Poole Janet L, Baldonado Monica, Powell Aubrie, Hukill Virginia Stofer
School of Medicine, University of New Mexico, Albuquerque, NM, USA.
Rio Rancho Public Schools, Rio Rancho, NM, USA.
Br J Occup Ther. 2024 Jan;87(1):31-38. doi: 10.1177/03080226231190506. Epub 2023 Aug 4.
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.
本研究探讨了系统性硬化症患者在进行有价值的义务性（自我护理）、承诺性（家庭管理、照顾他人、工作效率）和自主性（休闲和社交）活动时所采用的策略。
这项横断面研究纳入了92名系统性硬化症患者的便利样本，他们完成了“有价值生活活动量表”（VLA）。VLA将活动分为三个主要领域：义务性、承诺性和自主性。参与者指出了每项活动所采用的适应性策略类型（辅助设备、个人协助、减少频率和花费更多时间）。参与者还完成了一份人口统计学问卷以及疼痛、疲劳、抑郁和日常活动表现的测量。计算了每项活动所采用策略的频次。单向方差分析比较了三个领域（义务性、承诺性和自主性）中策略的平均使用情况。皮尔逊相关系数计算了策略使用与疼痛、疲劳、抑郁和日常活动表现之间的关系。
值得注意的是，与义务性活动相比，承诺性活动使用的策略更多。与义务性活动相比，在承诺性和自主性活动中，更多地采用了减少活动频率的策略。最少使用的策略是辅助设备和他人协助。疲劳和抑郁与策略使用有关，而疼痛和日常活动表现则无关。
系统性硬化症患者使用适应性策略来进行VLA活动。然而，最常使用的策略，如花费更多时间或减少某些活动的频率，可能会导致放弃其他有价值的活动。
