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Damgaard AJ, Primdahl J, Esbensen BA, Latocha KM, Bremander A. Self-management support needs of patients with inflammatory arthritis and the content of self-management interventions: a scoping review. Semin Arthritis Rheum 2023; 60:152203. [PMID: 37068398 DOI: 10.1016/j.semarthrit.2023.152203] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/29/2023] [Accepted: 04/03/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND Self-management skills can empower a person to manage the physical, psychological, and social impact of a health condition. However, the components of self-management interventions differ widely between studies and interventions. By performing a scoping review, we aimed to describe patients' self-management needs and how health professionals (HPs) can provide effective self-management support to patients with inflammatory arthritis (IA). OBJECTIVES 1) to identify the evidence for self-management support needs of patients with IA, and 2) to identify the content (theory/theoretical approach, mode of delivery, duration and frequency) of self-management interventions that target patients with IA. METHODS In May 2021, we performed a systematic literature search (from 2000 onward) in five databases (CINAHL (Ebsco), Cochrane Library, Embase (Ovid), Medline (Ovid) and PsycINFO (Ovid)) regarding self-management in patients with IA. RESULTS Out of 11,748 records identified, we included 31 articles describing patients' support needs and 33 articles describing the content of self-management interventions. Patients' support needs were sorted into six topics: 1) disease impact and the pharmacological treatment, 2) care continuity and relations with HPs, 3) the importance of non-pharmacological treatment, 4) the need for support from family and friends, 5) support needs related to work issues, and 6) contextual preferences for self-management support. The theory/theoretical approach, mode of delivery, duration and frequency varied widely and were often unclearly or insufficiently described. In addition, the self-management concept was scarcely - or not - defined in the included articles. The identified topics for support needs were compared with the described content in the included articles. Only a few self-management interventions focused on patients' need for support in relation to work, and to family and friends. CONCLUSION HPs provided self-management support to patients with IA in various ways, but there were gaps between the patients' support needs and the identified interventions. In developing self-management interventions, the self-management concept needs to be defined and a clear theory is required to support the development of the intervention. Future studies should seek to investigate various modes of delivery, frequency and duration, to develop effective interventions that meet patients' support needs.
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2
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Cozad MJ, Lindley LC, Crosby K, Alshareef N, Kennedy AB, Merchant G, Evans P, Horner RD. Patient Goals for Living with Rheumatoid Arthritis: A Qualitative Study. Clin Nurs Res 2023; 32:40-48. [PMID: 35128973 DOI: 10.1177/10547738221075784] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Rheumatoid arthritis is highly individualized in terms of its flare ups and periods of remission. Each patient's unique experience requires a high level of personalization in terms of treatment making it necessary to understand what their goals for living are. This study explores patient perceptions on how the burden of RA shapes patients' goals for living and their preferences for symptom and side-effect management within the United States. Fifteen patients diagnosed with RA with varying lengths of diagnosis were interviewed. A thematic analysis was conducted to construct a conceptual framework. Emerging themes identified disease burdens as: (1) inability to perform essential needs, (2) negative feelings about disease, and (3) its influence on relationships. These burdens shaped desired goals for living which guided the symptom and side-effect priorities the patient wanted managed. Practitioners should consider patient goals and preferences in conjunction with disease progression when engaging in treatment decisions.
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Affiliation(s)
| | | | | | | | | | | | - Pam Evans
- University of South Carolina, SC, USA
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3
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Fairley JL, Seneviwickrama M, Yeh S, Anthony S, Chou L, Cicuttini FM, Sullivan K, Briggs AM, Wluka AE. Person-centred care in osteoarthritis and inflammatory arthritis: a scoping review of people's needs outside of healthcare. BMC Musculoskelet Disord 2021; 22:341. [PMID: 33836697 PMCID: PMC8035722 DOI: 10.1186/s12891-021-04190-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/24/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Arthritis, regardless of cause, has significant physical, social and psychological impacts on patients. We aimed to identify the non-healthcare needs perceived by patients with inflammatory arthritis (IA) and osteoarthritis (OA), and to determine if these differ. METHODS We electronically searched MEDLINE, PsycINFO, EMBASE and CINAHL (1990-2020) systematically to identify non-healthcare-related needs of people with IA or OA. All citations were screened and quality appraised by two reviewers. Data was extracted by a single reviewer. RESULTS The search identified 7853 citations, with 31 studies included (12 for OA, 20 for IA). Six areas of need emerged and these were similar in both group These were: 1) Assistance with activities of daily living especially related to a lack of independence; 2) Social connectedness: need for social participation; 3) Financial security: worry about financial security and increased costs of health-seeking behaviours; 4) Occupational needs: desire to continue work for financial and social reasons, facilitated by flexibility of workplace conditions/environment; 5) Exercise and leisure: including limitation due to pain; 6) Transportation: limitations in ability to drive and take public transport due to mobility concerns. Many areas of need were linked; e.g. loss of employment and requiring support from family was associated with a sense of "failure" and loss of identity, as social isolation. CONCLUSIONS This review highlights the pervasive impact of arthritis on peoples' lives, regardless of aetiology, albeit with a limited evidence base. Improved identification and targeting of non-healthcare needs of people with arthritis is likely to improve person-centred care.
