SAT0585-HPR Sedentary Behaviour in Patients with Rheumatoid Arthritis. A Qualitative Study

Background Sedentary behaviour (SB) has been defined as any waking behaviour characterized by an energy expenditure < 1.5 METs while in a sitting or reclining position and not simply as the absence of physical activity. SB and in particular watching TV has been identified as an independent predictor of e.g. cardiovascular disease mortality and type 2 diabetes in healthy persons. Currently there exist few intervention studies investigating the health effects of reducing SB. Patients with rheumatoid arthritis (RA) have increased risk of cardiovascular diseases. In addition, many patients are physically inactive and may be unable to adopt recommended levels of regular physical activity. Reducing SB rather than solely increasing physical activity may be suitable in sedentary patients with RA. However, SB is not well investigated, specifically not how patients perceive SB in their everyday life. Objectives The aim of this study was to describe how and when patients with RA engage in SB. Furthermore, to illuminate what from patients perspective is influencing SB Methods A qualitative study was conducted based on individual semi-structured interviews. Patients were recruited from a cross-sectional questionnaire study (N=438) investigating physical activity in patients with RA (unpublished data). Patients with more than four hours of self-reported daily leisure time SB were invited to participate. In total, 15 patients (10 women and five men; mean age 57 years), diagnosed with RA for an average of 13 years (range: 4-27 years) covering different degrees of disability were included. The recorded interviews were transcribed verbatim and analyzed using qualitative content analysis and by use of Nvivo software program. Results Patients with RA mainly engage in SB during mornings and evenings. In addition, they plan rest time and small breaks of sitting during the day and in between daily activities. SB includes activities such as computer, TV watching, resting in bed, reading and creative hobbies, e.g. needlework and painting. The analysis revealed four main categories influencing SB: (1) Fatigue and pain: referring to two dominant symptoms of RA influencing SB, (2) SB as an adaptation to RA referring to patients’ fear of straining the joints and thus planning of daily rest time with prolonged sitting, (3) Social network referring to influences from partners, children, grandchildren and friends and (4) SB is independent of RA referring to patients’ premorbid habits, th