Arthritis: Patients’ Perspectives on Quality of Life and Occupation

PURPOSE: This qualitative study explored patients’ perspectives on how they viewed quality of life and how arthritis affected their quality of life and their occupations.

DESIGN: This qualitative study was based on grounded theory. Participants were recruited from three closed, online, arthritis and/or pain Facebook support communities, ensuring they were engaged patients. They were age 18 or older, resided in the United States, spoke English, and had a self-report diagnosis of arthritis by a health professional.

METHOD: Following approval from the institutional review board, the researchers posted a link to a survey on three closed arthritis- and pain-related Facebook communities. The survey contained open-ended questions about engaged patients’ perspectives on quality of life and occupations of people who live with osteoarthritis and rheumatoid arthritis. The survey consisted of questions about comorbid conditions, symptoms, quality of life, occupation and participation, coping methods, and goals. Open-ended questions allowed the participants to provide their voices to investigators. Data were collected from members of multiple arthritis and pain support groups to ensure rigor and trustworthiness of the data, and multiple researchers participated in data analysis to support triangulation. Qualitative data were analyzed using grounded theory to produce themes until saturation was reached.

RESULTS: Saturation was reached at Respondent 31. Responses from participants indicated a decrease in activities of daily living, physical activity, employment, and leisure activities. In spite of these limitations, participants defined quality of life in terms of occupations in which they would like to participate rather than things they could not do. Participants defined quality of life in terms of participation in valued occupations.

CONCLUSION: Standard measures of quality of life are based on the clinically defined health-related quality of life measures on the SF–36 (Kosinski, Keller, Hatoum, Kong, & Ware, 1999). Participants need to be able to express their goals and desired occupations in their own voices. This study used qualitative methods to use patients’ voices to explore their perception of quality of life. Our research shows that patients with arthritis define quality of life in terms of occupational autonomy, meaning the ability to participate in desired occupations when one so desires (Kornblau, 2006). The American Occupational Therapy Association’s (2017) Vision 2025 says, “Occupational therapy maximizes health, well-being, and quality of life for all people, populations, and communities through effective solutions that facilitate participation in everyday living” (p. 1). Findings in this study support Vision 2025 because they show maximizing health, well-being, and facilitate participation. This study also supports research promoting health behaviors to prevent and manage chronic conditions. With both osteoarthritis and rheumatoid arthritis, the primary concern for living with these conditions is to decrease the impact of the conditions on quality of life. This study supports occupational therapy intervention to address engaged patients’ perceived needs for occupation and participation to support quality of life for individuals with arthritis and perhaps other chronic conditions.

IMPACT STATEMENT: This study supports occupational therapy intervention to address quality of life and participation of individuals with arthritis and other chronic conditions. As the population ages, this study could open doors for occupational therapy intervention to improve quality of life.