CAM), with 30 items constituting six scales (linked to each mode), possessing concrete, behavioral content. Methods. Occupational therapy students () completed the N-SETMU and the N-CAM derived items, along with sociodemographic information. Component structure was analyzed with Principal Components Analysis (PCA), internal consistency of scales with Cronbach’s α, and associations between scale scores with Pearson’s . Results. All items on all N-CAM derived scales loaded on one latent component, except one item related to problem-solving. After removing this item, the scale functioned appropriately. Cronbach’s α for all N-CAM derived scales ranged 0.88–0.94, and the associations between the N-CAM derived scales and the corresponding N-SETMU items ranged between 0.60 (advocating) and 0.79 (encouraging). Conclusions. In view of the strong associations between the concrete, N-CAM derived scales and the abstract N-SETMU items, this study supports the concurrent validity of the N-SETMU.

• Brown, Ted; Fong, Kenneth; Bonsaksen, Tore; Tan, Hwei-Lan; Murdolo, Yuki & Cruz-Gonzales, Pablo [Show all 7 contributors for this article] (2017). Approaches to learning among occupational therapy undergraduate students: A cross-cultural study. Scandinavian Journal of Occupational Therapy. ISSN 1103-8128. 24(4), p. 299–310. doi: 10.1080/11038128.2016.1229811. Full text in Research Archive
• Opseth, Thea M.; Carstensen, Tove & Bonsaksen, Tore (2017). Job satisfaction, interest and control among Norwegian occupational therapists. Ergoterapeuten. ISSN 0800-3475. 60(5), p. 44–52. Full text in Research Archive
• Bonsaksen, Tore & Torgrimsen, Silje (2017). Den terapeutiske relasjonen i ergoterapi – teori, praksis og forskning. In Geirdal, Amy Østertun & Varvin, Sverre (Ed.), Relasjoner i psykisk helsearbeid. Universitetsforlaget. ISSN 9788215027906. p. 141–156. Full text in Research Archive
• Bonsaksen, Tore & Donohue, Mary V. (2017). Are individual student characteristics and -performance associated with group-level functioning in educational groups? An exploratory study. Ergoterapeuten. ISSN 0800-3475. 60(2), p. 40–49. Full text in Research Archive Show summary

  Background : The recently developed Social Profile assessment allows for classifying a group’s interaction behaviors within five levels. However, empirical associations between the levels, and factors related to an overall Social Profile measure, have not been examined. Methods : A sample of 35 occupational therapy students was recruited. Data was collected by self-report questionnaires, including the Social Profile and basic sociodemographic information. Descripti - ve statistics, bivariate correlation, and linear regression analyses were performed. Results : The basic cooperative level was most frequently found in the study groups. In general, levels of social interaction were more strongly associated with nearby levels, and more weakly or negative - ly associated with levels representing more different behaviors. The overall Social Profile measure related to the levels of interaction in a mostly logical way. Spending more time with the group was associated with a higher Social Profile measure, but this measure was unrelated to individual exam grades. Conclusion : Student study groups appear to operate at all levels of social interaction, but most frequently at the basic cooperative level. Associations between the five levels and the overall Social Profile measure was mostly logical, indicating the theoretical accuracy of the model concepts.

• Bonsaksen, Tore; Brown, Ted; Lim, Hua Beng & Fong, Kenneth (2017). Approaches to studying predict academic performance in undergraduate occupational therapy students: a cross-cultural study. BMC Medical Education. 17(76), p. 1–9. doi: 10.1186/s12909-017-0914-3. Full text in Research Archive Show summary

  Background Learning outcomes may be a result of several factors including the learning environment, students’ predispositions, study efforts, cultural factors and approaches towards studying. This study examined the influence of demographic variables, education-related factors, and approaches to studying on occupational therapy students’ Grade Point Average (GPA). Methods Undergraduate occupational therapy students (n = 712) from four countries completed the Approaches and Study Skills Inventory for Students (ASSIST). Demographic background, education-related factors, and ASSIST scores were used in a hierarchical linear regression analysis to predict the students’ GPA. Results Being older, female and more time engaged in self-study activities were associated with higher GPA among the students. In addition, five ASSIST subscales predicted higher GPA: higher scores on ‘seeking meaning’, ‘achieving’, and ‘lack of purpose’, and lower scores on ‘time management’ and ‘fear of failure’. The full model accounted for 9.6% of the variance related to the occupational therapy students’ GPA. Conclusions To improve academic performance among occupational therapy students, it appears important to increase their personal search for meaning and motivation for achievement, and to reduce their fear of failure. The results should be interpreted with caution due to small effect sizes and a modest amount of variance explained by the regression model, and further research on predictors of academic performance is required.

• Lerdal, Anners; Gay, Caryl; Bonsaksen, Tore & Fagermoen, May Solveig (2017). Predictors of physical and mental health in persons with morbid obesity attending a patient education course - a two-year follow-up study. Health and Quality of Life Outcomes. 15(1). doi: 10.1186/s12955-017-0675-z. Full text in Research Archive Show summary

  Background People with morbid obesity (body mass index ≥40) may experience changes in their health after participating in a tailored patient education course. The aims of this study were to assess the changes in physical and mental health in persons with morbid obesity during the 2 years following an educational course and to explore possible socio-demographic, treatment, and personal predictors of physical and mental health outcomes. Methods In this prospective longitudinal cohort study, self-report questionnaire data were collected from people with morbid obesity at the beginning of mandatory educational courses while on a waiting list for gastric surgery and at two-year follow-up. Of the 185 who attended the courses, 142 (77%) volunteered to participate in the study, and the 59 with complete data at the two-year follow-up were included in the analysis. Physical and mental health were measured with the physical and mental component summary scores from the Short Form 12v2. Self-esteem was measured by the Rosenberg Self-Esteem Scale, and self-efficacy by the General Self-Efficacy Scale. Results The participants reported better physical health at two-year follow-up than at baseline. Mental health did not change significantly over time. Receiving surgical treatment during the study period predicted better physical health at two-year follow-up, even after controlling for physical health at baseline. Mental health at baseline was the only significant baseline predictor of mental health at follow-up. However, increasing self-esteem and self-efficacy over the two-year study period independently predicted better mental health at follow up after controlling for mental health at baseline. Conclusion Our study showed that people with morbid obesity on a waiting list for bariatric surgery improved their physical health during the 2 years after attending a tailored patient educational course. Improving self-esteem and self-efficacy may be important personal factors for maintaining mental health during this period. Trial Registration NCT01336725. Registered 14 April 2011.

• Bonsaksen, Tore; Thørrisen, Mikkel Magnus & Sadeghi, Talieh (2017). Occupational therapy students in Norway: Do their approaches to studying vary by year in the program? The Open Journal of Occupational Therapy. 5(4), p. 1–12. doi: 10.15453/2168-6408.1339. Full text in Research Archive Show summary

  Approaches to studying may be influenced by students’ age, maturity, and experience in higher education. Students’ approaches to studying may develop toward deep and/or strategic approaches and away from a surface approach as they move through the curriculum, which is generally considered a positive development. This study aimed to identify differences in approaches to studying among first-, second-, and third-year students enrolled in an occupational therapy program. Three cohorts of students (n = 160) from one university college completed the Approaches and Study Skills Inventory for Students (ASSIST) along with sociodemographic information. One-way analyses of variance were used to identify differences in approaches to studying among the student cohorts. The scores on the ASSIST were largely similar between the cohorts. However, first-year students had higher scores on the surface approach and on syllabus-boundness, compared to third-year students. There was a linear trend of decreasing scores on these two scales: from highest among first-year students to lowest among third-year students. With few exceptions, students in three cohorts showed similar levels of deep, strategic, and surface approaches to studying. More efforts should be placed on assisting students to adopt a deep and/or strategic approach to studying and to reduce a surface approach.

• Opseth, Thea Moos; Carstensen, Tove; Yazdani, Farzaneh; Ellingham, Brian; Thørrisen, Mikkel Magnus & Bonsaksen, Tore (2017). Self-efficacy for therapeutic mode use among occupational therapy students in Norway. Cogent Education. 4:1406630(1), p. 1–9. doi: 10.1080/2331186X.2017.1406630. Full text in Research Archive Show summary

  Background: The intentional relationship model (IRM) proposes six distinct ways of relating to clients. A new instrument for measuring self-efficacy for using the therapeutic modes in occupational therapy practice was recently found to have good psychometric properties. To date, however, no research has investigated factors associated with self-efficacy for therapeutic mode use. Aim: This study aimed to explore sociodemographic and education-related factors associated with self-efficacy for therapeutic mode use in a sample of occupational therapy students in Norway. Methods: Occupational therapy students (n = 111) from two education programs completed the Norwegian version of the recently developed “Self-efficacy for therapeutic mode use” (N-SETMU), in addition to reporting sociodemographic and education-related information. Hierarchical linear regression analysis was used to examine factors independently associated with the students’ N-SETMU scores. Results: Higher N-SETMU scores were associated with better average academic performance among the students. Otherwise, none of the associations were statistically significant. Conclusions: As better academic results were linked with higher self-efficacy for therapeutic mode use, the study indicates that some students perform well academically and have high self-efficacy for practical skills, whereas others perform less well academically and have lower self-efficacy for practical skills. A potential transfer of self-efficacy beliefs from one area of performance (academic) to another (practical skills) seems possible, and this may be investigated in future studies.

• Bonsaksen, Tore & Carstensen, Tove (2017). Psychometric properties of the Norwegian self-efficacy for therapeutic mode use (N-SETMU). Scandinavian Journal of Occupational Therapy. ISSN 1103-8128. 25(6), p. 475–480. doi: 10.1080/11038128.2017.1316421. Full text in Research Archive Show summary

  Background: According to the Intentional Relationship Model (IRM), the intentional use of relational approaches in therapy (therapeutic modes) is essential for obtaining successful relationships to clients. There have been no attempts to combine the IRM with self-efficacy theory, and instruments for measuring self-efficacy for therapeutic mode use are lacking. Aim: This study aimed to examine the component structure and internal consistency of the Norwegian version of the Self-Efficacy for Therapeutic Mode Use (N-SETMU). Methods: Occupational therapy students (n = 111) from two education programs completed the N-SETMU along with sociodemographic information. Principal Components Analysis (PCA) was performed and component extraction was controlled using Parallel Analysis. Internal consistency was assessed with Cronbach’s α and inter-item correlations. Results: All items on the N-SETMU loaded on the same latent dimension, tentatively called Self-Efficacy for Therapeutic Mode Use. Cronbach’s α for all scales ranged 0.73–0.82. Conclusions: The N-SETMU is a unidimensional measure of self-efficacy for therapeutic mode use in general. The N-SETMU may be a useful tool for occupational therapy research and audits focusing on occupational therapists’ use of therapeutic modes in client interactions.

• Bonsaksen, Tore; Sadeghi, Talieh & Thørrisen, Mikkel Magnus (2017). Associations between self-esteem, general self-efficacy and approaches to studying in occupational therapy students: A cross-sectional study. Occupational Therapy in Mental Health. ISSN 0164-212X. 33(4), p. 326–341. doi: 10.1080/0164212X.2017.1295006. Full text in Research Archive Show summary

  The aim of this study was to explore associations between self-esteem, general self-efficacy, and the deep, strategic, and surface approaches to studying. Norwegian occupational therapy students (n = 125) completed questionnaires measuring study approaches, self-esteem, and general self-efficacy. Regression analyses were used to explore the direct relationships between self-esteem, general self-efficacy and the approaches to studying, after controlling for age, gender, prior higher education, and time spent on independent studying. General self-efficacy displayed positive associations with deep and strategic approaches to studying and a negative relationship with a surface approach to studying. Self-esteem was not significantly associated with approaches to studying.

• Bredal, Inger Schou; Heir, Trond; Skogstad, Laila; Bonsaksen, Tore; Lerdal, Anners & Grimholt, Tine Kristin [Show all 7 contributors for this article] (2017). Population-based norms of the Life Orientation Test–Revised (LOT-R). International Journal of Clinical and Health Psychology. ISSN 1697-2600. 17(3), p. 216–224. doi: 10.1016/j.ijchp.2017.07.005. Full text in Research Archive Show summary

  Background/Objective: The most common used instrument to measure optimism, both in psychological and medical research, is the Life Orientation Test- Revised (LOT-R). A multi-countries study using the future item from the LOT-R, found that level of optimism varied between countries. The provision of population-based norms is necessary, since norms enable the application of the LOT-R in individual diagnosis to compare individuals or special patient groups’ scores with reference data. Method: A representative population based survey was conducted in 2014-2015. Norwegian aged 18–94 years (N = 1,792) completed questionnaires assessing sociodemographic, optimism and health and quality of life. Results: The mean age was 53.2 (SD = 16.6) and 53% were women. Mean LOT-R score was 17.2 (SD 3.0). There were marginal age and no gender differences. Although optimism was associated with sociodemographic variables, these were considered negligible due to small effect size. Norm data are given for the entire population. Optimism was associated with better health and quality of life. Conclusions: This study provides age and gender specific norm values from a representative sample of the Norwegian population. The normative data may be used in comparisons of optimism between individuals or between different samples of patients or sub-groups of people.

• Carstensen, Tove & Bonsaksen, Tore (2017). Differences and similarities in therapeutic mode use between occupational therapists and occupational therapy students in Norway. Scandinavian Journal of Occupational Therapy. ISSN 1103-8128. 24(6), p. 448–454. doi: 10.1080/11038128.2016.1261940. Full text in Research Archive Show summary

  Background: The Intentional Relationship Model (IRM) is a new model of the therapeutic relationship in occupational therapy practice. Two previous studies have focused on therapist communication style, or ‘mode’ use, but to date no group comparisons have been reported. Aim: To explore differences between occupational therapists and occupational therapy students with regard to their therapeutic mode use. Methods: The study had a cross-sectional design, and convenience samples consisting of occupational therapists (n¼109) and of second-year occupational therapy students (n¼96) were recruited. The Self-Assessment of Modes Questionnaire was the main data collection tool. Group differences were analysed with independent t-tests. Results: The occupational therapists responded more within the collaborative and empathizing modes than the students did. The students responded more within the advocating and instructing modes than the occupational therapists did. Conclusion and significance: There may be systematic differences between occupational therapists and students concerning their therapeutic mode use. Some modes, such as the collaborating and empathizing modes, may be viewed as requiring more experience, whereas other modes, such as the advocating mode may be related to more recent rehabilitation ideologies. These factors may contribute to explaining several of the group differences observed.

