Social role participation and the life course in healthy adults and individuals with osteoarthritis: Are we overlooking the impact on the middle-aged?

Abstract

Little is known about life course differences in social role participation among those with chronic diseases. This study examined role salience (i.e., importance), role limitations, and role satisfaction among middle- and older-aged adults with and without osteoarthritis (OA) and its relationship to depression, stress, role conflict, health care utilization and coping behaviours. Participants were middle- and older-aged adults with OA (n = 177) or no chronic disabling conditions (n = 193), aged ≥40 years. Respondents were recruited through community advertising and clinics in Ontario, Canada (2009-2010). They completed a 45-50 min telephone interview and 20 min self-administered questionnaire assessing demographics (e.g., age, gender); health (e.g., pain, functional limitations, health care utilization); the Social Role Participation Questionnaire (SRPQ) (role salience, limitations, satisfaction in 12 domains), and psychological variables (e.g., depression, stress, role conflict, behavioural coping). Analyses included two-way ANOVAs, correlations, and linear regression. Results indicated that middle-aged adults (40-59 years) reported greater role salience than older-aged adults (60 + years). Middle-aged adults with OA reported significantly greater role limitations and more health care utilization than all other groups. Middle-aged adults and those with OA also reported greater depression, stress, role conflict, and behavioural coping efforts than older adults or healthy controls. Controlling for age and OA, those with higher role salience and greater role limitations reported more health care utilization. Those with greater role limitations and lower role satisfaction reported greater depression, stress, role conflict, and behavioural coping. This study has implications for research and interventions, highlighting the need to characterize role participation as multidimensional. It points to the importance of taking into account the meaning of roles at different ages among those with chronic diseases like OA when developing interventions to help understand the impact of roles on psychological well-being.

A Life Course Perspective to Spinal Cord Injury and Employment Participation in Canada

“…34 Although a reduced work capacity and withdrawal from roles like employment might be typical of this age group, 25,28,35,36 there is a risk that older adults with SCI might be retiring prematurely or choosing to not return to work post injury. As indicated in research of other disabling conditions, work disability in the older life phases may have significant negative implications for physical and psychosocial well-being and long-term loss of income.…”

“…It may be that participation in employment contributes to financial resources and self-confidence that supports participation in other valued social roles. 28,42 Alternatively, participating in roles such as parenting or marriage may encourage people with SCI to find paid work and attain financial independence to further support their involvement in those domains of life. Finally, the relationship between community participation and employment could be reciprocal and reinforce one another.…”

“…27 Involvement in these various roles is often associated with greater time demands or pressures. 28 In comparison, older adults at the later phase of their careers may be moving into another phase of life in which they could be preparing to withdraw from their involvement in multiple roles or reprioritize those that are most important. 25,26,[28][29][30] SCI and employment research has not typically examined changes in roles across the life course.…”

“…28 In comparison, older adults at the later phase of their careers may be moving into another phase of life in which they could be preparing to withdraw from their involvement in multiple roles or reprioritize those that are most important. 25,26,[28][29][30] SCI and employment research has not typically examined changes in roles across the life course. Also, commonly accessed disability models that guide research and practice often focus on age as a personal factor related to an increased likelihood of poorer functioning and may neglect the adaptations people may make to foster participation in valued social roles.…”

“…Also, commonly accessed disability models that guide research and practice often focus on age as a personal factor related to an increased likelihood of poorer functioning and may neglect the adaptations people may make to foster participation in valued social roles. 28,31 Consequently, for people living with SCI, the interrelationship between their injury, life phase, and involvement in important social roles like employment is not completely understood and requires examination.…”