Productive activities, mental health and quality of life in disability: exploring the role enhancement and the role strain hypotheses

Background: Engagement in productive activities is an important determinant of mental health and quality of life (QoL). Persons with physical disabilities are often confronted with constraints to engage in productive activities and it remains largely unknown whether persons who nevertheless manage to be productive experience beneficial effects for mental health and QoL. This is the first study to analyse different productive activities (paid work, volunteering, education, housework) and its gender-specific associations with mental health and QoL in the disability setting, testing two contrasting hypotheses of Role Theory, the role strain and the role enhancement hypotheses.

Methods: We used data from a representative sample of 1157 men and women of employable age who sustained a severe physical disability (spinal cord injury). Load of engagement in paid work, volunteering, education, and housework was classified into three groups (none; moderate; high). To assess the total productivi...