• Bonsaksen, Tore & Thørrisen, Mikkel Magnus (2017). Psychometric properties of two interrelated measures: «Conceptions of learning» and «Preferences for different types of courses and teaching”. Ergoterapeuten. ISSN 0800-3475. 60(4), p. 32–44. Full text in Research Archive
• Bonsaksen, Tore (2016). Predictors of academic performance and education programme satisfaction in occupational therapy students. British Journal of Occupational Therapy. ISSN 0308-0226. 79(6), p. 361–367. doi: 10.1177/0308022615627174. Full text in Research Archive Show summary

  Introduction: Thriving and performing well in entry-level programmes is important to occupational therapy students, but also for the competitive status of the institutions providing their education. The literature is sparse concerning the factors of importance for occupational therapy students’ academic performance in, and satisfaction with, their education programme. Method: This cross-sectional study explored sociodemographic, relationship, education and work-related variables and their associations with the students’ academic performance and satisfaction with the education programme. The data were analysed with multivariate linear regression. Results: Participants were 123 students (mean age 24 years, 80% women) enrolled in an undergraduate occupational therapy programme in Norway. Having prior experience of higher education was associated with better academic performance, whereas having occupational therapy as the highest priority line of study at entry, and spending fewer hours on self-studies, were associated with lower satisfaction with the education programme. Conclusion: To improve academic performance, occupational therapy educators are encouraged to help students learn about the tasks, requirements, standards and culture that constitute higher education. To improve satisfaction, it may be most efficient to target students who initially indicate the most interest in studying occupational therapy

• Bonsaksen, Tore; Donohue, Mary V. & Milligan, Robert Malcolm (2016). Occupational therapy students rating the Social Profile of their educational group: Do they agree? Scandinavian Journal of Occupational Therapy. ISSN 1103-8128. 23(6), p. 477–484. doi: 10.1080/11038128.2016.1187203. Full text in Research Archive Show summary

  Background: During the curriculum, occupational therapy students learn to administer a range of assessment procedures. Interrater agreement between occupational therapy students’ ratings of group functioning has not yet been examined. Aims: To examine the interrater agreement within groups of students’ ratings using the Social Profile. Methods and Materials: The Social Profile (1) assesses the social interaction behaviors in activity groups, and thirty-five students completed the measure. Two methods of obtaining an overall Social Profile score were explored. Intraclass correlation coefficients (ICC) were calculated to assess the level of agreement within groups of raters. Results: Social interaction in the study groups occurred more frequently within the basic cooperative level. There was substantial agreement within groups of raters on this level, whereas there was low to moderate agreement on the other four levels. The weighted method of obtaining an overall Social Profile score showed higher ICC than the simpler method. Conclusion and significance: It appears to be easier to reach high interrater agreement when considering frequently occurring behaviors in a group. The weighted method of obtaining an overall Social Profile score showed the best ICC results and should preferably be used in future studies where an overall measure is sought.

• Bonsaksen, Tore; Lerdal, Anners; Småstuen, Milada C & Fagermoen, May Solveig (2016). Differences and similarities in the trajectories of self-esteem and positive and negative affect in persons with chronic illness: An explorative longitudinal study. Journal of Multidisciplinary Healthcare. 9, p. 355–363. doi: 10.2147/JMDH.S108891. Full text in Research Archive Show summary

  Background: Chronic illness is a risk factor for low self-esteem, and the research literature needs to include more studies of self-esteem and its development in chronic illness groups using longitudinal and comparative designs. The aim of this study was to explore the trajectories of self-esteem and of positive and negative affect in persons with morbid obesity and in persons with chronic obstructive pulmonary disease (COPD). Methods: Patient education course attendants in Norway having morbid obesity (n=139) or COPD (n=97) participated in the study. Data concerning self-esteem, positive and negative affect, and sociodemographic background were collected at the start and at the end of the patient education, with subsequent follow-ups at 3, 6, and 12 months. Data were analyzed using linear mixed models for repeated measures. Results: Taking all measurements into account, our data revealed a statistically significant increase in self-esteem for participants with morbid obesity but not for those with COPD. There were no significant differences in levels of negative and positive affect between the two groups, and the time-trajectories were also similar. However, participants in both groups achieved lower levels of negative affect for all the successive measurement points. Conclusion: An increase in self-esteem during the first year after the patient education course was observed for persons with morbid obesity, but not for persons with COPD. Initial higher levels of self-esteem in the participants with COPD may indicate that they are less troubled with low self-esteem than people with morbid obesity are. The pattern of reduced negative affect for both groups during follow-up is promising.

• Bonsaksen, Tore; Fagermoen, May Solveig & Lerdal, Anners (2016). Trajectories of physical and mental health among people with morbid obesity and people with COPD: A longitudinal comparative study. Journal of Multidisciplinary Healthcare. 9, p. 191–200. doi: 10.2147/JMDH.S102630. Full text in Research Archive Show summary

  Background: Morbid obesity and chronic obstructive pulmonary disease (COPD) are prevalent diseases associated with impaired health-related quality of life (HRQoL). Research generally indicates that persons with morbid obesity increase their HRQoL following intervention, whereas evidence of increases in HRQoL in persons with COPD is mixed. Examining the patterns of change over time instead of merely examining whether HRQoL changes will add to the knowledge in this field. Methods: A sample of persons with morbid obesity and persons with COPD was recruited from learning and mastery courses and rehabilitation centers in Norway. The data were collected by self-report questionnaires at the start of patient education and at four subsequent time points during the 1-year follow-up. HRQoL was measured with the Short Form 12, version 2, and repeated measures analysis of variance was employed in the statistical analysis. Results: Participants with morbid obesity linearly increased their physical HRQoL during the 1-year follow-up, whereas participants with COPD showed no change. None of the groups changed their mental HRQoL during follow-up. In all subdomains of HRQoL, the participants with morbid obesity showed favorable, linearly increasing trajectories across the follow-up period. Among the participants with COPD, no change patterns occurred in the subdomains of HRQoL, except for a fluctuating pattern in the mental health domain. Age, sex, and work status did not influence the trajectories of HRQoL in any of the domains. Conclusion: A more favorable trajectory of HRQoL was found for persons with morbid obesity than for persons with COPD, possibly due to the obese persons’ better chances of recovery.

• Bonsaksen, Tore; Fouad, Maria; Celo, Cecilia & Nakamura-Thomas, Hiromi (2016). Occupational therapy students rating with the N-ACIS: Do they agree? Ergoterapeuten. ISSN 0800-3475. 59(3), p. 28–36. Full text in Research Archive
• Bonsaksen, Tore; Fouad, Maria; Skarpaas, Lisebet Skeie; Nordli, Hege; Fekete, Orsolya Reka & Stimo, Torhild (2016). Characteristics of Norwegian clubhouse members and factors associated with their participation in work and education. British Journal of Occupational Therapy. ISSN 0308-0226. 79(11), p. 669–676. doi: 10.1177/0308022616639977. Full text in Research Archive Show summary

  Introduction: People with mental illness, in particular those with psychosis, have more problems related to getting and keeping a job than people in the general population. Clubhouses for people with mental illness are becoming increasingly common, but little is known about clubhouse members and their participation in work and education. The aim of this study was to explore these issues. Method: A member survey was conducted at one clubhouse in Oslo during February 2015. The data were analyzed with descriptive statistics and logistic regression analysis. Results: Eighty-nine clubhouse members completed the survey (response rate 55.6%). More than half of the sample had a desire to work, but only 14% participated in ordinary work. Sixty-seven percent of the participants were more than 50 years old, and they were frequent users and long-time members of the clubhouse. Higher age among the participants decreased their chances for participating in work and/or education. Conclusion: The study indicates that the clubhouse is of importance to its members, and that older members who have a desire to participate in work and/or education may be particularly challenged in their work towards such goals.

• Bonsaksen, Tore; Kvarsnes, Hildegunn; Eirum, Mari Nesset; Torgrimsen, Silje & Hussain, Ratna (2016). Development and content validity of the Norwegian Self-Assessment of Modes Questionnaire (N-SAMQ). Scandinavian Journal of Occupational Therapy. ISSN 1103-8128. 23(4), p. 253–259. doi: 10.3109/11038128.2015.1091896. Full text in Research Archive Show summary

  Background: The Intentional Relationship Model (IRM) introduced six therapeutic modes as ways of relating to clients. By increasing occupational therapists’ awareness of modes, and by increasing their skills in using them, therapists may improve their interactions with clients. The Self-Assessment of Modes Questionnaire may assist in increasing awareness of modes. Aim: To describe the process of developing a Norwegian version of the Self-Assessment of Modes Questionnaire (N-SAMQ) and to evaluate its content validity. Materials and methods: A 10-step translation and adaptation procedure was followed. Occupational therapists working in diverse practice areas completed the preliminary N-SAMQ version. Individual cognitive interviews were performed with these therapists in order to examine the comprehensibility and cultural appropriateness of the N-SAMQ. Results: Initially, one item was omitted. Following the pilot study (n = 7), two of the remaining items were modified with a view to increasing their cultural relevance. Otherwise, modifications were made mostly in terms of words and phrasing. Conclusion: The N-SAMQ appears to have good face and content validity. Significance: With the N-SAMQ, Norwegian occupational therapists can assess their preferred therapeutic modes.

• Yazdani, Farzaneh; Carstensen, Tove & Bonsaksen, Tore (2016). Therapeutic mode preferences and associated factors among Norwegian undergraduate occupational therapy students: A cross-sectional exploratory study. Scandinavian Journal of Occupational Therapy. ISSN 1103-8128. 24(2), p. 136–142. doi: 10.1080/11038128.2016.1220620. Full text in Research Archive
• Bonsaksen, Tore; Kvarsnes, Hildegunn & Dahl, Mona (2016). Who wants to go to occupational therapy school? Characteristics of Norwegian occupational therapy students. Scandinavian Journal of Occupational Therapy. ISSN 1103-8128. 23(4), p. 297–303. doi: 10.3109/11038128.2015.1105293. Full text in Research Archive Show summary

  Background: Research on occupational therapy students has often been concerned with quite narrow topics. However, the basic characteristics of this group are yet to be examined in more depth. Methods: This study aimed to explore the sociodemographic, education-related, and workrelated characteristics of occupational therapy students. A sample of 160 occupational therapy students in Norway participated. Differences between cohorts of students were examined with one-way analyses of variance (ANOVA) for continuous variables and with chi-square tests for categorical variables. Results: The sample had a mean age of 24 years and was predominantly female (79%). More than one -third of the students had one or both parents in an occupation requiring health education, whereas two-thirds of the students had one or both parents in an occupation requiring higher education. At entry, 57% of the participants had occupational therapy as their preferred choice of education and 43% had previous higher education experience. The few significant differences between the study cohorts were negligible. Conclusion: In the education programmes, specific attention may be considered for students with characteristics associated with increased risk of poorer study performance or other problems. This may concern male students and students with no previous higher education experience

• Bonsaksen, Tore & Kvarsnes, Hildegunn (2016). Role Performance and Role Valuation Among Occupational Therapy Students in Norway. The Open Journal of Occupational Therapy. 4(1). doi: 10.15453/2168-6408.1180. Full text in Research Archive Show summary

  Background: The Model of Human Occupation describes roles as providing the person with a framework around which to organize daily occupations. Role performance and role valuation in young adults may be related to gender, but there are few research studies to date to support this view. Methods: This study is a cross-sectional design using a sample of 87 occupational therapy students in Norway. We used the Role Checklist to assess the students’ performance and valuation of roles, and a variety of statistical procedures were employed in the analysis. Results: Compared to the female participants, males performed roles in the community, social, and civic life area of participation more frequently. Otherwise, male and female participants were largely equal in current role performance. For most roles, we found associations between role performance and high valuation of the respective roles. Discussion: Gender appears to be a factor of relevance for our understanding of role performance. This study suggests that occupational therapists should consider the societal as well as the personal aspects of roles. In addition, occupational therapy interventions could aim toward improving congruence between the roles clients perform and the value these roles have for them

• Horghagen, Sissel; Bonsaksen, Tore; Dolva, Anne-Stine; Hagby, Cathrine; Solbakken, Alf Inge & Sveen, Unni [Show all 7 contributors for this article] (2015). På vei inn i en kunnskapsbasert praksis Ergoterapeuters begrunnelser for bruk eller ikke bruk av vurderingsredskaper. Ergoterapeuten. ISSN 0800-3475. 58(6), p. 48–59. Full text in Research Archive
• Geirdal, Amy Østertun; Nerdrum, Per; Aasgaard, Trygve; Misund, Aud R. & Bonsaksen, Tore (2015). The Norwegian version of the scale to assess the therapeutic relationship (N‑STAR) in community mental health care: Development and pilot study. International Journal of Therapy and Rehabilitation (IJTR). ISSN 1741-1645. 22(5), p. 217–224. doi: 10.12968/ijtr.2015.22.5.217. Full text in Research Archive Show summary

  Background/Aims: Psychotherapy research has continually placed emphasis on the role of the therapeutic relationship. The current provision of mental health care, however, is often carried out in a variety of contexts and involves a range of health professionals. Measures for assessing the therapeutic relationship provided in community settings by multidisciplinary mental health teams is therefore required. The aim of this study was to describe the development of the Norwegian version of the Scale To Assess the therapeutic Relationship (N‑STAR) and to examine its reliability. Methods: A pilot study was conducted with clients with mental health issues (n=29) and mental health practitioners (n=29). Participants were recruited from a Norwegian community mental health setting and asked to complete the N‑STAR. Data were analysed using T‑tests, Cronbach’s alpha, the Pearson correlation coefficient (r) and the intraclass correlation coefficient (ICC). Results: The internal consistency of the N‑STAR total scale was good, whereas the subscales showed acceptable to questionable internal consistencies. There was a significant association between the total scores of clients and therapists (r = 0.42, p = 0.02), and the consistency in agreement between the clients’ and the therapists’ scores was good (ICC= 0.57, p = 0.02). Conclusion: The N‑STAR total scale showed promising results in terms of its internal consistency and level of client‑therapist agreement. Further research is needed to evaluate N-STAR measurement properties in larger samples in order to establish this method as a way of assessing and monitoring the therapeutic relationship in community mental health settings in Norway

• Bonsaksen, Tore; Lund, Anne; Ellingham, Brian; Hussain, Ratna; Meier, Margrit R & Sveen, Unni (2015). Norsk oversettelse og tilpasning av Occupational Questionnaire: Kartlegging av Dine Aktiviteter (KDA). Ergoterapeuten. ISSN 0800-3475. 58(2), p. 50–58. Full text in Research Archive
• Bonsaksen, Tore; Meidert, Ursula; Schuman, Deana; Kvarsnes, Hildegunn; Haglund, Lena & Prior, Susan [Show all 9 contributors for this article] (2015). Does the Role Checklist Measure Occupational Participation? The Open Journal of Occupational Therapy. 3(3). doi: 10.15453/2168-6408.1175. Full text in Research Archive Show summary

