title: Occupational performance modification and personal change among clients receiving rehabilitation services for rheumatoid arthritis.
abstract: BACKGROUND
  A client's personal process of change is recognised as an important element in the rehabilitation process that may affect the acceptance and outcome of recommended occupational therapy self-management interventions. Recent research has examined the transformative process of changing underlying values, beliefs, feelings and knowledge, collectively known as meaning perspectives, in clients receiving rehabilitation for various chronic conditions.
  
  
  OBJECTIVE
  This article presents the findings of a Grounded Theory Qualitative retrospective study of 10 adults diagnosed with rheumatoid arthritis receiving occupational therapy to modify their daily living environment and activities to maximise the quality of life and occupational performance. They were interviewed twice in a semidirected manner.
  
  
  RESULTS
  Two personal change processes were identified for two different courses of the illness: progressive adaptation during a course of gradual steady development of symptoms without remission, and complex adaptation that led to transformation during a course of acute development of symptoms with periods of remission.
  
  
  CONCLUSIONS
  Implications for more effective and efficient occupational therapy interventions are suggested.
authors.affiliation: School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada. Dubouloz@uottawa.ca
authors.forename: Claire-Jehanne
authors.initials: CJ
authors.lastname: Dubouloz
authors.forename: Josée
authors.initials: J
authors.lastname: Vallerand
authors.forename: Diane
authors.initials: D
authors.lastname: Laporte
authors.forename: Brenda
authors.initials: B
authors.lastname: Ashe
authors.forename: Martha
authors.initials: M
authors.lastname: Hall
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D001172:Arthritis, Rheumatoid / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy / Q000379:methods*; D009864:Ontario; D010353:Patient Education as Topic / Q000379:methods*; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome