Factors influencing occupational engagement in day centers for people with psychiatric disabilities.

Occupational engagement is a vital factor in people's lives since it has been shown to be important for health and well-being. Community-based day centers (DCs), both meeting place-oriented and work-oriented ones, are common service alternatives in many western countries for enabling engagement in productive and leisure occupations among people with psychiatric disabilities. Little is, however, known about factors influencing occupational engagement in such settings. We aimed to investigate how factors pertaining to day center attendance, socio-demographics, motivation, clinical and self-related characteristics were related to how day center attendees rated their occupational engagement in productive occupations. These variables were assessed among day center attendees in meeting place-oriented (n = 39) and work-oriented (n = 54) DCs in Sweden through questionnaires and interviews. Logistic regression models showed that (1) less general psychopathology and more time spent on day center occupations were indicators of belonging to the group with a high level of occupational engagement according to a median cut; (2) higher perceived self-mastery was the only important factor with respect to ratings of occupational engagement above the third quartile. The models may be seen as creating a stepwise indication on which factors are important for reaching a medium level of occupational engagement (less severe general psychopathology and time spent at the day center) and for reaching a still higher level (a high level self-mastery), respectively, of occupational engagement. The findings may also be discussed in relation to different levels of engagement in a recovery process.