  Background: Among the Model of Human Occupation (MOHO) assessments, the Role Checklist is one of the most established. In spite of its widespread use, no studies have examined role examples and their association with the three embedded levels of doing, as established in the MOHO theory. Method: A cross-sectional survey of 293 respondents from the US, the UK, Japan, Switzerland, Sweden, and Norway produced 7,182 role examples. The respondents completed Part I of the Role Checklist and provided examples of each internalized role they performed. Responses were classified as occupational skill, occupational performance, or occupational participation. Results: Thirty-three percent of the examples were classified as examples of occupational participation, whereas 65% were classified as examples of occupational performance. Four roles linked mostly with occupational participation, another four roles linked mostly with occupational performance, and the two remaining roles were mixed between occupational participation and occupational performance. Discussion: The Role Checklist assesses a person’s involvement in internalized roles at the level of both occupational participation and occupational performance. There are differences among countries with regard to how roles are perceived and exemplified, and different roles relate differently to the occupational performance and occupational participation levels of doing. There are related implications for occupational therapists

• Bonsaksen, Tore; Fagermoen, May Solveig & Lerdal, Anners (2015). Factors associated with self-esteem in persons with morbid obesity and in persons with chronic obstructive pulmonary disease: A cross-sectional study. Psychology, Health & Medicine. ISSN 1354-8506. 20(4), p. 431–442. doi: 10.1080/13548506.2014.959529. Full text in Research Archive Show summary

  Living with chronic illnesses can be stressful and may negatively impact persons’ self-esteem. Personal factors, like self-efficacy and illness perceptions, and also factors related to the environment, activity, and participation may be associated with self-esteem in chronic illness populations. This cross-sectional comparative study explored sociodemographic variables, work, physical activity, illness perceptions, and general self-efficacy in relation to self-esteem in persons with morbid obesity and in persons with chronic obstructive pulmonary disease (COPD). The study had a cross-sectional design. A total of 223 eligible participants were recruited from patient education courses, and data were collected at baseline. Self-esteem was measured with The Rosenberg self-esteem scale; the general self-efficacy scale was used to measure self-efficacy, and brief illness perception questionnaire was also used. This is an instrument assessing cognitions about the illness and emotional responses towards it. Multivariate linear regression was used in the statistical analyses. In obese participants (n = 134), higher self-esteem was associated with lower emotional response, a shorter timeline, and higher general self-efficacy. In COPD participants (n = 89), higher self-esteem was associated with higher general self-efficacy. The independent variables accounted for 42.9% (morbid obesity) and 49.4% (COPD) of the self-esteem variance. In participants in both illness groups, higher self-efficacy was associated with increased self-esteem. A shorter timeline and lower emotional response to illness was related to higher self-esteem only for the obese participants. The results indicate that believing in one’s capacity to cope with everyday challenges is important for self-esteem in persons with morbid obesity and in persons with COPD, whereas illness perceptions related to the duration of illness and the coping with emotions also is important for self-esteem in persons with morbid obesity.

• Bonsaksen, Tore; Eirum, Mari Nesset & Donohue, Mary V. (2015). The Social Profiles of Occupational Therapy Students’ Educational Groups. The Open Journal of Occupational Therapy. 3(3). doi: 10.15453/2168-6408.1162. Full text in Research Archive Show summary

  Background: Today’s occupational therapy models emphasize that a person’s choice of, satisfaction with, and performance in occupations are markedly influenced by the context. For students undergoing a group-based study module, the group is an important context factor. Until recently, there has been a lack of instruments available for the assessment of functioning and participation at the group level. This mixed methods pilot study aimed to examine occupational therapy students’ perceptions of their group’s level of functioning and course of development during one study module. Methods: The students’ perceptions of their group’s functioning were assessed in two ways: by examining their scores on the Social Profile (SP), a new instrument, and by examining their qualitative descriptions of the groups and how the groups developed over time. The sample consisted of four occupational therapy students. Results: Two students perceived their group functioning as stable over time. One student’s scores indicated an increase in group functioning over time, whereas one student’s showed a decrease. The interview statements showed varying degrees of connectedness with the SP items. Conclusions: Descriptions of stability and change corresponded very well with the students’ SP trajectories, indicating content validity of the assessment as a whole.

• Bonsaksen, Tore (2015). Predictors of General Self-Efficacy and Self-Esteem in Occupational Therapy Students: A Cross-Sectional Study. Occupational Therapy in Mental Health. ISSN 0164-212X. 31(3), p. 298–310. doi: 10.1080/0164212X.2015.1055536. Full text in Research Archive Show summary

  A national survey reported college students showed higher risk of mental health problems than the general population. Using selfefficacy and self-esteem as indicators of mental health, this study explores sociodemographic, relational, educational, and work factors associated with these outcomes. A sample of 148 occupational therapy students in Norway participated, and data were analyzed with multiple linear regression. Factors associated with positive self-efficacy and self-esteem were higher general satisfaction with the education program, amount of time spent on self-study, and being male. Implications are attention toward female students’ self-perceptions, improving the learning environment, and encouraging students to do more self-study.

• Bonsaksen, Tore (2014). Fysisk aktivitet. In Goth, Ursula-Georgine Småland (Eds.), Folkehelse i et norsk perspektiv. Gyldendal Akademisk. ISSN 9788205463950. p. 118–135. Full text in Research Archive
• Sporild, Inger Anne & Bonsaksen, Tore (2014). Therapeutic factors in expressive art therapy for Persons with eating disorders. Groupwork. ISSN 0951-824X. 24(3), p. 46–60. doi: 10.1921/10201240104. Full text in Research Archive
• Lerdal, Anners; Fagermoen, May Solveig; Bonsaksen, Tore; Gay, Caryl & Kottorp, Anders (2014). Rasch analysis of the Sense of Coherence scale in a sample of people with morbid obesity - A cross-sectional study. BMC Psychology. 2(1). doi: 10.1186/2050-7283-2-1. Full text in Research Archive Show summary

  Background: The prevalence of morbid obesity is an increasing health problem in most parts of the world and is related to lower quality of life. Sense of coherence, or the perception that the world is meaningful and predictable, is considered a promising health resource for changing behaviour and adopting a healthier lifestyle. Thus, a valid and reliable instrument for measuring sense of coherence is needed to further research and clinical efforts in this area. The purpose of the study was to examine the psychometric properties of the 13-item Sense of Coherence scale and its sub-dimensions (Comprehensibility, Manageability, and Meaningfulness) in a sample of people with morbid obesity using a Rasch analysis approach. Methods: Data were collected cross-sectionally in Norway in 2009 from 142 patients attending a mandatory patient education course for patients with morbid obesity on a waiting list for treatment. Participants completed a socio-demographic questionnaire and the 13-item Sense of Coherence scale at the beginning of the course. Evidence of rating scale functioning, internal scale validity, person-response validity, person-separation reliability and differential item functioning of the 13-item version were explored. The scale’s three sub-dimensions were also evaluated. Results: A 12-item version of the scale demonstrated the best fit to the Rasch model and increased the variance explained without reducing the separation index. The three sub-dimensions demonstrated good fit but lacked unidimensionality and person-separation reliability. The Meaningfulness sub-dimension showed better psychometric properties than the Comprehensibility and Manageability sub-dimensions. Conclusion: A 12-item version of the Sense of Coherence scale has better psychometric properties than the original 13-item version among persons with morbid obesity. Further studies should explore whether these questionable validity findings for the 13-item scale generalize to other populations and examine whether including other items from the longer 29-item version may improve the psychometric properties of an abbreviated Sense of Coherence measure

• Bonsaksen, Tore; Fagermoen, May Solveig & Lerdal, Anners (2014). Trajectories of self-efficacy in persons with chronic illness: An explorative longitudinal study. Psychology and Health. ISSN 0887-0446. 29(3), p. 350–364. doi: 10.1080/08870446.2013.856432. Full text in Research Archive Show summary

  Background: Self-efficacy is important for changing health behavior in persons with chronic illness. Longer-term trajectories have not been previously explored. Objective: This study’s objective was to explore the trajectories of self-efficacy in two different groups with chronic illnesses attending a patient education course. Design: The study design was a longitudinal, comparative cohort study with five time points during a one year follow-up, using repeated measures analysis of variance. Setting and participants: Persons with morbid obesity (n = 55) and persons with chronic obstructive pulmonary disease (COPD; n = 56) were recruited at the start of patient education courses in Norway and followed-up four times the following year. Main outcome measure: The General Self-Efficacy Scale (GSE) was the main outcome. Results: Obese persons showed a linear pattern of increasing self-efficacy during the follow-up period, whereas persons with COPD had an initial increase followed by a decrease in self-efficacy. Having paid work was associated with a more positive self-efficacy trajectory. Conclusion: The results provide support for the currently employed patient education course for morbidly obese persons. In contrast, persons with COPD may need more extensive and/or more frequent support in order to increase and maintain self-efficacy across time

• Bonsaksen, Tore (2014). Engaging students in research and inquiry: Issues to consider. British Journal of Therapy & Rehabilitation (BJTR). ISSN 1354-8581. 21(3), p. 108–109. Full text in Research Archive
• Bonsaksen, Tore; Borge, Finn Magnus & Hoffart, Asle (2013). Group Climate as Predictor of Short- and Long-Term Outcome In Group Therapy for Social Phobia. International journal of group psychotherapy. ISSN 0020-7284. 63(3), p. 394–417. doi: 10.1521/ijgp.2013.63.3.394. Full text in Research Archive
• Bonsaksen, Tore; Haukeland-Parker, Stacey; Lerdal, Anners & Fagermoen, May Solveig (2013). A 1-year follow-up study exploring the associations between perception of illness and health-related quality of life in persons with chronic obstructive pulmonary disease. The International Journal of Chronic Obstructive Pulmonary Disease. ISSN 1176-9106. 9, p. 41–50. doi: 10.2147/COPD.S52700. Full text in Research Archive Show summary

  Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disease with an increasing prevalence worldwide. Its potential consequences, including reduced function and reduced social participation, are likely to be associated with decreased health-related quality of life (HRQoL). However, illness perceptions and self-efficacy beliefs may also play a part in determining HRQoL in persons with COPD. The aim of this study was to explore the relationships between illness perceptions, self-efficacy, and HRQoL in a sample of persons with COPD in a longitudinal perspective. The context of the study was a patient education course from which the participants were recruited. Data concerning sociodemographic variables, social support, physical activity, illness perceptions, general self-efficacy, and HRQoL were collected before the course started and 1 year after completion. Linear regression was used in the analyses. The results showed that less consequences and less symptoms (identity) were associated with higher physical HRQoL (PCS) at baseline and at 1-year follow-up. Less emotional response was similarly associated with higher mental HRQoL (MCS) at both time points. Lower self-efficacy showed a borderline significant association with higher PCS at baseline, but was unrelated to MCS at both time points. Self-efficacy showed no influence on the associations between illness perceptions and HRQoL. In conclusion, the study showed that specific illness perceptions had a stable ability to predict HRQoL in persons with COPD, whereas self-efficacy did not. The associations between illness perceptions and HRQoL were not mediated by self-efficacy

• Bonsaksen, Tore (2013). Self-reported therapeutic style in occupational therapy students. British Journal of Occupational Therapy. ISSN 0308-0226. 76(11), p. 496–502. doi: 10.4276/030802213X13833255804595. Full text in Research Archive Show summary

  Introduction: The client-therapist relationship has long been viewed as important for both the process and outcomes of occupational therapy. The recently developed Intentional Relationship Model introduced six therapeutic modes as different ways of relating to clients. Increasing students’ awareness of modes, and increasing their skills in using them flexibly, has the potential of improving their subsequent practice as occupational therapists. This article aims to describe occupational therapy students’ affiliation with the therapeutic modes in a variety of hypothesized practice situations. In addition, relationships between the students’ affiliation with the different modes are explored. Method: The study had a cross-sectional design. Data were collected from 31 occupational therapy students in Norway, using the Self-Assessment of Modes Questionnaire. Descriptive analyses, repeated measures ANOVA tests, and correlation analyses were employed in the analytic procedures. Findings: The students identified the problem-solving mode to be their most preferred way of relating to clients, whereas the advocating mode was the least preferred. High affiliation with the problem-solving mode was significantly associated with low affiliation with the collaborating mode. Conclusion: Several limitations indicate that caution should be taken when comparing this study with previous research. Nonetheless, differences between the results of this study and previous work on the therapeutic modes are of interest. Possible explanations for differences are discussed, as are implications for practice and research.

• Bonsaksen, Tore; Kottorp, Anders; Gay, Caryl; Fagermoen, May Solveig & Lerdal, Anners (2013). Rasch analysis of the General Self-Efficacy Scale in a sample of persons with morbid obesity. Health and Quality of Life Outcomes. 11(202). doi: 10.1186/1477-7525-11-202. Full text in Research Archive Show summary

  Background: Self-efficacy is needed for effectuating lifestyle changes, and it is therefore an important target related to health. The purpose of this study was to evaluate the psychometric properties of the General Self-Efficacy Scale (GSE) using Rasch analysis in a sample of adults with morbid obesity. Methods: A convenience sample of adults with morbid obesity was recruited from patient education courses. A total of 141 participants completed the GSE and a demographic questionnaire at the beginning of the course. The statistical approach included analysis of rating scale function, item fit to the Rasch partial credit model, unidimensionality, aspects of person-response validity, person-separation reliability, and differential item function. A version omitting items with poor fit to the Rasch model was also evaluated. Results: The rating scale did not advance monotonically for item #2 in the original 10-item version, and the first three GSE items did not demonstrate acceptable goodness-of-fit to the Rasch model. In a 7-item version omitting these three items, the rating scale functioned well for all items, and all items demonstrated good fit to the Rasch model. Both the 10-item and 7-item versions of the GSE partially met the criteria for unidimensionality. Neither version met the criterion for person response validity, although the results were slightly better for the 7-item than for the 10-item version. Both versions of the GSE demonstrated the ability to separate the respondents into three distinct levels of general self-efficacy. Several items had differential item function in relation to age, education or work status, but there were fewer in the 7-item version. Conclusions: For adults with morbid obesity, a 7-item version of the GSE seems to have better psychometric properties than the original 10-item version.

• Bonsaksen, Tore; Granå, Kjell Emil; Celo, Cecilia; Ellingham, Brian & Myraunet, Ingunn (2013). A practice placement design facilitating occupational therapy students' learning. Journal of Mental Health Training, Education and Practice. ISSN 1755-6228. 8(4), p. 169–180. doi: 10.1108/JMHTEP-08-2012-0028. Full text in Research Archive Show summary

  Purpose – The purpose of this paper is to describe an addition to the practice placement design for occupational therapy students in Oslo, and to report on the learning experiences related to this modified practice placement design among the participants. Design/methodology/approach – Occupational therapy students and practice educators were interviewed in focus groups after having participated in an exploration of the utility of the Assessment of Communication and Interaction Skills during mental health placement. Thematic analysis was applied to the data material. Findings – Four themes emerged relating to the students’ learning experiences during practice placement. They were theory-practice integration; the role of supervision; self-awareness of communication; and socialization to the therapist role. Practical implications – The practice placement design addition presented in this paper was well received by students and practice educators. It contributed to students’ focussed experience and to their active participation within a community of practice. The program appears to be one way of organizing placement with a potential for making a substantial contribution to occupational therapy students’ learning. Originality/value – The study adds to the existing literature in providing an example of a successful addition to the practice placement design, and in the detailed account of the learning experiences among the participants.

