UBC Theses and Dissertations
The health-promoting potential of occupations : an exploratory study of adults with and without inflammatory arthritis To-Miles, Flora
Introduction: Inflammatory arthritis (IA) can limit everyday occupations, yet engaging in valued occupations is believed to promote health. This dissertation explores the relationship between occupation and health in adults with IA and a healthy comparison (HC) group, and the impact of public health restrictions on occupation and health during the first wave of the COVID-19 pandemic. Methods: A cross-sectional design was employed with participants recruited through community advertising. Occupations were elicited and occupational characteristics measured using Personal Projects Analysis; and aspects of health assessed using the SF-36 Health Survey (Physical and Mental Component Scores), Occupational Balance Questionnaire, Satisfaction with Life Scale, and telomere length (from dried blood spots). During the first “stay home” phase of the pandemic, all self-report measures were repeated online to compare with pre-pandemic ratings. Data were analyzed with content analyses, Chi-square tests, t-tests, linear regressions, and ANCOVAs. Results: 143 adults (76 HC, 67 IA) participated in the cross-sectional study; a subset of 71 (37 HC, 34 IA) participated in the pandemic before-and-after study. Participants engaged in six major categories of occupations related to health, leisure, home, community, relationships, and life planning. These categories did not differ between IA and HC groups. The IA group rated occupational characteristics higher than the HC group, with between-group differences in three of the 19 characteristics after controlling for demographic covariates. Different occupational characteristics were associated with physical health for the two groups; among the more salient characteristics were the perceived Difficulty, Importance, Stress, Progress, Others’ view, and Control attributed to one’s occupations. Occupational balance was higher in the HC group than the IA group, but not statistically significant when adjusted for physical health. There was no between-group difference in telomere length, or associations between occupational characteristics and telomere length. Mental health scores decreased compared to pre-pandemic ratings in the HC group only, and the IA group engaged in fewer social occupations than the HC group. Conclusion: These findings help fill a gap in the literature with a nuanced understanding of the association between occupation and health, which may inform recommendations on the kinds of occupations likely to promote health.
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