Strategies used by people with systemic sclerosis to perform valued occupations

This study explored the strategies used by people with systemic sclerosis to perform valued obligatory (self-care), committed (home management, care of others, productivity), and discretionary (leisure and socialization) activities. This cross-sectional study included a convenience sample of 92 people with systemic sclerosis who completed the Valued Life Activities Scale (VLA). The VLA categorizes activities into three main domains: obligatory, committed, and discretionary. Participants indicated the type of adaptive strategy used for each activity (assistive devices, personal assistance, limited frequency, and taking more time). Participants also completed a demographic questionnaire and measures of pain, fatigue, depression, and daily activity performance. Frequency counts were calculated for strategies used for each activity. One-way analyses of variance compared the mean use of strategies across the three domains (obligatory, committed, and discretionary). Pearson correlation coefficients calculated relationships between strategy use and pain, fatigue, depression, and daily activity performance. Significantly, more strategies were used for committed activities compared to obligatory activities. Limiting the frequency of performing an activity was used significantly more for committed and discretionary activities than for obligatory activities. The least used strategies were assistive devices and assistance from another person. Fatigue and depression were related to strategy use, whereas pain and daily activity performance were not. People with systemic sclerosis use adaptive strategies to perform VLA. However, the strategies, most frequently used, such as taking more time or limiting the frequency of performing some activities, may result in relinquishing other valued activities.