Reshaping daily life: An observational study on the impact of rheumatoid arthritis on occupational repertoire

Rheumatoid arthritis (RA) restricts function and limits participation in everyday activities. While functional impairments are well-documented, RA's impact on occupational repertoire, particularly in leisure activities, remains underexplored.

To examine pre-post changes in occupational repertoire following RA onset and explore associations with functional status and disease activity.

In this cross-sectional study, 32 adults with RA (28 women) from a tertiary rheumatology clinic completed the DAS-28, HAQ-DI, and Activity Card Sort - Brazil (ACS-BR) rating changes in their occupational repertoire before and after disease onset.

Post-onset participation fell in all ACS-BR domains (p < 0.01), most sharply in Instrumental (r = 0.73), High-Demand leisure (r = 0.75), and Social activities (r = 0.63), with an ICF mapping showing increased participation in health-management tasks (p < 0.01, r = 0.40). Functional disability, not disease activity, correlated with reduced Instrumental (ρ = -0.57) and Social (ρ = -0.39) participation.

RA causes broad occupational disruptions, beyond self-care and productivity activities. Routine mapping of occupational repertoire can help occupational therapists detect early withdrawal from leisure and social roles, set client-centered goals, and monitor outcomes. Interventions that protect leisure and social participation, alongside self-management, may help sustain meaningful participation and quality of life.