Negotiating Occupational Identities while Living with Chronic Rheumatic Disease

Abstract

The purpose of this study was to explore everyday occupation for five persons living with chronic rheumatic disease. Data were collected through qualitative interviews, followed by participant observations in the subjects’ homes. The data were analysed using a qualitative comparative approach, followed by an interpretation of the results based on narrative theory. Four themes were identified from the analyses: (a) the continuing challenges of everyday occupational life, (b) activities anchored to personal occupational history, (c) everyday occupations mediating personal meaning, and (d) activities involving suspense or unpredictability. The results showed that everyday occupation was a challenge for the participants, as their illness caused considerable variation in pain and functional abilities. This influenced the subjects’ ability to perform occupations of everyday life. Their individual occupational history was closely interwoven with their everyday life and served as the foundation for their way of managing the situation. The everyday occupations of the subjects also served as mediators of their personal values and interests, and they made changes following these issues, not as anticipated due to their changing functional condition. The narrative structure of occupation was found to provide the subjects with opportunities to manage issues concerning their identity and created high-level negotiating skills. Processes of negotiating occupational identities in the subjects’ everyday life are presented and discussed, and may add new knowledge to occupational therapy and occupational science, as well as generating further research questions.