Influences of the social environment on engagement in occupations: The experience of persons with rheumatoid arthritis

Abstract

The aim of this explorative study was to describe and enhance the understanding of how persons with rheumatoid arthritis (RA) experience the influence of the social environment on their engagement in occupations. Nine persons were interviewed and the data obtained were analysed using a comparative method. The findings revealed that other persons in the social environment influenced informants' experiences of engaging in occupations in two ways, which formed the categories: "Constructive collaboration" and "Insufficient collaboration". These categories had certain properties related to the actions the others undertook to assist the informants during their collaboration. These assisting actions influenced the informants' possibilities to engage in occupations, and also their experience of engagement. The findings also showed that the "Conditions for collaboration" varied and influenced their collaboration, which thereby constituted a third category. The findings may contribute to a deeper understanding of how other persons can facilitate and restrict meaningful occupational experiences. This provides knowledge that can be used by occupational therapists when empowering their clients and those close to them to reflect on their actions and the consequences of these actions to enhance occupational engagement.

Being part of an unfolding story: togetherness in everyday occupations when ageing

“…Being invited, encouraged, and included by others was understood as a way to gain access to togetherness, especially when a person's life situation was challenged in some way. These findings are in line with earlier research (17)(18)(19)21,24) highlighting the significance of including the social environment when designing interventions and providing services aiming to promote participation and prevent loneliness and isolation.…”

“…Interestingly, these experiences are similar regardless of contexts and the health condition of the people studied. For example, participation involves doing something for or with others and meaning something to others (15)(16)(17)(18)(19), having an impact on and supporting others, as well as having a sense of social connection and community with others based on reciprocity (19,20). In addition, participation is experienced when people are included and valued by others (19,21) and when they feel needed and appreciated (17,19).…”

The importance for daily occupations of perceiving good health: Perceptions among women with rheumatic diseases

“…By using strategies and by avoiding certain occupations the individuals could persist in performing several daily occupations (15). RA can make individuals dependent on assistance when performing occupations such as self-care (15,18). The need for assistance can be essential for individuals with RA (15,(18)(19)(20)(21).…”

Living in the Present

“…This notion of disruption is emphasized in Scambler and Scambler (2010) who interpreted chronic illnesses as "assaults on the lifeworld." As an assault, chronic illness is a jarring intrusion within the context of people's private and public lives, it is uninvited and unwelcome (Nyman & Lund, 2007). The presumed assumptions that assist in directing everyday life to ensure that it is predictable and certain are no longer appropriate, relevant, or useful (S. Williams, 2000).…”

“…Within a multifaceted understanding of RA, the professionalclient relationship is informed by and "adapted to the everyday realities of individual's lives" (Plach, Stevens, & Moss, 2004, p. 138). The health professional's role is primarily one of actively supporting the individual's process of rethinking taken for granted assumptions and behaviors and reattributing meaning to everyday activities and roles (Hyden, 1997;Nyman & Lund, 2007). In this process, professional skills are used to "reframe the sufferer's [sic] situation, to reduce self-blame, validate the sufferer, provide a critical lens to their .…”