Rheumatoid Arthritis and Self Esteem: The Impact of Quality Occupation

Abstract

Objective: To examine the influence of the quality of occupation on the rheumatoid arthritis-self-esteem relationship. Method: This study was a case comparison survey of 143 adults with rheumatoid arthritis (RA) and 142 non-disabled persons. Self-esteem (SE) was measured using a 10-item index. A daily log, which the individuals completed over a 24-hour period for 7 days, was used to capture time spent in occupations performed, which included work, activities of daily living (ADL) and leisure. The quality of occupation consisted of valued occupations, competently performed occupations, and dyadic occupations (occupations that were both valued and competently performed). Valued or competently performed occupation was operationalized as the product of the amount of time spent in hours in an occupation and the self-rating of that occupation when it had a 4.0 or higher rating on a 5.0 scale for either valued or competent occupations. For dyadic occupations, the means of the products, of the amount of time spent in an occupation and the self-rating when it was 4.0 or higher on a 5.0 scale for both, were calculated for both competent and valued occupations and combined. Results: Statistically significant differences existed between RA and the comparison group (t= 4.16, p <0.0001) for selfesteem. Competence in performing an occupation was the strongest moderator when the occupation was divided into its component parts of valued, competently performed or the dyad. When the occupation was further partitioned into the three categories -work, ADL and leisure -in combination with the three qualities of occupation, all were statistically significant at p < 0.05. Conclusions:The results provide support for the theoretical construct that occupation has a positive influence on the self-esteem of individuals with and without RA. The presence of valued and competently performed occupation, whether work, leisure or ADL related, appeared to be particularly important. These findings suggest a focus on a balance between doing (occupation) and being (self-esteem) which reflects satisfaction to them a balance between quality of occupation and quality of life should be considered. While there are differences between the two groups, it appears that being competent is more important for SE for individuals with RA while the value attached to the occupation is a more important feature for SE for those without RA. These differences make investigating the determinants of occupation more interesting and challenging.

Are persons with rheumatoid arthritis deconditioned? A review of physical activity and aerobic capacity

“…In seven studies [14,22,24-27,30] samples of patients and controls were of equal size, in the remaining 5 studies group sizes differed significantly [13,23,28,29,31]. The majority of the patients were recruited from rheumatology or arthritis clinics, in one study from a rehabilitation centre [24] and in two studies [28,29] the recruitment method was unclear.…”

“…No information on the recruitment of controls was available in six of the studies [22,24-27,29]. In four studies healthy persons living in the same area were recruited [14,22,28,30], in one study healthy relatives acted as controls [31] and one study used information from the general Dutch population as reference [13]. …”

“…Different combinations of the following factors were used: race [26,27], age [22-24,26-28,30], gender [22,24,26,28,30] and body composition [22,26,27]. In one study groups were matched based on genetic and ethnic variables [31].…”

“…In another study time spent on PA was recorded during one week using an occupation log consisting of 10 different activities collapsed into 3 categories: work, activities of daily living (ADL) and leisure [30]. Results of these studies [26,30] showed that patients with RA spent an equal amount of time on PA as controls, but more time on light activities [26]. When PA was categorized as ADL, leisure and work, patients spent more time on ADL while spending less on work [30].…”

“…Results of these studies [26,30] showed that patients with RA spent an equal amount of time on PA as controls, but more time on light activities [26]. When PA was categorized as ADL, leisure and work, patients spent more time on ADL while spending less on work [30]. …”