Activity problems in everyday life – patients’ perspectives of hand osteoarthritis: “try imagining what it would be like having no hands”

Abstract

Purpose: To explore first-person perspectives on activities and participation in everyday life among people with hand osteoarthritis (OA). Method: Semi-structured interviews were carried out with 5 men and 26 women of different ages living with hand OA. Supplemental data were collected via photo-interviews of two of the men and nine of the women. The analytical process was inspired by the interpretive phenomenological analysis and informed by the interpretive frameworks of critical psychology and social practice theory. Results: Empirical findings indicate that persons with hand OA experience activity problems and participation limitations in the conduct of everyday life. Activity problems were related to self-care, paid work, as well as leisure activities. The participants also reported employing different strategies attempting to overcome the challenges of their everyday lives in order to keep actively performing valued activities. They reported environmental support of utmost importance for these attempts. Social participation in networks was also reported to be affected by the participants’ activity problems. Conclusions: Arranging everyday life is complex and is carried out in structures of social practice. A supportive physical and social environment facilitates participation. The findings highlight the importance of paying attention to individual needs in rehabilitation processes.

Implications for Rehabilitation

• Patients with hand osteoarthritis might have unmet needs for rehabilitative interventions targeting activity problems and participation restrictions related to work, self-care and leisure.

• Interventions targeting individual needs within fields such as ergonomics, adaptations of workplace environment, assistive technology and home modifications, may be relevant.

• Single living persons or people with sparse networks need special attention in clinical practice as they have fewer options for allocating difficult-to-perform tasks and therefore experience huge challenges in daily living.

• Hand
• osteoarthritis
• participation
• rheumatic disease

Acknowledgements

We thank the participants who willingly shared with us their experiences of activity and participation in the conduct of everyday life. Thanks also to the two rheumatologists Hanne Lindegaard and Jannie Beyer for assisting with the recruitment of participants for the study, and to associate professor Karen la Cour and senior researcher Tove Borg for their contribution in part of the early analysis process.