• Bonsaksen, Tore; Celo, Cecilia; Myraunet, Ingunn; Granå, Kjell Emil & Ellingham, Brian (2013). Promoting academic-practice partnerships through students’ practice placement. British Journal of Therapy & Rehabilitation (BJTR). ISSN 1354-8581. 20(1), p. 33–39. Full text in Research Archive
• Bonsaksen, Tore (2013). Changes during hospital treatment in patients with SMI. British Journal of Mental Health Nursing. ISSN 2049-5919. 2(3), p. 162–170. doi: 10.12968/bjmh.2013.2.3.162. Full text in Research Archive
• Bonsaksen, Tore; Lerdal, Anners & Fagermoen, May Solveig (2013). Trajectories of illness perceptions in persons with chronic illness: An explorative longitudinal study. Journal of Health Psychology. ISSN 1359-1053. 20(7), p. 942–953. doi: 10.1177/1359105313504235. Full text in Research Archive Show summary

  Accurate illness perceptions are essential to the self-management of chronic illness. This study explored trajectories of illness perceptions in persons with morbid obesity (n = 53) and persons with chronic obstructive pulmonary disease (n = 52) following a patient education course. Participants completed the Brief Illness Perception Questionnaire five times over a 1-year period. Repeated measures analysis of variance was employed. Over time, obese participants perceived shorter illness duration, fewer consequences, less emotional stress, and more personal control. Chronic obstructive pulmonary disease participants had initial increases in personal control and understanding, but these changes were not maintained throughout the follow-up period.

• Bonsaksen, Tore & Lerdal, Anners (2012). Relationships between physical activity, symptoms and quality of life among inpatients with severe mental illness. British Journal of Occupational Therapy. ISSN 0308-0226. 75(2), p. 69–75. doi: 10.4276/030802212X13286281651036. Full text in Research Archive
• Bonsaksen, Tore (2012). Exploring Gender Differences in Quality of Life. Mental Health Review Journal. ISSN 1361-9322. 17(1), p. 39–49. doi: 10.1108/13619321211231815. Full text in Research Archive Show summary

  Purpose – The purpose of this study is to examine gender differences with regard to physical activity, psychiatric symptoms, and quality of life in patients with severe mental illness. In addition, associations between the variables are to be explored. Design/methodology/approach – A cross-sectional design was employed. Eighteen patients, 12 men and six women, were assessed at admission to hospital with the International Physical Activity Questionnaire, the Hospital Anxiety and Depression Scale, and the WHO Quality of Life-Bref. Mann-Whitney U-tests, Spearman’s correlation coefficient, and partial correlation were used in the statistical analyses. Findings – Women had lower levels of quality of life and trended towards being more depressed than men, whereas men had more global psychiatric symptoms. When controlling for depression in the participants, the bivariate relationships between male gender and higher quality of life were weakened. The findings indicate that the initial association between gender and quality of life may be mediated by depression levels. Practical implications – Women with severe mental illness tend to have more depression and lower quality of life than their male counterparts, and combating depression appears to be important for increasing quality of life in women with severe mental illness. Originality/value – This is the first explorative study of gender differences in hospitalized patients with severe mental illness

• Bonsaksen, Tore; Lerdal, Anners & Fagermoen, May Solveig (2012). Factors associated with self-efficacy in persons with chronic illness. Scandinavian Journal of Psychology. ISSN 0036-5564. 53(4), p. 333–339. doi: 10.1111/j.1467-9450.2012.00959.x. Full text in Research Archive Show summary

  Change of lifestyle may be necessary for persons with chronic illnesses in order to manage their health situation and reduce symptom distress. Success in changing lifestyle partly depends on a person’s self-efficacy beliefs. This cross-sectional study explores social support, physical activity, and illness perceptions in relation to self-efficacy in a sample with morbid obesity and in a sample with chronic obstructive pulmonary disease (COPD). The linear regression analyses showed that higher physical activity and less emotional response to illness were directly associated with higher self-efficacy among persons with obesity, while more social support; fewer perceived consequences from illness; and more understanding of the illness were directly associated with higher self-efficacy among persons with COPD. The results indicate that obese persons are likely to benefit from increasing physical activity and from receiving emotional support. Persons with COPD may be empowered by being able to utilize cognitive coping strategies and by receiving social support.

• Bonsaksen, Tore; Myraunet, Ingunn; Celo, Cecilia; Granå, Kjell Emil & Ellingham, Brian (2011). Experiences of occupational therapists and occupational therapy students in using the Assessment of Communication and Interaction Skills in mental health settings in Norway. British Journal of Occupational Therapy. ISSN 0308-0226. 74(7), p. 332–338. doi: 10.4276/030802211X13099513661117. Full text in Research Archive Show summary

  Introduction: This study investigated the utility of the Assessment of Communication and Interaction Skills (ACIS) in mental health settings, as experienced by Norwegian occupational therapists and occupational therapy students. Method: An informal draft translation was used to investigate the appropriateness of the assessment for mental health practice. Focus group interviews were conducted with three occupational therapy practice educators working in mental health settings and six occupational therapy students on practice placement, who used the ACIS during an 8-week mental health practice placement in 2009. The focus groups aimed to explore the experiences of using the translated ACIS in working with clients. Findings: Three main themes emerged: observing with the ACIS, scoring the ACIS and using the ACIS in clinical practice. Conclusion: The ACIS has the potential for making a positive contribution, both for the individual client and for the larger team of multiprofessional staff, by giving a structure and terminology that supports precise observation and reporting. Questions were raised as to how the therapist’s level of engagement during the observation may have an impact upon the client’s performance. The process of scoring and giving feedback concerning the client’s skills may be emotionally challenging for therapists, students and clients, and issues about how to give feedback to clients require consideration.

• Bonsaksen, Tore (2011). Participation in Physical Activity among Inpatients with Severe Mental Illness: A Pilot Study. International Journal of Therapy and Rehabilitation (IJTR). ISSN 1741-1645. 18(2), p. 91–99. doi: 10.12968/ijtr.2011.18.2.91. Full text in Research Archive
• Bonsaksen, Tore (2011). Commentary to "Physical activity participation, functional exercise capacity and self-esteem in patients with schizophrenia". International Journal of Therapy and Rehabilitation (IJTR). ISSN 1741-1645. 18(4), p. 230–230. Full text in Research Archive
• Bonsaksen, Tore; Lerdal, Anners; Borge, Finn Magnus; Sexton, Hal & Hoffart, Asle (2011). Group climate development in cognitive and interpersonal group therapy for social phobia. Group Dynamics. ISSN 1089-2699. 15(1), p. 32–48. doi: 10.1037/a0020257. Full text in Research Archive Show summary

  This study was designed as a longitudinal study of 80 participants in cognitive group therapy (RCT, n=40) and interpersonal group therapy (RIPT, n=40) for social phobia during 10 weeks of residential therapy. The aim was to investigate the patterns of group climate development and its impact on treatment outcome. Data were collected using MacKenzie`s Group Climate Quesionnaire (GCQ) 4 times during treatment, and a multilevel (mixed) model approach was used in the analyses. Engagement in RCT groups showed a linear increase during treatment in contrast to a linear decline among patients in RIPT groups. The divergence might be explained by the focus on extragroup and intragroup relationships in RCT and RIPT, respectively. Neither conflict nor avoidance followed the expected pattern, nor did their mean levels influence outcome. However, when 6 extreme values of conflict were removed, there was support for a low-high-low pattern of conflict. In general, these results do not support MacKenzie`s generic model group climate development but suggest that sample characteristics, treatment models, and setting can play major roles in determining the group climate. Of the group climate variables, only the mean level of engagement predicted a change in social anxiety over the course of treatment.

• Lerdal, Anners; Andenæs, Randi; Bjørnsborg, Eva; Bonsaksen, Tore; Borge, Lisbet & Christiansen, Bjørg [Show all 9 contributors for this article] (2011). Personal factors associated with health-related quality of life in persons with morbid obesity on treatment waiting lists in Norway. Quality of Life Research. ISSN 0962-9343. 20(8), p. 1187–1196. doi: 10.1007/s11136-011-9865-z. Full text in Research Archive Show summary

  Purpose To explore relationships of socio-demographic variables, health behaviours, environmental characteristics and personal factors, with physical and mental health variables in persons with morbid obesity, and to compare their health-related quality of life (HRQoL) scores with scores from the general population. Methods A cross-sectional correlation study design was used. Data were collected by self-reported questionnaire from adult patients within the first 2 days of commencement of a mandatory educational course. Of 185 course attendees, 142 (76.8%) volunteered to participate in the study. Valid responses on all items were recorded for 128 participants. HRQoL was measured with the Short Form 12v2 from which physical (PCS) and mental component summary (MCS) scores were computed. Other standardized instruments measured regular physical activity, social support, self-esteem, sense of coherence, self-efficacy and coping style. Results Respondents scored lower on all the HRQoL subdomains compared with norms. Linear regression analyses showed that personal factors that included self-esteem, self-efficacy, sense of coherence and coping style explained 3.6% of the variance in PCS scores and 41.6% in MCS scores. Conclusion Personal factors such as self-esteem, sense of coherence and a high approaching coping style are strongly related to mental health in obese persons.

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• Bonsaksen, Tore & Ellingham, Brian (2017). Klinisk resonnering i ergoterapi. Mankoni Media. ISBN 9788269058826. 125 p. Full text in Research Archive

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• Bonsaksen, Tore (2026). Verdenskongress i ergoterapi. Ergoterapeuten. ISSN 0800-3475. 69(2), p. 6–9. Full text in Research Archive
• Breen-Franklin, Adele; Maher, Colleen & Bonsaksen, Tore (2026). Work readiness among occupational therapy students in the USA: Associations with approaches to studying and study efforts. Full text in Research Archive
• Doorn, Janca Molthe van; Bonsaksen, Tore; Grov, Ellen Karine; Kversøy, Kjartan Skogly & Kjøs, Bente Ødegård (2026). Gjensidig involvering forbedrer kvaliteten i sykepleierstudentenes praksis. Sykepleien Forskning. ISSN 1890-2936. p. 104910–104910. doi: 10.4220/sykepleiens.2026.104910. Full text in Research Archive Show summary

  Hovedbudskap Gjensidig involvering mellom utdanningsinstitusjon, praksisfeltet og sykepleierstudenter kan bidra til bedre kvalitet i praksisstudiene. Når partene samarbeider og lærer sammen, styrkes veilednings- og vurderingskompetansen, og praksis blir mer relevant for både studentene og arbeidslivet. Praksis i sykepleierutdanningen utgjør halvparten av studietiden og er den læringsarenaen sykepleierstudenter opplever som mest betydningsfull for sykepleieryrket (1). Likevel beskriver mange at de er for dårlig forberedt på klinisk arbeid når de begynner som nyutdannede sykepleiere (2). Sykepleiere ved praksisstedene veileder studentene, men flere uttrykker utrygghet i veilederrollen (3) og savner et tettere samarbeid med lærere i praksisperiodene (4).

• Stigen, Linda; Sveen, Unni; Bonsaksen, Tore; Maass, Ruca Elisa Katrin; Horghagen, Sissel & Gramstad, Astrid [Show all 7 contributors for this article] (2026). Community-based Occupational Therapy Before and After Becoming a Statutory Service. Full text in Research Archive
• Redzovic, Skender Elez; Vereijken, Beatrix & Bonsaksen, Tore (2026). Aging at home: factors associated with independence in activities of daily living among older adults in Norway-a HUNT study. Full text in Research Archive Show summary

  Introduction: Maintaining independence in activities of daily living (ADL) is crucial for older adults. Norway, with its advanced healthcare system, provides an interesting case to explore how social context impacts ADL performance among older adults. Objectives: This study examined the relationship between demographic and living situation factors and ADL independence among community-dwelling older adults in Norway. Methods: Included in the current cross-sectional study were 22,504 community-living individuals aged 70 years or older from the fourth wave of the ongoing Trøndelag Health Study (HUNT), who completed the survey and responded to all items constituting the ADL outcome measure. Group differences in ADL independence were examined with Chi Square tests, while crude and adjusted associations with ADL independence were examined with logistic regression analyses. Results: The participants reported a high degree of independence in primary ADL and slightly lower in instrumental ADL. In the fully adjusted analyses, ADL independence was associated with lower age, female gender, higher levels of education and income, higher subjective well-being, having no chronic or disabling disease, and having someone to talk to in confidence. Surprisingly, women who were married had higher likelihood of ADL independence than unmarried women, whereas married men had lower likelihood of ADL independence than unmarried men. Conclusion: In addition to known demographic and disease-related factors, the social context affects independence in ADL even in a society that offers advanced health and homecare services to all older adults equally. Furthermore, the same social setting can have differential effects on men and women.

• Bonsaksen, Tore; Tannoubi, Amayra; Stigen, Linda; Gramstad, Astrid; Carstensen, Tove & Mørk, Gry (2026). Study approaches mediate associations between learning environment and academic performance. Full text in Research Archive
• Bonsaksen, Tore; Johansen, Ingvill Jeanette Hektoen & Redzovic, Skender Elez (2026). Adolescents' participation in wildlife activities and its mental health implications. Full text in Research Archive Show summary

  Introduction/Rationale: Adolescent mental health challenges are on the rise globally as well as in Norway. Wildlife activities have been promoted as a potential measure to improve adolescent well-being, but studies in the area are few. Objectives: To explore adolescent participation in wildlife activities and to examine the association between such participation and their mental distress. Methods/Approach: The study used cross-sectional survey data from the Young-HUNT study in Norway collected 2017-2019, including 6361 participants. Participants were grouped according to their level of participation in wildlife activities. Adjusted regression analyses were used to assess factors associated with the participants' level of wildlife activity and associations between wildlife activity and mental distress. Results/Practice Implications: Most participants reported a low level (34.6%) or a medium level (53.2%) of wildlife activity participation. Adjusted analyses showed that higher levels of participation in wildlife activity was associated with a range of factors, most notably female gender, having both parents born in Norway, and a medium or high level of physical activity. A weak but statistically significant relationship was found between higher levels of wildlife activity and higher levels of mental distress. Conclusion/Significance to the Occupational Therapy Profession: Various sociodemographic, lifestyle, and social factors influence wildlife activity involvement. The observed weak but significant association between higher participation and higher mental distress raises questions about the assumption that wildlife activities are universally beneficial for adolescent mental health. Occupational therapists are advised to consider for whom, and under which circumstances, such activities may be helpful.

