Time use patterns among women with rheumatoid arthritis: association with functional limitations and psychological...

This study assessed time use patterns among 375 women with rheumatoid arthritis (RA). We hypothesized that (i) as functional limitations increased, time use imbalances would occur (i.e. time needed for obligatory activities would conflict with time needed for productive and free-time activities) and (ii) time use imbalances would be associated with psychological distress.

Time use estimates were obtained from written questionnaires; other study data were collected from annual telephone interviews. Activities were categorized as obligatory, committed or discretionary, as defined by Verbrugge. Time use estimates were aggregated to define number of obligatory (e.g. self-care) activities requiring >2 h/day and a number of committed and discretionary activities in which no time was spent each day.

After adjusting for age, education, marital status and pain severity, women with more functional limitations were significantly more likely to spend >2 h/day in obligatory activities. As functional limitations increased, the proportion spending no time in each committed activity and many discretionary activities increased. Spending >2 h/day in obligatory activities was not significantly associated with poor psychological status, but spending no time in a greater number of committed and discretionary activities was associated with lower life satisfaction and higher levels of depressive symptoms.

Having more severe functional limitations appears to shift time use patterns towards more time spent in obligatory activities and less time spent in committed and discretionary activities. These imbalances in time use were associated with psychological distress, highlighting the need for women with RA to maintain important productive, social and discretionary activities.