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ID: 110144729 | Shivani Patel

Occupational science Assignment 3 Ischaemic heart diseases Introduction Occupational life is constituting of important factors that influence health and well-being. As occupation is identified as every task or activities of daily living, in which people engage and consist meaning in their lives. Through participating in occupation individual create their own identity. In the assignment will discuss the occupational identity that is influenced by a chronic condition such as rheumatoid arthritis. This limits the development of identity and restricting engagement in the occupation of choice due to physical pain and psychological distress.

Additionally, occupational allow opportunities to construct identity through

engagement in occupation. Occupation identity is impacted by chronic condition and result in loss of self-identity in a context of the individual. For individual identity is essential for lives and well-being. Background Chronic diseases have a prolonged duration, do not cure spontaneously and are rarely cured completely (AIHW 2012, p.5). Chronic diseases are complex and has extent of condition effect on the community (AIHW 2012, p.5). While some chronic condition can cause premature death, others contribute more to disability. As chronic condition has a longer development period with no symptoms and later cause other health complication which can be associated with functional impairment or disability (AIHW 2012, p.5). In Australia, musculoskeletal condition like rheumatoid arthritis is a most common joint disease that has affected around 28% of Australians (AIHW 2015), it is considered as second most common type of arthritis (AIHW 2009). A research stated that rheumatoid arthritis significantly increases a chance of premature death. In Australia, there was 169 (123 females and 46 males) death from rheumatoid arthritis in 2006 (AIHW 2009). Rheumatoid arthritis is more common between females and older age group. It is an autoimmune disease, which means immune system attacks its own body tissue and affect other organs as well as the joints (AIHW 2009, p1). The main symptoms of the disease are a pain, morning stiffness, swelling, fatigue and limited movement of the affected joints (AIHW

ID: 110144729 | Shivani Patel

2009, p1). The cause of rheumatoid arthritis is not well evidenced, to cause by genetic or environmental factors. Although, genetic factor is considered to play a key role and along with smoking may increase the risk of developing the diseases AIHW (2009). The major cause of rheumatoid arthritis is disability and psychological distress among individual, which result in lack of daily life activities and inversely impact on their family members. According to AIHW (2009), the diseases reduces person’s capacity to work with 31% of those affected in full-time employment in 2004-05 compared with 53% of the general population. There is only 4% accounted expenditure for rheumatoid arthritis assistance by a government (AIHW 2009). While rheumatoid arthritis is known as disabling disease which causes pain, reduces mobility, fatigue and depression. By decreasing physical functioning and limiting the activity of choice resulting in altering the individual perception of health and well-being considerably (AIHW 2009). Also, affect earning capacity and restriction in social interaction are more devastating. Hence, the disease increases the level of disability in the community and impact on health care system to manage disease (AIHW 2009). Furthermore, persons age 15-64 years being unable to work is one of the most common problems associated with rheumatoid arthritis (AIHW 2009). As, decrease capacity to work cause major financial and psychological issues for a person with the diseases. Due to person inability to workplace social and economic burden on the community to maintain employment is affected and individual identity. Occupational identity Occupation identity is defined as “a composite sense of who one is and wishes to become as an occupational being is generated from one’s history of occupational participation” (Kielhofner 2002 cited in Phelan and Kinsella 2009). Occupational identity integrates all one’s habituation, volition and experience in life. In model by Kielhofner (2008) on human occupation, occupational identity and occupation competence are stated to be interrelated and influence the success of occupational adaptation. As occupational competence form pattern for occupational participation to reflect on one’s identity (Phelan and Kinsella 2009). While occupational adaptation is defined as constructing a positive occupational identity and achieve occupational competence in one’s environment context (Kielhofner 2008). Thus,