• Doorn, Janca Molthe van; Palleschitz, Marte; Norderhaug, Maren Viken & Bonsaksen, Tore (2026). Studentene blir tryggere i sykepleierrollen gjennom refleksjon i praksis. Sykepleien Forskning. ISSN 1890-2936. p. 104263–104263. doi: 10.4220/sykepleiens.2026.104263. Full text in Research Archive
• Redzovic, Skender Elez; Johansen, Ingvill J. H. & Bonsaksen, Tore (2025). På tur for bedre psykisk helse? Ungdoms deltakelse i friluftslivsaktiviteter. Ergoterapeuten. ISSN 0800-3475. 68(4), p. 42–51. doi: https:/www.ergoterapeuten.no/fag-og-vitenskap/fagartikler/2025-2026. Full text in Research Archive Show summary

  Psykiske helseplager blant ungdom har økt de siste tiårene, og det er behov for helsefremmende tiltak. I norsk sammenheng har friluftsliv blitt løftet fram som positivt for psykisk helse. Målet med denne fagartikkelen er å beskrive ungdoms deltakelse i friluftslivsaktiviteter i en norsk kontekst, og hvordan dette kan være forbundet med deres psykiske helse. I motsetning til tidligere forskning og teoretiske antakelser om at kontakt med naturen har stressreduserende og helsefremmende effekter, viser funnene fra vår studie en svak, men signifikant sammenheng mellom høy deltakelse i friluftsliv og høyere nivåer av psykisk stress blant ungdom. I artikkelen diskuteres ulike forklaringer på funnene. I sammenheng med teori og tidligere forskning antyder studien at friluftslivets forhold til psykisk helse kan avhenge av faktorer som motivasjon, formål, sosial kontekst og individuelle omstendigheter. Funnene viser at ergoterapeuter bør være forsiktig med å anta en entydig positiv sammenheng mellom friluftsliv og psykisk helse blant ungdom.

• Arntzen, Cathrine; Stigen, Linda; Gramstad, Astrid; Bonsaksen, Tore; Horghagen, Sissel & Sveen, Unni [Show all 7 contributors for this article] (2025). Ergoterapeuter i fremtidens helsetjeneste: hva skal de løse, for hvem, og sammen med hvem? Full text in Research Archive
• Mørk, Gry; Gramstad, Astrid; Johnson, Susanne Grødem; Stigen, Linda; Carstensen, Tove & Bonsaksen, Tore (2025). Ergoterapeutstudenters studietilnærminger og læringsmiljø: Resultater fra en landsomfattende studie og implikasjoner for praksis. Ergoterapeuten. ISSN 0800-3475. 68(6), p. 12–23. Full text in Research Archive Show summary

  Forståelse av hvordan studenter tilnærmer seg læring og oppfatter læringsmiljøet er avgjørende for hvordan utdanningene utvikler studieprogrammene og tilrettelegger for læring. Høsten 2017 ble det igangsatt et nasjonalt forskningsprosjekt som involverte alle ergoterapeututdanningene i Norge, med mål om å skaffe kunnskap om ergoterapeutstudenters læringsprosesser og oppfatninger av læringsmiljøet i både et sammenlignende og langsgående perspektiv. I prosjektet deltok totalt 305 studenter. Deres studietilnærminger ble kartlagt ved hjelp av det oversatte og validerte "Approaches and Study Skills Inventory for Students," mens oppfatningene om ulike aspekter ved læringsmiljøet ble kartlagt med det oversatte og validerte "Course Experience Questionnaire." I tillegg ble det samlet inn eksamenskarakterer og bakgrunnsinformasjon om studentene. Prosjektet avdekket utviklingsmønstre i studentenes tilnærminger til å studere og deres oppfatninger om læringsmiljøet, og det ble identifisert sammenhenger mellom disse faktorene og studentenes eksamensresultater. Det ble også gjennomført internasjonale sammenligninger. Prosjektet resulterte i et tettere forskningssamarbeid mellom de ulike ergoterapeututdanningene i Norge.

• Hellem, Inger; Waagsaas, Line Digerud; Bonsaksen, Tore; Hinderaker, Liv Elisabeth; Hoydal, Kristina & Sanders, Anne-Marthe [Show all 8 contributors for this article] (2025). Oppdatert norsk oversettelse av Occupational Balance Questionnaire og tilhørende manual. Full text in Research Archive
• Kunnikoff, Hans Martin; Ellingsen, Kjersti Lunde; Hinderaker, Liv Elisabeth; Bonsaksen, Tore; Sund, Marianne & Hellem, Inger [Show all 9 contributors for this article] (2025). Experiences on Simulation as a Learning Activity in Occupational Therapy Bachelor's Programs. Full text in Research Archive Show summary

  Background: Simulation provides students with training in realistic environments and situations, closely resembling the challenges they encounter in professional practice. This learning activity is particularly relevant for the bachelor's programs in occupational therapy, which have a tradition of active learning. This aligns with the profession's philosophy that humans are inherently active learners who learn best by engaging in meaningful activities that suit their individual capacities. Aim: A research project on student’s experiences on simulation as a learning activity has been initiated. The goal of the workshop is to share experiences and gain increased understanding of how bachelor's programs implement simulation as a learning activity. Method: The workshop will begin with a presentation of the simulation learning activities implemented in mental health and rehabilitation courses, which underpins this research project. Then, a dialogue among participants will be facilitated, designed to encourage the sharing of experiences and insights from different bachelor's programs regarding simulation as a learning tool. Results and conclusion: The workshop discussion offers an overview of participants’ use of simulation in occupational therapy bachelor’s programs, aiming to enhance program planning for relevant and realistic simulations that allow students to practice skills particularly beneficial in their professional practice.

• Steigen, Anne Mari; Kleppang, Annette Løvheim; Stea, Tonje Holte; Opdal, Ida Marie & Bonsaksen, Tore (2025). In-person and online socialization among Norwegian adolescents in relation to the COVID-19 pandemic. Full text in Research Archive
• Stigen, Linda; Sveen, Unni; Arntzen, Cathrine; Bonsaksen, Tore; Maass, Ruca Elisa Katrin & Horghagen, Sissel [Show all 7 contributors for this article] (2025). Kommuneergoterapi i en nordisk kontekst: en scoping review. Full text in Research Archive
• Stigen, Linda; Bonsaksen, Tore; Sveen, Unni; Maass, Ruca Elisa Katrin; Horghagen, Sissel & Gramstad, Astrid [Show all 7 contributors for this article] (2025). Kommuneergoterapi: Kjennetegn før og etter å ha blitt en lovpålagt tjeneste. Full text in Research Archive
• Ragnhildsløkken, Hege; Bonsaksen, Tore & Aakhus, Eivind (2025). Bruk av sosiale medier og assosiasjoner med psykisk stress blant eldre voksne under Covid-19 pandemien. Full text in Research Archive
• Bonsaksen, Tore; Horghagen, Sissel; Arntzen, Cathrine; Gramstad, Astrid & Stigen, Linda (2025). Jobbtilfredshet blant kommuneergoterapeuter i Norge. Full text in Research Archive
• Bonsaksen, Tore; Tannoubi, Amayra; Stigen, Linda; Gramstad, Astrid; Magne, Trine A & Carstensen, Tove [Show all 7 contributors for this article] (2025). Ergoterapistudenters begreper om læring er forbundet med hvordan de selv studerer. Full text in Research Archive
• Bonsaksen, Tore & Kleppang, Annette Løvheim (2025). Social Media and Mental Health: Lessons Learned from the Psychology Research and Behavior Management Article Collection. Psychology Research and Behavior Management. Volume 18, p. 2052–2052. doi: 10.2147/prbm.s549588. Full text in Research Archive Show summary

  The article collection on social media and mental health attracted the interest of many researchers and resulted in 25 articles published in the collection. In this editorial, the guest advisors for the collection summarize the included studies and some of the most relevant findings from them. Five of the articles are given particular attention, representing both cross-sectional and longitudinal study designs. The article collection brings new and important insights into how mental health is shaped, and how mental health shapes behaviors, in the modern world of social media. It highlights mediational pathways from social media use to mental health problems through cyberbullying, social comparison, and cognitive overload, and from mental health problems to problematic social media use through self-referential processing. It is the guest advisors’ hope that researchers can use the collection, and indeed this editorial providing a synopsis and commentary to the collection, as a point of reference when choosing new research questions to explore and when deciding on certain aspects of design and methodology.

• Horghagen, Sissel; Bonsaksen, Tore; Arntzen, Cathrine; Maass, Ruca Elisa Katrin; Sveen, Unni & Stigen, Linda (2025). Ergoterapeuter i kommunehelsetjenesten deltok mindre i forsknings- og utviklingsarbeid i 2022 enn i 2018. Ergoterapeuten. ISSN 0800-3475. Full text in Research Archive
• Bonsaksen, Tore; Kleppang, Annette Løvheim & Steigen, Anne Mari (2025). Cyberbullying among adolescents in Norway 2014-2016: time trends and factors associated with perpetration and victimization. Full text in Research Archive
• Bonsaksen, Tore (2024). Evaluering og evalueringsdesign. Full text in Research Archive
• Bonsaksen, Tore (2024). Seksuell trakassering blant ungdom. [Radio]. P4. Full text in Research Archive
• Bonsaksen, Tore & Vazquez, Karelia (2024). La soledad deseada, necesaria y beneficiosa. [Journal]. El País. Full text in Research Archive
• Bonsaksen, Tore & Ringlund, Ole Martin (2024). En av tre ungdommer er utsatt for seksuell trakassering: Et alvorlig folkehelseproblem. [Internet]. forskning.no. Full text in Research Archive
• Doorn, Janca Molthe van; Bonsaksen, Tore; Palleschitz, Marte & Espeland, Elisabeth (2024). Gjensidig involvering villet endring (GIVE) - et samarbeid om praksis i kommunehelsetjenesten. Full text in Research Archive Show summary

  Bakgrunn Gjensidig Involvering Villet Endring (GIVE) er et flerårig samarbeidsprosjekt som skal forbedre kvaliteten i kommunal praksis i sykepleierutdanningen. Praksisfelleskapet består av deltagere fra Høgskolen i Innlandet, Hamar, Stange og Tynset kommune, Utviklingssenter for sykehjem og hjemmetjenesten (USHT) i Innlandet, Hedmark og sykepleierstudenter fra høgskolen. Hensikt Øke kompetanseutbytte i praksisveiledning i kommunehelsetjenesten gjennom innovativ bruk av digitale verktøy, slik at utdanningskvaliteten og arbeidslivsrelevansen i sykepleierutdanningen forbedres. Design og metode GIVE er et FOU-prosjekt som involverer deltagere i praksisfelleskapet gjennom utvikling, utprøving og evaluering av aktiviteter i praksisperioder. Fremgangsmåten er bruk av samskapende aksjonslæring gjennom arbeidsmøter, verkstedmetodikk, logg og spørreundersøkelser. Digitale plattformer anvendes for samhandling og dokumentasjon. Foreløpige resultater • GIVE lommefolder • En digital opplæringspakke i praksissamarbeid (DOPPS) tydeliggjør roller, ansvar og forventinger i praksisveiledningen • Sykepleierstudenter har publisert praksisfortellinger fra praksisperioder • www.GIVEpraksis.no Diskusjon Prosjektets nettside er en arena for deling av verktøy for økt kompetanseutbytte i praksissamarbeid og praksisveiledning. Digitale arenaer muliggjør samarbeid og dokumentasjon. Deltagerne i praksisfelleskapet har en likeverdig rolle i prosjektet. Det som utvikles skal være arbeidslivsrelevant og bidra til mestring. Prosjektet jobber med å skape tilhørighet, eierskap, forankring og involvering av nøkkelpersoner i forbedrings- og implementeringsarbeidet.

