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Adaptation to Chronic Illness and Disability and Its Relationship to Perceptions of Independence and Dependence

^a The Arthritis Community Research and Evaluation Unit, The University Health Network, Toronto, Ontario, Canada
^b Department of Public Health Sciences, University of Toronto, Ontario, Canada
^c Department of Physical Therapy, University of Toronto, Ontario, Canada

Monique A. M. Gignac, The Arthritis Community Research and Evaluation Unit, The University Health Network, PMH/OCI, 610 University Avenue, 16th floor Room 706, Toronto, Ontario, Canada, M5G 2M9 E-mail: gignac{at}uhnres.utoronto.ca.

Decision Editor: Toni C. Antonucci, PhD

This study extends research on living with chronic physical illness and disability by examining how adaptation processes are associated with different activity domains and how the combination of adaptations and activity domains relate to older adults' perceptions of their independence and dependence, helplessness, emotional reactivity, and coping efficacy. The study investigated the behavioral efforts that 286 older adults with osteoarthritis and/or osteoporosis used to adapt to disability arising from their condition. The findings revealed that adults used a wide range of adaptations, including compensations for loss, optimizing performance, limiting or restricting activities, and gaining help from others. The relative use of each of these adaptations varied across 5 domains of activity: personal care, in-home mobility, community mobility, household activities, and valued activities. Moreover, older adults' perceptions of their independence, dependence, helplessness, emotional reactivity, and coping efficacy varied depending on the domain of activity examined and the type of adaptation used.

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