Date Presented 4/20/2018
People with arthritis often experience limitations in leisure activity engagement. In-depth interviews with four women with arthritis revealed occupational performance modifications to support full participation in quilting-related leisure activities.
Primary Author and Speaker: Rachel Proffitt
Additional Authors and Speakers: Meredith Abraham, Christina Hughes
PURPOSE: Arthritis can negatively impact hand function, limiting performance in all areas of daily life, including leisure activities. Little research has explored the impact of arthritis on leisure activities, and none has explored the specific occupation of quilting and related activities (e.g., sewing). For women with chronic conditions, participation in textile arts can lead to increased self-esteem and positive feelings. The aim of this study was to describe the experience of people with arthritis who engage in sewing and quilting as a leisure activity. Additionally, we sought to understand how occupational therapy practitioners can support new or continued engagement in these chosen occupations.
METHOD: This study had a qualitative, exploratory design similar to other studies of engagement in leisure activities. Participants were recruited via convenience and snowball sampling from local quilting and sewing groups if they had been diagnosed with arthritis (of either type) that affected their hands and regularly engaged in quilting or sewing. The study was approved by the University of Missouri Health Sciences institutional review board.
Face-to-face and phone interviews were conducted depending on participant availability. All interviews were audio recorded. The interview questions were structured to explore any functional limitations resulting from upper extremity deficits, ascertain barriers to participation, and learn about task modifications, including the use of assistive technology. Participants who completed in-person interviews also provided feedback on various seam ripper handles because this is one of the many tools used by quilters. This feedback provided additional information on assistive technology supports during quilting for people with arthritis.
Interviews were transcribed verbatim in preparation for coding. Researchers independently coded the transcripts and met continually during this process to ensure that themes defined were consistent. During these meetings, the researchers continually refined the themes to further ensure that themes were related to participant insight.
RESULTS: The Person–Environment–Occupation (PEO) Model provided a framework for describing the participants’ engagement in quilting as an occupation. Within the model, specific to engagement in quilting as a leisure activity, there were areas of overlap. The overlap between the P (arthritis) and the O (quilting) components included modifications to the time spent on quilting and sewing. The overlap between the P (arthritis) and the E (social support and environment) components included choice of tasks. The final overlap between the O (quilting) and the E (environment) components included use of tools.
CONCLUSION: These findings provide a basis of knowledge for ways occupational therapy practitioners can support full participation in quilting as a leisure activity for people with arthritis. A focus on modifications—to the task, to the environment, or with addition of tools—to support occupational performance was key to these women being able to quilt and sew.
IMPACT STATEMENT: This is the first study to explore the impact of arthritis on quilting-related leisure activities using an occupational therapy frame of reference. These findings provide a foundation for designing occupational therapy interventions and tools to support full participation in quilting.