• Bonsaksen, Tore; Horghagen, Sissel; Sveen, Unni; Gramstad, Astrid & Stigen, Linda (2024). Jobbtilfredshet blant ergoterapeuter i kommunehelsetjenesten. Ergoterapeuten. ISSN 0800-3475. 67(6), p. 26–29. Full text in Research Archive
• Mørk, Gry; Hinderaker, Liv Elisabeth; Johnson, Susanne Grødem; Gramstad, Astrid; Stigen, Linda & Carstensen, Tove [Show all 7 contributors for this article] (2024). Associations between occupational therapy students’ perceptions of learning environment and study satisfaction. Full text in Research Archive
• DaLomba, Elaina; Bonsaksen, Tore & Jan, Greer Mary (2023). Study, self-efficacy, and mental health changes in students during COVID-19. Full text in Research Archive
• Bonsaksen, Tore; Gramstad, Astrid; Stigen, Linda; Magne, Trine A; Carstensen, Tove & Mygland, Jenny Solveig [Show all 8 contributors for this article] (2023). Learning environment, study approaches and student performance: repeated cross-sectional analyses of associations. Full text in Research Archive
• Bonsaksen, Tore & Breen-Franklin, Adele (2023). Intrinsic relationships between learning conceptions, preferences for teaching and study approaches. Full text in Research Archive
• Bonsaksen, Tore (2023). Utdanning for bærekraft - måter å tenke om ergoterapiutdanningenes bidrag til bærekraftige helsetjenester. Full text in Research Archive
• Maass, Ruca Elisa Katrin; Arntzen, Cathrine; Horghagen, Sissel; Bonsaksen, Tore; Edvardsen, Even Elias & Sveen, Unni [Show all 9 contributors for this article] (2023). Kunnskapsbehov for fremtidens kommuneergoterapi: oppsummering av workshop ved fagkongress Stavanger 2022. Ergoterapeuten. ISSN 0800-3475. 66(3), p. 20–26. Full text in Research Archive
• Bonsaksen, Tore & Redzovic, Skender Elez (2023). Student­motivasjon handler om mer enn student­styrte problem­stillinger. Full text in Research Archive
• Edvardsen, Even Elias; Stigen, Linda; Hustoft, Merethe; Gramstad, Astrid; Arntzen, Cathrine & Maass, Ruca Elisa Katrin [Show all 9 contributors for this article] (2023). Organisatoriske faktorer påvirker kapasitet og kvalitet i praksisveiledning i ergoterapiutdanning. Full text in Research Archive
• Edvardsen, Even Elias; Dalseth, Eline Fjærestad; Johnson, Susanne Grødem; Stigen, Linda; Mørk, Gry & Magne, Trine A. [Show all 9 contributors for this article] (2023). Studenters læringspreferanser over en tre års bachelorutdanning i ergoterapi – er de stabile eller ikke? Full text in Research Archive
• Steigen, Anne Mari; Bonsaksen, Tore; Granrud, Marie Dahlen; Dangmann, Cecilie Ruud & Stea, Tonje Holte (2023). Time trends in sexual harassment exposure among adolescents in Norway between 2017 and 2021. Full text in Research Archive
• Bonsaksen, Tore; Steigen, Anne Mari; Stea, Tonje Holte; Kleppang, Annette Løvheim; Lien, Lars & Leonhardt, Marja (2023). Negative social media experiences and lower self-efficacy are associated with depressive symptoms. Full text in Research Archive
• Mørk, Gry; Gramstad, Astrid; Åsli, Lene Angel; Stigen, Linda; Johnson, Susanne Grødem & Magne, Trine A [Show all 9 contributors for this article] (2023). Approaches to studying: Changes during a three-year undergraduate study program. Full text in Research Archive
• Mørk, Gry; Stigen, Linda; Gramstad, Astrid; Magne, Trine A; Carstensen, Tove & Bonsaksen, Tore (2023). Stable and unstable associations between learning environment factors and study approaches. Full text in Research Archive
• Mørk, Gry; Bonsaksen, Tore & Lie, Silje Stangeland (2023). Opplevelser og nytteverdi av VR- teknologi i utdanningen. Full text in Research Archive
• Mechraoui, Oumaima; Jelleli, Hilmi; Fekih-Romdhane, Feten; Rebhi, Mahmood; Saidane, Mouna & Guelmami, Noomen [Show all 10 contributors for this article] (2023). The relationship between nomophobia and psychological distress in Tunisian students: The moderating effect of physical activity. Tunisian Journal of Sports Science and Medicine. 1(1), p. 24–35. doi: 10.61838/kman.tjssm.1.1.4. Full text in Research Archive
• Arntzen, Cathrine; Sveen, Unni; Bonsaksen, Tore & Horghagen, Sissel (2022). Innhold, dilemmaer og prioriteringer i kommuneergoterapipraksis. Full text in Research Archive
• Stigen, Linda; Mørk, Gry; Carstensen, Tove; Magne, Trine A; Gramstad, Astrid & Johnson, Susanne Grødem [Show all 8 contributors for this article] (2022). Oppfatninger av læringsmiljøet blant ergoterapistudenter- endringer i løpet av det treårige bachelorprogrammet. Full text in Research Archive
• DaLomba, Elaina; Mansur, Saji; Bonsaksen, Tore & greer, Mary Jan (2022). Exploring student approaches to studying, general self-efficacy, and positive mental health factors and potential implications for teaching, learning, and learner support. Full text in Research Archive
• Bonsaksen, Tore; Dolva, Anne-Stine; Hagby, Cathrine; Sveen, Unni; Horghagen, Sissel & Thyness, Else Merete [Show all 7 contributors for this article] (2022). Involvement in research and development projects among community-working occupational therapists in Norway. Full text in Research Archive
• Bonsaksen, Tore; Magne, Trine A; Stigen, Linda; Gramstad, Astrid; Åsli, Lene Angell & Mørk, Gry [Show all 8 contributors for this article] (2022). Associations between occupational therapy students’ academic performance and their study approaches and perceptions of the learning environment. Full text in Research Archive
• Horghagen, Sissel; Bonsaksen, Tore; Sveen, Unni & Arntzen, Cathrine (2022). WFOT: Dilemmas experienced by occupational therapists in community health services. Full text in Research Archive
• Jentoft, Rita; Horghagen, Sissel; Fløtten, Heidi E. & Bonsaksen, Tore (2022). RETHOS - Hvordan sikre ergoterapeuters fremtidsrettede kompetanse? Full text in Research Archive
• Stigen, Linda; Sveen, Unni; Arntzen, Cathrine; Bonsaksen, Tore; Maass, Ruca Elisa Katrin & Horghagen, Sissel [Show all 7 contributors for this article] (2022). What does the research tell us about occupational therapy services in primary health care in the Nordic countries? Full text in Research Archive
• Bonsaksen, Tore; Magne, Trine A; Stigen, Linda; Gramstad, Astrid; Åsli, Lene Angel & Mørk, Gry [Show all 8 contributors for this article] (2022). Eksamensprestasjoner blant ergoterapistudenter - sammenhenger med læringsmiljø og studietilnærminger. Full text in Research Archive
• Morttjernet, Hanne; Borg, Diesen Kajsa Annika & Bonsaksen, Tore (2022). Ansatte i helsehus må ha kompetanse i psykisk helsearbeid. Tidsskriftet sykepleien. ISSN 0806-7511. 110(87808), p. e-87808–e-87808. Full text in Research Archive
• Torland, Emilie Aas; Thørrisen, Mikkel Magnus; Bonsaksen, Tore; Karlstad, Cecilie & Aas, Randi Wågø (2022). Ungdoms deltagelsesutfordringer - ergoterapeuters utvidede rolle i skolehelsetjenesten? Resultater fra INSchool-project. Full text in Research Archive
• Leonhardt, Marja; Granrud, Marie Dahlen; Bonsaksen, Tore & Lien, Lars (2022). Worries about climate change in Norwegian adolescents. Full text in Research Archive
• Lie, Silje Stangeland; Helle, Nikolina; Sletteland, Nina Vahl; Bonsaksen, Tore & Vikman, Miriam Dubland (2022). Implementation of Virtual Reality in Health Professional Higher Education: Protocol for a Scoping Review. JMIR Research Protocols. 11(7). doi: 10.2196/37222. Full text in Research Archive Show summary

  Background: The use of virtual reality in higher education show great potential to promote novel and innovative learning experiences. Until recently, virtual reality has mostly been used in technical higher education, but lately medical education programs have begun using virtual reality. Virtual reality for health professional education improves the knowledge and skills of health professionals compared with traditional or other digital education initiatives. However, the implementation of technology in higher education is slow because of barriers to technology use and innovative and successful practices are not shared. It is, therefore, of great interest to explore how virtual reality is implemented in higher health professional and continuing education. Objective: The aim of this scoping review is to identify studies that reported implementation of virtual reality in higher health professional education, to identify barriers and facilitators for implementation, and to highlight research gaps in this area. Methods: The scoping review will be conducted according to JBI Evidence Synthesis methodologies. CINAHL, the Academic Search Elite and Education Source electronic databases, and Google Scholar will be searched for studies published between 2017 and 2022. In addition, manual searching of key items, reference tracking, and citation tracking will be performed. Searches for white papers will also be manually conducted. All authors will independently extract data from full-text papers. We will use qualitative content analysis to abstract the findings. Results: The literature searches were conducted in January and February 2022. The review is expected to be completed by fall 2022, after which time it will be submitted for publication. Conclusions: We anticipate that, from the review, we will be able to coordinate recommendations for and present the challenges of virtual reality initiatives in health professional education programs. We will present recommendations for future research.

