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Adv Psychosom Med. 2004;25:41-62.

Function, disability, and psychological well-being.

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  • 1Department of Medicine, Division of Rheumatology and Institute for Health Policy Studies, University of California, San Francisco, San Francisco, Calif. 94143-0920, USA.


Disability research in arthritis, as in disability research in general, has focused on functional limitations and activities of daily living/instrumental activities of daily living (ADL/IADL) disability, and has thus ignored a great deal of daily life. Unfortunately, the areas of life that have been ignored may be those that are most important to individuals, and may also be the most sensitive to the first signs of developing disability. The ability to perform valued life activities, the wide range of activities that individuals find meaningful or pleasurable above and beyond activities that are necessary for survival or self-sufficiency, has strong links to psychological well-being--in some cases, stronger links than functional limitations and disability in basic activities of daily living. A broader assessment of disability has great potential for interrupting the disablement and distress process, thereby improving the quality of life of individuals with arthritis. Assessment of the effects of arthritis, pain, or other chronic health conditions should expand beyond assessment of functional limitations and disability in basic activities to include assessment of disability in advanced, valued activities.

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