ArticleThe American journal of occupational therapy : official publication of the American Occupational Therapy Association2024
Whole Day Workload: Evaluation of a New Outcome Measure in Occupational Therapy for Adults With Type 1 Diabetes.
Article in The American journal of occupational therapy : official publication of the American Occupational Therapy Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Real-Time Psychological Factors Using Ecological Momentary Assessment With Continuous Glucose Monitoring in Diabetes Mellitus: Scoping Review.JMIR diabetes · 2026Review
- Ecological Momentary Assessment of Person-Reported Outcomes in Diabetes: Unlocking Insights with Continuous Glucose Monitoring and the Potential for Precision Medicine.Current diabetes reports · 2026Review
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7 authors.
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Abstract
importanceTypical whole day workload is a metric with potential relevance to the occupational balance and well-being of individuals with chronic conditions.
objectiveTo examine the reliability and validity of using multiple daily NASA Task Load Index measures (whole day TLX) as an indicator of typical whole day workload experienced by adults with Type 1 diabetes (T1D).
designParticipants with T1D completed cross-sectional measures and 2 wk of ecological momentary assessments (EMA) and daily diaries. Reliability was assessed across subgroups (e.g., workers vs. nonworkers); validity was evaluated with multilevel confirmatory factor analysis and with tests of convergent and divergent validity with patient-reported outcomes and blood glucose measures.
settingThree outpatient endocrinology clinics in the United States.
participantsData from 164 U.S. adults with T1D (42% Latino, 30% White). OUTCOMES AND MEASURES: Measures used included the whole day TLX (assessed via 2 wk of daily diaries), time in target blood glucose range (assessed with a continuous glucose monitor), illness intrusiveness (measured cross-sectionally), and stress (measured cross-sectionally and with EMA).
resultsNumber of days required for at least 0.70 reliability of the average whole day TLX ranged between 2 and 6 days depending on the subgroup. Results supported convergent and divergent validity of the average of the whole day TLX, including associations with average stress (r = .63, p < .001) and time in target blood glucose range (r = -.25, p = .002). CONCLUSIONS AND RELEVANCE: The whole day TLX was a reliable and valid indicator of typical whole day workload. Plain-Language Summary: The health management responsibilities for Type 1 diabetes can be extremely burdensome. When these responsibilities are experienced, in addition to duties such as work and caregiving, the totality of demands experienced (i.e., whole day workload) can create further issues, such as unhealthy physiological changes and interference with self-care. We tested the psychometric properties of a measurement tool that assesses the typical level of workload people experience. This measure, referred to as the NASA Task Load Index (whole day TLX), was found to be a reliable and valid indicator of typical whole day workload. Occupational therapists may use the whole day TLX to track progress in interventions focused on reducing clients' whole day workload exposure to promote their health and well-being. Occupational therapists' expertise in areas such as activity analysis, task adaptation, and energy conservation makes them especially well-suited to intervene on whole day workload.
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