• Bonsaksen, Tore; Thørrisen, Mikkel Magnus; Hashemi, Neda; Porras, David Gimeno Ruiz de & Aas, Randi Wågø (2022). Correction: Do health professionals’ attitudes towards alcohol use matter for alcohol prevention efforts? Results from the WIRUS-OHS study (BMC Health Services Research, (2022), 22, 1, (1004), 10.1186/s12913-022-08400-9). BMC Health Services Research. 22(1). doi: 10.1186/s12913-022-08533-x. Full text in Research Archive
• Magne, Trine A; Bonsaksen, Tore & Carstensen, Tove (2022). Do the students' have all the answers? -a qualitative study of students' experience of learning environment. Full text in Research Archive
• Bonsaksen, Tore; Mørk, Gry; Magne, Trine A; Carstensen, Tove; Stigen, Linda & Johnson, Susanne Grødem [Show all 11 contributors for this article] (2022). Læringsmiljøstudien ved ergoterapeututdanningene 2017-2020: oppsummering av foreløpige resultater. Ergoterapeuten. ISSN 0800-3475. 64(1), p. 22–29. Full text in Research Archive
• Bonsaksen, Tore (2021). Flere nordmenn fikk PTSD-symptomer etter pandemien rammet landet. [Internet]. https://forskning.no/. Full text in Research Archive
• Thordardottir, Björg; Stigen, Linda; Magne, Trine A; Johnson, Susanne Grødem; Gramstad, Astrid & Gran, Adrian W. [Show all 9 contributors for this article] (2021). Student perceptions of the learning environment in Norwegian Occupational therapy education programs. Full text in Research Archive
• Aas, Randi Wågø; Thørrisen, Mikkel Magnus; Sagvaag, Hildegunn; Skogen, Jens Christoffer; Bonsaksen, Tore & Skarpaas, Lisebet Skeie (2021). WIRUS-prosjektet. Hva fant vi ut? #alkoholbruk #sykefravær #sykenærvær. Full text in Research Archive
• Bonsaksen, Tore; Brown, Ted; Lim, Hua Beng; Fong, Kenneth & Småstuen, Milada Cvancarova (2021). Associations between occupational therapy students’ approaches to studying and their academic grade results: A cross-cultural study. Full text in Research Archive
• Bonsaksen, Tore (2021). Det er ikke flere som drikker hver dag under pandemien. [Internet]. Forskning.no. Full text in Research Archive
• Thørrisen, Mikkel Magnus; Aas, Randi Wågø; Sagvaag, Hildegunn; Skogen, Jens Christoffer; Hashemi, Neda & Kjeken, Ingvild [Show all 10 contributors for this article] (2021). WIRUS-prosjektet: Risikodrikking, alkoholrelatert sykenærvær og alkoholforebygging i regi av bedriftshelsetjenesten. Full text in Research Archive
• Bonsaksen, Tore (2021). Intervju. [Radio]. NRK Innlandet. Full text in Research Archive
• Leung, Janni; Schoultz, Mariyana; Chiu, Vivian; Bonsaksen, Tore; Ruffolo, Mary & Thygesen, Hilde [Show all 7 contributors for this article] (2021). Concerns over the Spread of Misinformation and Fake News on Social Media–challenges Amid the Coronavirus Pandemic. Full text in Research Archive
• Gramstad, Astrid; Åsli, Lene Angel; Johnson, Susanne Grødem; Magne, Trine A; Carstensen, Tove & Mørk, Gry [Show all 8 contributors for this article] (2021). Do approaches to studying differ between students at different educational programs? Full text in Research Archive
• Leung, Janni; Schoultz, Mariyana; Chiu, Vivian; Bonsaksen, Tore; Ruffolo, Mary & Thygesen, Hilde [Show all 8 contributors for this article] (2021). Concerns over the Spread of Misinformation and Fake News on Social Media — Challenges Amid the Coronavirus Pandemic. Medical Sciences Forum. ISSN 2673-9992. 4(1), p. 39–39. doi: 10.3390/ECERPH-3-09078. Full text in Research Archive
• Stigen, Linda; Arntzen, Cathrine; Horghagen, Sissel; Sveen, Unni; Gramstad, Astrid & Bonsaksen, Tore (2021). Kjennetegn, styrker og utfordringer ved norske kommuneergoterapeuters praksis. Ergoterapeuten. ISSN 0800-3475. 64(2), p. 28–37. Full text in Research Archive
• Mørk, Gry; Magne, Trine A; Carstensen, Tove; Stigen, Linda; Johnson, Susanne Grødem & Bonsaksen, Tore (2021). Associations between learning environment variables and students' approaches to studying: A cross-sectional study. Full text in Research Archive
• Jentoft, Rita; Bonsaksen, Tore; Horghagen, Sissel; Fløtten, Heidi E.; Osen, David W. & Kjølstad, Eva S. [Show all 7 contributors for this article] (2020). RETHOS - utdanning av framtidens ergoterapeuter. Ergoterapeuten. ISSN 0800-3475. 63(4), p. 20–30. Full text in Research Archive
• Bonsaksen, Tore; Thørrisen, Mikkel Magnus; Skogen, Jens Christoffer & Aas, Randi Wågø (2020). Hvem opplever at de har de mest stressende jobbene? uis.no. Full text in Research Archive
• Thørrisen, Mikkel Magnus; Bonsaksen, Tore; Hashemi, Neda; Kjeken, Ingvild; Mechelen, Willem van & Aas, Randi Wågø (2020). Ansatte som drikker mye alkohol kan ha redusert arbeidsevne på jobb. uis.no. Full text in Research Archive
• Bonsaksen, Tore & Carstensen, Tove (2020). Terapeutisk samhandling blant ergoterapeuter og ergoterapistudenter - funn fra to norske prosjekter. Ergoterapeuten. ISSN 0800-3475. 63(2), p. 20–28. Full text in Research Archive
• Fan, Chia-Wei; Yazdani, Farzaneh; Carstensen, Tove & Bonsaksen, Tore (2020). Psychometric Properties of the Self-Efficacy for Therapeutic Use of Self Questionnaire. American Journal of Occupational Therapy. ISSN 0272-9490. 74. doi: 10.5014/ajot.2020.74S1-PO8030. Full text in Research Archive
• Bonsaksen, Tore; Dolva, Anne-Stine; Hagby, Cathrine; Sveen, Unni; Horghagen, Sissel & Thyness, Else Merete [Show all 7 contributors for this article] (2019). Deltakelse i forskning og utviklingsarbeid blant ergoterapeuter i kommunehelsetjenesten. Ergoterapeuten. ISSN 0800-3475. 62(3), p. 56–57. Full text in Research Archive
• Bonsaksen, Tore; Sveen, Unni; Dolva, Anne-Stine; Horghagen, Sissel; Thyness, Else Merete & Hagby, Cathrine [Show all 7 contributors for this article] (2019). Ergoterapeuter i norske kommuner: I hvilken grad opplever de å påvirke kommunens målsettinger? Ergoterapeuten. ISSN 0800-3475. 62(1), p. 48–49. Full text in Research Archive
• Bonsaksen, Tore; Dolva, Anne-Stine; Horghagen, Sissel; Sveen, Unni; Hagby, Cathrine & Arntzen, Cathrine (2019). Praksisveiledning av studenter blant ergoterapeuter i kommunehelsetjenesten. Ergoterapeuten. ISSN 0800-3475. 62(5), p. 48–49. Full text in Research Archive
• Bonsaksen, Tore; Dolva, Anne-Stine; Horghagen, Sissel; Sveen, Unni; Hagby, Cathrine & Arntzen, Cathrine (2019). Kjennetegn ved ergoterapeuters praksis i kommunehelsetjenesten. Ergoterapeuten. ISSN 0800-3475. 62(4), p. 48–49. Full text in Research Archive
• Arntzen, Cathrine; Sveen, Unni; Hagby, Cathrine; Bonsaksen, Tore; Dolva, Anne-Stine & Horghagen, Sissel (2019). Kommuneergoterapi: innhold, dilemmaer og prioriteringer. Ergoterapeuten. ISSN 0800-3475. 62(5), p. 50–51. Full text in Research Archive
• Asbjørnslett, Mona; Bull, Helen; Mørk, Gry; Gramstad, Astrid; Carstensen, Tove & Bonsaksen, Tore (2019). New modules - new shocks. Experiences and perspectives of Learning. Full text in Research Archive
• Bonsaksen, Tore (2019). #IncreaseImpact: Added value for your published article. British Journal of Occupational Therapy. ISSN 0308-0226. 82(6), p. 323–325. doi: 10.1177/0308022619825806. Full text in Research Archive
• Bonsaksen, Tore; Gramstad, Astrid; Mørk, Gry; Johnson, Susanne Grødem & Magne, Trine A (2019). Perceptions of assessment in Norwegian occupational therapy students. Full text in Research Archive
• Morttjernet, Hanne; Diesen, Annika Borg; Olsen, Cecilie Fromholt; Elin, Berven; Ellingham, Brian & Bonsaksen, Tore (2019). Tverrprofesjonelt samhandlingsprosjekt - Kropp og sjel! Full text in Research Archive
• Bonsaksen, Tore; Sandberg, Trine Marie; Söreskog, Mikaela & Ellingham, Brian (2018). Aktivitet - ergoterapeuters sentrale bidrag til miljøterapi. Ergoterapeuten. ISSN 0800-3475. 61(1), p. 82–91. Full text in Research Archive
• Bonsaksen, Tore; Brown, Ted; Lim, Hua Beng & Fong, Kenneth (2018). Approaches to studying predict academic performance in undergraduate occupational therapy students: a cross-cultural study. Full text in Research Archive
• Bonsaksen, Tore & Carstensen, Tove (2018). Differences and similarities in therapeutic mode use between occupational therapists and occupational therapy students in Norway. Full text in Research Archive
• Bonsaksen, Tore; Fagermoen, May Solveig; Småstuen, Milada C & Lerdal, Anners (2018). Selvfølelse og positive og negative følelser etter pasientopplæring. BestPractice. Lungemedisin. 8(2), p. 18–21. Full text in Research Archive
• Bonsaksen, Tore; Fekete, Orsolya Reka & Nordli, Hege (2018). Tilfredshet med å delta på et klubbhus for personer med psykisk sykdom. Ergoterapeuten. ISSN 0800-3475. 61(1), p. 48–53. Full text in Research Archive
• Yazdani, Farzaneh & Bonsaksen, Tore (2017). Introduction to the Model of Occupational Wholeness. Ergoscience. ISSN 1861-6348. 12(1), p. 32–36. Full text in Research Archive
• Bonsaksen, Tore & Ellingham, Brian (2017). Klinisk resonnering – veien til reflektert yrkesutøvelse. 60(6), p. 50–51. Full text in Research Archive
• Arntzen, Cathrine; Bonsaksen, Tore; Sveen, Unni; Hagby, Cathrine; Dolva, Anne-Stine & Horghagen, Sissel [Show all 8 contributors for this article] (2017). KE prosjektet 2017 til 2022 Kommuneergoterapi. Kjennetegn før og etter å ha blitt en lovpålagt tjeneste. Full text in Research Archive
• Bonsaksen, Tore; Fong, Kenneth; Lim, Hua Beng & Brown, Ted (2017). Hva karakteriserer studenter som presterer godt på ergoterapistudiet? En kryss-kulturell studie. Full text in Research Archive
• Hagby, Cathrine; Arntzen, Cathrine; Horghagen, Sissel; Dolva, Anne-Stine; Sveen, Unni & Thyness, Else Merete [Show all 8 contributors for this article] (2017). Kjennetegn ved den kommunale ergoterapitjenesten i Norge i 2017. Full text in Research Archive
• Bonsaksen, Tore & Kjeken, Ingvild (2017). Hvordan holde et muntlig kongressfremlegg. Tore og Ingvilds Presentasjonsråd i Sammenfatning (TIPS). Ergoterapeuten. ISSN 0800-3475. 60(3), p. 48–49. Full text in Research Archive
• Bonsaksen, Tore; Sadeghi, Talieh & Thørrisen, Mikkel Magnus (2017). Mestringsforventning bidrar til å forklare ergoterapistudenters tilnærming til det å studere. Full text in Research Archive
• Bonsaksen, Tore; Ellingham, Brian & Thyness, Else Merete (2017). Klinisk resonnering: En bok er født! Full text in Research Archive
• Bonsaksen, Tore; Thørrisen, Mikkel Magnus; Kjeken, Ingvild; Sveen, Unni; Aas, Randi Wågø & Lund, Anne (2017). Karaktersetting på ergoterapistudenters bacheloroppgaver: Hvor enige er sensorene? Full text in Research Archive
• Hagby, Cathrine; Arntzen, Cathrine; Dolva, Anne-Stine; Horghagen, Sissel; Sveen, Unni & Bonsaksen, Tore [Show all 8 contributors for this article] (2017). Kommuneergoterapi: Kjennetegn før og etter å ha blitt en lovpålagt tjeneste. Full text in Research Archive
• Opseth, Thea M.; Carstensen, Tove & Bonsaksen, Tore (2017). Trivsel i arbeidet blant norske ergoterapeuter. Full text in Research Archive
• Carstensen, Tove; Opseth, Thea M. & Bonsaksen, Tore (2017). Koss terapeut e du? Full text in Research Archive
• Bonsaksen, Tore & Horghagen, Sissel (2016). Forsker på utdanning og psykisk helse. [Journal]. Ergoterapeuten. Full text in Research Archive
• Bonsaksen, Tore; Fagermoen, May Solveig & Lerdal, Anners (2016). Utviklingsforløpet av fysisk og mental helse etter pasientopplæring for personer med KOLS. BestPractice. Lungemedisin. 6(9), p. 9–11. Full text in Research Archive
• Bonsaksen, Tore (2016). Validation of the Norwegian translation of the Self-Assessment of Modes Questionnaire II. Full text in Research Archive
• Bonsaksen, Tore (2016). Den terapeutiske relasjonen i ergoterapi - teori, praksis, forskning. Full text in Research Archive
• Ellingham, Brian & Bonsaksen, Tore (2016). Klinisk vurdering av ferdigheter i kommunikasjon og interaksjon – kurs i bruk av Assessment of Communication and Interaction Skills (ACIS), Dag 2. Full text in Research Archive
• Ellingham, Brian & Bonsaksen, Tore (2016). Klinisk vurdering av ferdigheter i kommunikasjon og interaksjon – kurs i bruk av Assessment of Communication and Interaction Skills (ACIS). Full text in Research Archive
• Yazdani, Farzaneh; Raber, Christine & Bonsaksen, Tore (2016). The 2016 COTEC-ENOTHE Congress: Some reflections. Ergoterapeuten. ISSN 0800-3475. 59(4), p. 42–46. Full text in Research Archive
• Stimo, Torhild; Jarål, Grethe Berntsen; Ellestad, Anne-Kari; Ellingham, Brian; Skarpaas, Lisebet Skeie & Bonsaksen, Tore (2016). The Clubhouse model - A Method in harmony with occupational therapy theory? Full text in Research Archive
• Decker, Lone; Hansen, Henrik; Torgrimsen, Silje & Bonsaksen, Tore (2016). Teaching the Intentional Relationship Model to occupational therapy students. Full text in Research Archive
• Bonsaksen, Tore; Eirum, Mari Nesset & Donohue, Mary V. (2016). The Social Profiles of occupational therapy students' educational groups. Full text in Research Archive
• Fouad, Maria; Bonsaksen, Tore; Skarpaas, Lisebet Skeie; Nordli, Hege; Fekete, Orsolya Reka & Stimo, Torhild (2016). Characteristics of Norwegian clubhouse members and factors associated with their participation in work and education. Full text in Research Archive
• Brown, Ted; Bonsaksen, Tore & Fong, Kenneth (2016). Are occupational therapy students' approaches to study a predictor of their academic achievement? Full text in Research Archive
• Scott, Patricia J.; Meidert, Ursula; Bonsaksen, Tore & Fenger, Kristjana (2016). The Modified Role Checklist as a cross-culturally valid measure of participation. Full text in Research Archive
• Brown, Ted; Fong, Kenneth & Bonsaksen, Tore (2016). A cross-cultural comparison of occupational therapy students' approaches to academic study. Full text in Research Archive
• Yazdani, Farzaneh & Bonsaksen, Tore (2016). A reflection on reviewing the occupational therapy curriculum. OTnews. Full text in Research Archive
• Bonsaksen, Tore (2016). Using the Intentional Relationship Model in practice. Full text in Research Archive
• Yazdani, Farzaneh; WIllis, Suzie & Bonsaksen, Tore (2016). Workshop on the Intentional Relationship Model. Full text in Research Archive
• Bonsaksen, Tore (2016). Self-efficacy and use of activities in therapeutic settings. Full text in Research Archive
• Antwerp, Leah R. Van; Donohue, Mary V. & Bonsaksen, Tore (2016). Reflections after the 2016 AOTA Annual Conference. Ergoterapeuten. ISSN 0800-3475. 59(3), p. 40–45. Full text in Research Archive
• Bonsaksen, Tore (2015). Reflections after the MOHO Institute 2015. Full text in Research Archive
• Bonsaksen, Tore; Hagby, Cathrine; Solbakken, Alf Inge; Horghagen, Sissel; Sveen, Unni & Dolva, Anne-Stine [Show all 7 contributors for this article] (2015). I hvilke situasjoner bruker norske ergoterapeuter undersøkelses- og vurderingsredskaper? Resultater fra medlemsundersøkelsen i 2013: Del 2. Ergoterapeuten. ISSN 0800-3475. 58(2), p. 38–42. Full text in Research Archive
• Bonsaksen, Tore & Scott, Patricia J. (2015). Clinical Applications of the Role Checklist Version 2: Quality of Performance. Full text in Research Archive
• Bonsaksen, Tore (2015). Addication as occupation? Initiating a discussion. Full text in Research Archive
• Nakamura-Thomas, Hiromi; Antwerp, Leah R. Van; Ikiugu, Moses; Scott, Patricia J. & Bonsaksen, Tore (2015). Summary and reflections following the 4th International MOHO Institute. Ergoterapeuten. ISSN 0800-3475. 58(6), p. 62–62. Full text in Research Archive
• Bonsaksen, Tore; Lerdal, Anners & Fagermoen, May Solveig (2015). Mestringsforventning hos personer med KOLS. BestPractice. Lungemedisin. 5(9), p. 20–23. Full text in Research Archive
• Scott, Patricia J.; Bonsaksen, Tore; Haglund, Lena; Forsyth, Kirsty & Yamada, Takashi (2015). New Developments in a Traditional Assessment to Measure Occupational Role Participation Consistent with MOHO and the ICF. Full text in Research Archive
• Bonsaksen, Tore (2015). Addiction as occupation? British Journal of Occupational Therapy. ISSN 0308-0226. 78(3), p. 205–206. doi: 10.1177/0308022615575025. Full text in Research Archive
• Kvarsnes, Hildegunn & Bonsaksen, Tore (2015). Research assistants in occupational therapy (RIOT): An opportunity for the advancement of occupational therapy? Full text in Research Archive
• Bonsaksen, Tore (2015). Assessment of communication and interaction skills: Litt om hva, hvordan, hvorfor, og noen erfaringer. Full text in Research Archive
• Bonsaksen, Tore & Lorentzen, Marte (2015). Hvordan kan man integrere læringsfremmede tilbakemeldinger i utdanningene? [Internet]. http://blogg.hioa.no/fpksatsing/2015/02/02/fra-utdanningene-. Full text in Research Archive
• Dolva, Anne-Stine; Sveen, Unni; Bonsaksen, Tore; Hagby, Cathrine; Horghagen, Sissel & Solbakken, Alf Inge [Show all 7 contributors for this article] (2015). Hvilke undersøkelses- og vurderingsredskaper bruker norske ergoterapeuter? Resultater fra medlemsundersøkelsen i 2013: Del 3. Ergoterapeuten. ISSN 0800-3475. 58(2), p. 44–49. Full text in Research Archive
• Kvarsnes, Hildegunn; Dahl, Mona & Bonsaksen, Tore (2015). Studenter som forskningsassistenter i ergoterapi – hvorfor og hvordan? Ergoterapeuten. ISSN 0800-3475. 58(4), p. 32–37. Full text in Research Archive
• Stimo, Torhild; Jarål, Grethe Berntsen; Ellestad, Anne-Kari; Ellingham, Brian; Skarpaas, Lisebet Skeie & Bonsaksen, Tore (2015). Fontenehusmodellen i Norge: En metode i harmoni med tenkning i ergoterapifaget? Ergoterapeuten. ISSN 0800-3475. 58(4), p. 22–30. Full text in Research Archive
• Bonsaksen, Tore & Kvarsnes, Hildegunn (2015). Advancing occupational therapy. Ergoterapeuten. ISSN 0800-3475. 58(4), p. 52–55. Full text in Research Archive
• Fagermoen, May Solveig; Bonsaksen, Tore & Lerdal, Anners (2015). Pasientopplæring kan bidra til positive endringer i faktorer knyttet til mestring av helseproblemer - en longitudinell studie. Full text in Research Archive
• Bonsaksen, Tore & Vøllestad, Knut (2014). Modellen for tilsiktet samspill - the Intentional Relationship Model (IRM). Full text in Research Archive
• Bonsaksen, Tore & Hermansen, Hege (2014). Sampublisering med studenter. [Internet]. http://khrono.no/debatt/sampublisering-med-studenter. Full text in Research Archive
• Korban, Elisabet T. & Bonsaksen, Tore (2014). Riktig strategi til riktig tid – Bruk av den transteoretiske modellen for å fremme fysisk aktivitet hos personer med depresjon. Ergoterapeuten. ISSN 0800-3475. 57(2), p. 34–42. Full text in Research Archive
• Bonsaksen, Tore & Vøllestad, Knut (2014). Self-reported therapeutic style in occupational therapy students. Full text in Research Archive
• Nakamura-Thomas, Hiromi; Bonsaksen, Tore & Kyougoku, M (2014). Measuring Communication Skills among Occupational Therapy Students using the Assessment of Communication and Interaction Skills (ACIS). Full text in Research Archive
• Scott, Patricia J.; Bonsaksen, Tore; Forsyth, Kirsty; Haglund, Lena; Meidert, Ursula & Yamada, Takashi (2014). Establishing cross-cultural validity of the Role Checklist Version 2: Quality of Performance (RC V2: QP). Full text in Research Archive
• Ellingham, Brian; Myraunet, Ingunn; Celo, Cecilia; Granå, Kjell Emil & Bonsaksen, Tore (2014). Experiences of occupational therapists and occupational therapy students in using the Assessment of Communication and Interaction Skills in mental health settings in Norway. Full text in Research Archive
• Ellingham, Brian; Bonsaksen, Tore & Hiromi, Nakamura-Thomas (2014). The Assessment of Communication and Interaction Skills (ACIS). Full text in Research Archive
• Bonsaksen, Tore; Ellingham, Brian; Celo, Cecilia; Hiromi, Nakamura-Thomas & Myraunet, Ingunn (2014). Utilizing the Assessment of Communication and Interaction Skills in a fieldwork design to facilitate occupational therapy students’ learning. Full text in Research Archive
• Hagby, Cathrine & Bonsaksen, Tore (2014). Fagartikler i Ergoterapeuten - status og oppdaterte retningslinjer fra 2014. Ergoterapeuten. ISSN 0800-3475. 57(2), p. 50–53. Full text in Research Archive
• Bonsaksen, Tore & Hermansen, Hege (2014). Sampublisering med studenter gjennom videreutvikling av bacheloroppgaver. [Internet]. https://blogg.hioa.no/fpksatsing/2014/03/31/fra-utdanningene. Full text in Research Archive
• Aslaksen, Maya; Scott, Patricia J.; Haglund, Lena; Ellingham, Brian & Bonsaksen, Tore (2014). Occupational Therapy Process in a Psychiatric Hospital - Using the Role Checklist Version 2: Quality of Performance. Ergoterapeuten. ISSN 0800-3475. 57(4), p. 38–45. Full text in Research Archive
• Myraunet, Ingunn; Celo, Cecilia; Ellingham, Brian; Granå, Kjell Emil & Bonsaksen, Tore (2014). Hva skjer mellom oss? Vurdering av kommunikasjons- og samhandlingsferdigheter hos mennesker med psykiske lidelser. Ergoterapeuten. ISSN 0800-3475. 57(4), p. 46–52. Full text in Research Archive
• Hagby, Cathrine; Bonsaksen, Tore; Dolva, Anne-Stine; Horghagen, Sissel; Sveen, Unni & Solbakken, Alf Inge [Show all 7 contributors for this article] (2014). Bruker norske ergoterapeuter undersøkelses- og vurderingsredskaper? Resultater fra medlemsundersøkelsen i 2013: Del 1. Ergoterapeuten. ISSN 0800-3475. 57(4), p. 22–27. Full text in Research Archive
• Bonsaksen, Tore; Haukeland-Parker, Stacey; Lerdal, Anners & Fagermoen, May Solveig (2014). Oppfatninger om egen sykdom har betydning for livskvaliteten hos personer med KOLS. BestPractice. Lungemedisin. 4(11), p. 8–11. Full text in Research Archive
• Vøllestad, Knut; Torgrimsen, Silje; Öqvist, Therese & Bonsaksen, Tore (2014). Interpersonlig resonnering - praktisk anvendelse av modellen for tilsiktet samspill. Ergoterapeuten. ISSN 0800-3475. 57(5), p. 44–50. Full text in Research Archive
• Myraunet, Ingunn; Bonsaksen, Tore; Celo, Cecilia; Ellingham, Brian & Granå, Kjell Emil (2013). Et praksisdesign som fremmer ergoterapistudenters læring. Full text in Research Archive
• Bonsaksen, Tore; Fagermoen, May Solveig & Lerdal, Anners (2013). Forløp av mestringsforventning hos personer med kronisk sykdom etter deltakelse på Lærings og mestringskurs: en longitudinell studie. Full text in Research Archive
• Hagby, Cathrine; Thyness, Else Merete; Bonsaksen, Tore; Sveen, Unni; Dolva, Anne-Stine & Horghagen, Sissel [Show all 8 contributors for this article] (2013). Hvordan kan vi lage et enda bedre fagblad? Full text in Research Archive
• Bonsaksen, Tore; Celo, Cecilia; Myraunet, Ingunn; Granå, Kjell Emil & Ellingham, Brian (2013). Partnerskap mellom utdanning og praksisfelt kan fremmes gjennom studenters praksisperioder. Full text in Research Archive
• Bonsaksen, Tore & Vøllestad, Knut (2013). Selvrapportert terapeutstil blant studenter i ergoterapi. Full text in Research Archive
• Bonsaksen, Tore & Kjeken, Ingvild (2013). Hvordan holde et muntlig kongressfremlegg? Tore og Ingvilds Presentasjonsråd i Sammenfatning (TIPS). Ergoterapeuten. ISSN 0800-3475. 56(3), p. 34–35. Full text in Research Archive
• Mostad, Marita; Skjelbred, Mariken Røsnes; Bråten, Veslemøy & Bonsaksen, Tore (2013). Forventning om mestring – et perspektiv på aktivitetsmotivasjon blant klienter med depresjon. Ergoterapeuten. ISSN 0800-3475. 56(4), p. 30–35. Full text in Research Archive
• Bonsaksen, Tore; Vøllestad, Knut & Taylor, Renee R. (2013). The Intentional Relationship Model – Use of the therapeutic relationship in occupational therapy practice. Ergoterapeuten. ISSN 0800-3475. 56(5), p. 26–31. Full text in Research Archive
• Öqvist, Therese; Torgrimsen, Silje; Vøllestad, Knut & Bonsaksen, Tore (2013). The Intentional Relationship Model (IRM) and its utility in clinical practice. Full text in Research Archive
• Bonsaksen, Tore & Ellingham, Brian (2012). Assessment of Communication and Interaction Skills (ACIS): Kartlegging av ferdigheter i kommunikasjon og interaksjon ved utførelse av aktiviteter og bruk av redskapet innen psykisk helsearbeid. Full text in Research Archive
• Bonsaksen, Tore; Myraunet, Ingunn; Celo, Cecilia; Granå, Kjell Emil & Ellingham, Brian (2012). Usefulness of the Assessment of Communication and Interaction Skills as experienced by occupational therapy practitioners and their students. Full text in Research Archive
• Bonsaksen, Tore & Melton, Jane (2011). The MOHO Institute 2011: Summary and Reflections. Ergoterapeuten. ISSN 0800-3475. 54(1), p. 6–9. Full text in Research Archive
• Fagermoen, May Solveig; Lerdal, Anners & Bonsaksen, Tore (2011). Kan endring i mestring etter LMS-kurs måles? Full text in Research Archive
• Bonsaksen, Tore; Hustadnes, Anne Lise; Axelsen, Per Møller & Bjørnsborg, Eva (2011). Lærer å mestre sykelig fedme. Tidsskriftet sykepleien. ISSN 0806-7511. 99(2), p. 58–60. Full text in Research Archive
• Bonsaksen, Tore (2011). The role of mindfulness in physical activity. International Journal of Therapy and Rehabilitation (IJTR). ISSN 1741-1645. 18(3), p. 177–177. Full text in Research Archive
• Bonsaksen, Tore & Hagby, Cathrine (2010). Kommentarartikler i Ergoterapeuten – en ny arena for faglig diskusjon. Ergoterapeuten. ISSN 0800-3475. 53(5), p. 38–39. Full text in Research Archive
• Bonsaksen, Tore; Myraunet, Ingunn; Celo, Cecilia; Granå, Kjell Emil & Ellingham, Brian (2010). Bedre samarbeid mellom utdanning og praksis – erfaringer fra ACIS-prosjektet. Ergoterapeuten. ISSN 0800-3475. 53(6), p. 52–55. Full text in Research Archive
• Andenæs, Randi; Lerdal, Anners; Bjørnsborg, Eva; Bonsaksen, Tore; Borge, Lisbet & Christiansen, Bjørg [Show all 9 contributors for this article] (2010). Personal factors associated with health related quality of life in patients attending patient education courses while waiting for bariatric surgery. Quality of Life Research. ISSN 0962-9343. 19. Full text in Research Archive
• Hagby, Cathrine & Bonsaksen, Tore (2010). Retningslinjer for fagartikler i Ergoterapeuten. Ergoterapeuten. ISSN 0800-3475. 53(4), p. 46–47. Full text in Research Archive
• Andenæs, Randi; Lerdal, Anners; Bjørnsborg, Eva; Bonsaksen, Tore; Borge, Lisbet & Eide, Hilde [Show all 9 contributors for this article] (2010). Personal factors associated with Health Related Quality of Life in patients attending patient education courses while waiting for Bariatric Surgery. Full text in Research Archive Show summary

