Perceptions of Occupational Therapy Interventions by People With Rheumatoid Arthritis

PURPOSE AND BACKGROUND: The purpose of this study was to explore perceptions of occupational therapy services and their effectiveness for people living with rheumatoid arthritis (RA). Treatment for RA can cost up to $20,000 throughout an individual’s lifetime because of the continually rising costs of medication. Pain is one of the primary symptoms in people with RA, who seek various forms of treatment for their pain. Occupational therapy intervention is one such treatment option. Common occupational therapy interventions include splinting and heat treatments (Ekelman et al., 2014). The goal is to improve quality of life and overall well–being.

METHOD: This qualitative study explored how people with RA view occupational therapy services through an online survey of open–ended questions. Participants were recruited with permission from closed Facebook support communities for individuals with chronic pain and RA, Twitter, and word of mouth. Inclusion criteria were self–report of RA diagnosis, age 18 or older, and receipt of occupational therapy services. Following approval by the institutional review board, a recruitment message with a link was posted to the online sources. The link led participants to an online, Qualtrics–based (Provo, UT) survey of open–ended questions that explored how people with RA view occupational therapy. Data were analyzed by a team of three researchers using content analysis. Data analysis was reviewed by an experienced qualitative researcher. Multiple researchers and data collection from multiple sources ensured triangulation and rigor and trustworthiness of the data.

RESULTS: Eight female participants aged 45 and older completed the survey. Several themes emerged from the data analysis. One theme supported assistive devices as an effective method to reduce RA pain. Another theme stressed the temporary nature of occupational therapy intervention for RA pain. Another theme indicated that whereas before RA onset most participants could work and engage in social participation, the quality of their social participation changed after diagnosis. RA interfered with participants’ ability to participate in meaningful activities they were once able to do. Some participants found occupational therapy services helpful and effective in addressing their pain through a variety of interventions, such as assistive devices, splinting, and interventions directed at achieving their goals and improving their quality of life, whereas others seemed to disagree. Additionally, some found only temporary pain relief during treatment sessions and believed that more sessions would help with pain management.

IMPACT STATEMENT: This study provides a glimpse into how people with RA view occupational therapy services. Occupational therapy can provide an important link between RA and participation in daily life. A greater focus on pain management in occupational therapy can promote participation for people with RA.

References

Ekelman, B. A., Hooker, L., Davis, A., Klan, J., Newburn, D., Detwiler, K., & Ricchino, N. (2014). Occupational therapy interventions for adults with rheumatoid arthritis: An appraisal of the evidence. Occupational Therapy in Health Care, 28, 347–361. https://doi.org/10.3109/07380577.2014.919687

Fox, A., Kelly, C., Heycock, C., Saravanan, V., Rynne, M., & Hamilton, J. (2014). Pain management in patients with rheumatoid arthritis [Abstract]. Rheumatology, 53(Suppl. 1), i171–i172. https://doi.org/10.1093/rheumatology/keu126.002

Kay, J., & Upchurch, K. S. (2012). ACR/EULAR 2010 rheumatoid arthritis classification criteria. Rheumatology, 51(Suppl. 6), vi5–vi9. https://doi.org/10.1093/rheumatology/kes279