To assess the importance of different social roles in the lives of people with osteoarthritis (OA), and satisfaction with time spent in roles and role performance, as well as the relationship of demographic, health, and psychological factors to role perceptions.
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Sixty women and 27 men (age 42-86 yrs) with hip or knee OA were recruited from rehabilitation programs and community advertising. Participants completed interview-administered questionnaires measuring demographics, OA symptoms, activity limitations, and well-being (e.g., depression). They also completed the Social Role Participation Questionnaire (SRPQ) assessing the influence of arthritis on role salience and satisfaction across diverse role domains (e.g., close relationships, employment).
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Participants reported many salient roles, but low to moderate satisfaction with them related to OA. SRPQ dimensions of salience and satisfaction were distinct; satisfaction with time spent in roles and with role performance was highly correlated (r = 0.83). Lower role salience was associated with being older, having less education and income, and greater illness intrusiveness. Less satisfaction with time spent in roles due to OA was associated with being younger, greater pain, and greater illness intrusiveness, whereas less satisfaction with role performance was associated with greater illness intrusiveness and depression.
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This study addresses a gap - the influence of OA on social role participation. It underscores the importance of taking into account individual perceptions of roles, and that these perceptions are multifaceted. Understanding diverse factors related to social roles may help identify individuals at risk for role difficulties and provide targets for interventions to improve role participation.
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Figure 1 presents mean role salience scores for the entire sample and satisfaction with time spent in roles and role performance means for those occupying the role across the 11 specific role domains and the global role question. Education was omitted because so few participants were involved in this role. Across the entire sample, social roles rated most salient included relationships with children, other family, and physical leisure activities. Roles rated less important included paid work and community, religious, or cultural activities. Social roles rated most satisfactory, considering OA joint problems, included intimate relationships, employment, relationships with children and other family. Roles rated less satisfactory considering OA joint problems included physical leisure, travel, hobbies and social events.
Separate multivariate regression analyses examined factors associated with role salience, satisfaction with time spent in roles, and role performance (see Table 4). Age, education, income, other chronic health conditions, and illness intrusiveness were significantly associated with role salience. Specifically, older adults (p < 0.02), those with secondary school or less education (p < 0.04), and those with less income (p < 0.04) reported lower importance of roles. There was also a trend for those with other chronic health conditions in addition to OA to report lower role importance overall (p < 0.08). Greater role salience was associated with the perception that OA was more intrusive in life (p < 0.02). These variables accounted for 46% of the variance. Less satisfaction with the time spent in roles related to OA joint problems was significantly associated with being younger, reporting more pain, and illness intrusiveness (all p < 0.01). A trend emerged with those reporting lower self-reported health also reporting lower satisfaction with time spent in roles (p <0.07). These variables accounted for 63% of the variance. Less satisfaction with role performance related to OA joint problems was associated with greater illness intrusiveness (p <0.03) and depression (p < 0.01) and with a trend for greater pain (p < 0.06). These variables also accounted for 63% of the total variance.