  AIMS: In Norway, patients who are on the waiting list for bariatric surgery have to attend a comprehensive patient education course at a Patient Education Resource Center. Previous research has shown that obesity is related to the individuals self-report of physical and mental health. The aim of this study was to explore factors related to HRQoL that might be targeted in future health promotion interventions among participants in patient educational courses. METHODS: Data were collected in a cross-sectional correlation design by self-reported questionnaires. Setting: Day 1 or 2 in health promotion educational courses in Norway. Subjects: Out of the 185 patients who attended the courses, 142 (76.8%) volunteered to participate and 128 had valid responses on all items. Mean age was 42.4 years (SD=10.4) and 90 of the participants (70.3%) were women. Measures: HRQoL was measured with the Short Form-12v2 . Other standardized instruments measured Self-Esteem Scale (RSES 4 item version), Sense of Coherence (SOC-13), Self efficacy (GSE), Coping style (BACQ), social support, and regular physical activity. Descriptive, correlational and multivariate linear regression. RESULTS: The obese scored lower on all the HRQoL sub-domains compared with norms. Lower age, having a paid job, being physical active was related to the participants physical health. Multivariate analyses showed that personal factors explained 3.6% of the variance in physical health and 41.6% in the mental health. CONCLUSIONS: Personal factors as self-esteem, sense of coherence and a high approached coping style are strongly related to obese peoples mental health.

• Brown, Ted; Voigt-Radloff, Sebastian; Bonsaksen, Tore & Nes, Fenna van (2009). Respons op “Reacties” op het artikel “Wetenschappenlijk onderzoek in de ergotherapie: Overdenkingen na het achtste Europese ergotherapiecongres”. Voortzetting van de dialoog. Wetenschappenlijk Tijdschrift voor Ergotherapie. ISSN 1876-3227. p. 27–29. Full text in Research Archive
• Bonsaksen, Tore (2009). Occupational Therapy and Life Course Development: A Work Book for Professional Practice. International Journal of Therapy and Rehabilitation (IJTR). ISSN 1741-1645. 16(10), p. 573–574. Full text in Research Archive
• Lund, Henriette Tuer; Ouazzif, Loubna; Edsbergløkken, Vidar & Bonsaksen, Tore (2009). Fysisk aktivitet ved alvorlig psykisk lidelse: Bakgrunn, intervensjon og kliniske erfaringer. Ergoterapeuten. ISSN 0800-3475. 52(9), p. 30–33. Full text in Research Archive
• Bonsaksen, Tore; Ouazzif, Loubna & Edsbergløkken, Vidar (2009). Fysisk aktivitet for pasienter med alvorlig psykisk lidelse. Full text in Research Archive
• Bonsaksen, Tore; Brown, Ted & Voigt-Radloff, Sebastian (2008). Occupational Therapy Research: Where do we take it from here? International Journal of Therapy and Rehabilitation (IJTR). ISSN 1741-1645. 15(9), p. 376–376. Full text in Research Archive
• Brown, Ted; Voigt-Radloff, Sebastian & Bonsaksen, Tore (2008). Research in Occupational Therapy. Ergoterapeuten. ISSN 0800-3475. 51(11), p. 32–37. Full text in Research Archive
• Bonsaksen, Tore; Lerdal, Anners; Borge, Finn-Magnus; Borge, Finn Magnus & Hoffart, Asle (2008). Utvikling av gruppeklima – hva betyr det for pasienters bedring i gruppeterapi? Ergoterapeuten. ISSN 0800-3475. 51(2), p. 12–19. Full text in Research Archive
• Bonsaksen, Tore & Torgersen, Tone (2008). Fagidentitet i ergoterapi. En gjennomgang av fagartikler i Ergoterapeuten i 2007. Ergoterapeuten. ISSN 0800-3475. 51(3), p. 26–31. Full text in Research Archive
• Bonsaksen, Tore & Torgersen, Tone Magna (2008). Fagidentitet i ergoterapi. En gjennomgang av fagartikler i Ergoterapeuten i 2007. Ergoterapeuten. ISSN 0800-3475. 51(3), p. 26–31. Full text in Research Archive
• Bonsaksen, Tore (2004). Endring av samspill, endring av selvbilde. Ergoterapeuten. ISSN 0800-3475. 47(6), p. 54–57. Full text in Research Archive
• Bonsaksen, Tore (1997). En hilsen til nissen på lasset. Ergoterapeuten. ISSN 0800-3475. 40(6), p. 8–12. Full text in Research Archive
• Bonsaksen, Tore & Baklien, Børge (2024). PROWORK – evaluering av en ny praksismodell for å fremme arbeidsdeltakelse blant unge med nedsatt arbeidsevne. Høgskolen i Innlandet. Full text in Research Archive
• Heir, Trond; Hansen, Marianne Bang; Bonsaksen, Tore; Saur, Randi & Brunes, Audun (2022). Synstap og psykisk helse. NKVTS, Nasjonal behandlingstjeneste for sansetap og psykisk helse. ISSN 9788281221673. Full text in Research Archive
• Kolltveit, Eldri; Bonsaksen, Tore & Berge, Guro (2021). Kva fremjar og kva hemmar deltaking i fysiske treningsgrupper ved ein kommunal frisklivssentral? VID. Full text in Research Archive Show summary

  Samandrag Mål: Å få kunnskap om kva som fremjar eller hemmar deltaking i dei fysiske aktivitetsgruppene ved ein frisklivssentral (FLS). Metode: Det er her utført kvalitative intervju av 8 deltakarar. Innhaldet i intervjua er kategorisert etter komponentane person, omgjevnad og aktivitet, og her er sett på kva som kan vere fremjande eller hemmande faktorar innan desse kategoriane. Resultat: Det finst hemmande og fremjande faktorar innan alle desse tre områda; person, omgjevnadar og aktivitet. Flest faktorar omhandla det personlege. Det er viktig at FLS tilpassar tilbodet, og vektlegg både fremjande faktorane samt identifiserar dei hemmande faktorane. Deltakarane skildrar at dei har andre behov for hjelp i dette arbeidet enn private aktørar kan gi dei. Dei har behov for at instruktør er helsepersonell som kjenner deira sjukesoge og utfordringar, og som kan tilpassa både motivasjonsstøtte, oppfylgjing og øvingar til den einskilde, i små grupper. Konklusjon: Fire hovudråd til praksisfeltet er her identifisert: 1) Det er eit sterkt behov for eit helseretta kommunalt tilbod som assisterar livsstilsendringar, slik FLS gjer. Tilbodet ved FLS er viktig for at deltakarane skal få til ei livsstilsendring. 2) Det er viktig at tilbodet er individuelt tilpassa og skreddarsydd for at deltakarane skal få til ei gradvis omlegging. 3) Det er viktig at FLS har tverrfaglege helsefaglege ressursar å tilby då deltakarane ofte har samansette både fysiske og psykiske utfordringar. 4) Det er viktig at tilbodet når dei personar som har behov for tilbodet, i rett tid. Det krev at tilbodet vert tilpassa både med tanke på personen, omgjevnadane og sjølve innhaldet på aktiviteten, og at FLS identifiserar både fremjande og hemmande faktorar innan alle desse 3 områda. Kunnskapsbasert skreddarsaum i aktivitetstilbodet er gjerne det viktigaste elementet i tilbodet ved FLS. Til dette trengs det tverrfaglege ressursar som har tid avsett til dette viktige arbeidet.

• Bonsaksen, Tore (2007). Predikerer gruppeklimaet behandlingsresultat i gruppeterapi? En sammenliknende studie av interpersonlig terapi og kognitiv terapi for innlagte pasienter med sosial fobi. Universitetet i Sørøst-Norge/Universitetet i Søraust-Noreg. Full text in Research Archive

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