ID: 110144729 | Shivani Patel

expect from people to be cultural narrative within their social grouping and life experiences, challenges and opportunities (Christiansen 1999). Occupation and identity have explicit connection between the individuals. Through participating in occupation, one can construct identity and a means for communication to ourselves with the context necessary for creating meaningful lives (Christiansen 1999, p. 547). Identity is an influential in social life, as it provides contexts for deriving meaning from daily experience and interpreting in our lives. By achieving occupational competence in tasks, it contributes to shaping identity and thus an acceptable identity will contribute to coherence and well-being (Christiansen 1999). Within the theories, there may be limited performance and resulting disfigurement due to a chronic condition which impacts on identity implication. This must be recognised by occupational therapy practitioner (Christiansen 1999) to help address the identity challenges of those who serve and contributing to wellbeing. An occupation is linked to well-being, as it fulfils humans needs and provides means to organise a space and time. To enable a medium for developing an acceptable self-identity, manage social identity and control essential condition factors that are affecting daily life activities (Rudman 2002). Hence occupational identity theory has proposition such as demonstration core characteristics, limiting and expanding possibilities, maintaining an acceptable self-identity and managing social identity (Rudman 2002). Occupation is a base through which people express their individuality among others and relates to occupational performance as their basic nature (Rudman 2002). In some case, occupation limits opportunities to engage in an occupation, which restricts individual identity management, whilst having opportunities for occupational engagement allows the potential for growth and reconstructing identities. As identity is an important central figure that provides meaning for everyday life (Phelan and Kinsella 2009). Because life is derived in the context of identity, it is a crucial element in promoting well-being and life satisfaction (Phelan and Kinsella 2009). Also, maintaining an acceptable self-identity is important for continuity of identity through occupation. Engaging in that occupation that is meaningful and important, which reflect the identity and continuing developing their identity through occupation engagement (Rudman 2002). Thus, an occupation to be successful there needs to be supportive environment context which enables individual identity development. According to Nelson (1988) occupation is defined as relationship between occupational form and performance depending on the meaningfulness of

ID: 110144729 | Shivani Patel

occupational form. The individual and their purpose for the occupational performance will reflect on their developing structure. The dynamic interwoven relationship of an occupation performance is influenced by the occupational form which influences individual occupational adaptation. Application of problem in terms of health and well-being A chronic condition such as rheumatoid arthritis results in consequences in life through loss of productive function, financial crises, family strain and a restricted existence. Due to reducing capacity to work result in unemployment and lack of social relationship. Over time, a person with the condition may become dependent and immobilised (Charmaz 2008). This causes a person to go through physical discomfort, psychological distress and deleterious effects on identity (Charmaz 2008). This influencing factors may lead to a person feeling a loss of self due to the chronic condition, with diminished control over their lives and their future. This would affect individual’s loss of their self-identity and self-esteem. In addition, occupational identity is impacted due to lack of occupation, which can be re-constructed through managing and negotiating with occupation in daily life. A rheumatoid arthritis is more common among female and in older age groups (AIHW 2009). This affects their identity in a family role and social life in the community.

ID: 110144729 | Shivani Patel

Reference: Australian Institute of Health and Welfare 2009, ‘A picture of rheumatoid arthritis in Australia’, Department of Health and Aging, Australian Government, no. 9, pp. 1-20, viewed 12 June 2017, < http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442459857> Australian Institute of Health and Welfare 2015, ‘Chronic diseases’, AIHW, Australian Government, viewed 12 June 2017, < http://www.aihw.gov.au/chronic-diseases/> Australian Institute of Health and Welfare 2012, ‘Risk factors contributing to chronic diseases’, AIHW, Australian Government, viewed 11 June 2017, < http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737421546> Charmaz, K 1983, 'Loss of self: a fundamental form of suffering in the chronically ill', Sociology of Health & Illness, vol. 5, no. 2, pp. 168-195. Christiansen, C 1999, ‘Defining lives: occupation as identity: an essay on competence, coherence, and the creation of meaning’, The American Journal of Occupational Therapy, 53(6), 547-558. Entezami, P, Fox, DA, Clapham, PJ & Chung, KC 2011, ‘Historical Perspective on the Etiology of Rheumatoid Arthritis’, Hand Clinic, Issue 1, vol. 27, pp. 1-10. Hammell, RW & Iwama, MK 2012, 'Well-being and occupational rights: An imperative for critical occupational therapy', Scandinavian Journal of Occupational Therapy, 2012, Vol.19(5), p.385-394, vol. 19, no. 5, pp. 385-394. Iwama, MI 2010, ‘Cultural perspective on occupation’, in Christiansen, C & Townsend, E (eds), Introduction to occupation: The art of science of living, 2nd edn, Prentice Hall, New Jersey, pp. 35-55. Kielhofner, G 2008, ‘Doing and Becoming: Occupational Change and Development’, Model of human occupation : theory and application, 4th edn, Lippincott Williams & Wilkins, Baltimore, Md., pp. 101-109. Laliberte-Rudman, D 2002, ‘Linking occupational identity: Lessons learned through qualitative exploration’, Journal of occupational Science, vol. 9, no. 1, pp. 12-19. Nelson, DL 1988, 'Occupation: form and performance', American journal of occupational therapy, The, vol. 42, no. 10, pp. 633-641. Phelan, S & Kinsella, EA 2009, ‘Occupational Identity: Engaging soci-cultural perspectives’, Journal of Occupational Science, vol. 16, no.2 pp. 85-91.

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