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Affiliation(s)
- Jessica L Fairley
- Department of Epidemiology and Preventative Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - Maheeka Seneviwickrama
- Department of Epidemiology and Preventative Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia.,Department of Community Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Sri Lanka
| | - Sabrina Yeh
- Department of Epidemiology and Preventative Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - Shane Anthony
- Department of Epidemiology and Preventative Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - Louisa Chou
- Department of Epidemiology and Preventative Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - Flavia M Cicuttini
- Department of Epidemiology and Preventative Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - Kaye Sullivan
- Monash University Library, Monash University, Melbourne, Victoria, Australia
| | - Andrew M Briggs
- Curtin School of Allied Health, Curtin University, Perth, Western, Australia
| | - Anita E Wluka
- Department of Epidemiology and Preventative Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia.
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4
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Donnelly S, Manning M, Mannan H, Wilson AG, Kroll T. Renegotiating dimensions of the self: A systematic review and qualitative evidence synthesis of the lived experience of self-managing rheumatoid arthritis. Health Expect 2020; 23:1388-1411. [PMID: 32869404 PMCID: PMC7752197 DOI: 10.1111/hex.13122] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 06/25/2020] [Accepted: 07/21/2020] [Indexed: 12/19/2022] Open
Abstract
Background As chronic illnesses, such as rheumatoid arthritis (RA), place an increased burden on health‐care systems, the ability of individuals to self‐manage these diseases is crucial. Objective To identify and synthesize the lived experience of self‐management described by adults living with RA. Design A systematic search of five electronic databases (MEDLINE, CINAHL, EMBASE, PsycINFO and ASSIA) was undertaken to identify relevant studies. Data were extracted and quality‐assessed using CASP guidelines. A meta‐synthesis was conducted based on Thomas and Harden's thematic synthesis approach. Results The search identified 8423 publications. After removing duplicates, 6527 records remained of which 32 studies met the inclusion criteria. Quality of studies was moderate to high, yet a considerable lack of reflection on researcher bias was evident. Our analysis identified 28 dimensions of self‐management RA across six domains: (a) cognitive‐emotional, (b) behavioural, (c) social, (d) environmental, (e) physical and (f) technological. Cognitive‐emotional experiences dominated the analysis. Renegotiating ‘the self’ (self‐concept, self‐esteem, self‐efficacy) was a key focus of self‐management among individuals with RA. Conclusion Our findings highlight the focus of ‘the self’ as a central concern in the self‐management of RA. Standardized self‐management programmes may primarily focus on disease management and daily functioning. However, we suggest that personal biographies and circumstances should move to the fore of self‐management support. Registration PROSPERO International Prospective Register of Systematic Reviews 2018: CRD42018100450. Patient or Public Contribution Patient and public involvement was not explicit in this review. However, three authors provided a patient perspective on the self‐management of arthritis and autoimmune disease.
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Affiliation(s)
- Susie Donnelly
- Centre for Interdisciplinary Research Education and Innovation in Health Systems (IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Molly Manning
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Hasheem Mannan
- Department of Social Sciences, School of Liberal Education, FLAME University, Pune, India
| | - Anthony G Wilson
- Centre for Arthritis Research, School of Medicine and Medical Science, Conway Institute, University College Dublin, Dublin, Ireland
| | - Thilo Kroll
- Centre for Interdisciplinary Research Education and Innovation in Health Systems (IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
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5
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Bergström M, Sverker A, Larsson Ranada Å, Valtersson E, Thyberg I, Östlund G, Björk M. Significant others' influence on participation in everyday life - the perspectives of persons with early diagnosed rheumatoid arthritis. Disabil Rehabil 2019; 42:385-393. [PMID: 30634863 DOI: 10.1080/09638288.2018.1499825] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Purpose: To describe the meaning of significant others in relation to participation in everyday life of persons with early diagnosed rheumatoid arthritis (RA).Materials and methods: Fifty-nine persons participated in this interview study. Inclusion criteria were three years' experience of diagnosis and being of working age. Semi-structured interviews were conducted using critical incident technique (CIT), and the material was analysed using content analysis.Results: Four categories were revealed: (1) My early RA causes activity adaptations for us all, referring to the person and significant others modifying activities. (2) Making the significant others balance between shortfalls and participation, where the participants distinguished between needing help and feeling involved in activities. (3) Physical interactions with significant others, referring to both the problematic and manageable impact RA could have on body contact. (4) Emotions in relation to activities with others, where participants described feelings of failing others, and anxiety about future activities.Conclusions: For persons with early diagnosed RA, significant others can be both hindering and facilitating for participation in everyday life. As a clinical implication, it is valuable to identify how significant others can be involved in the rehabilitation process, to enhance participation in everyday life early in the disease process.Implications for rehabilitationSignificant others of persons with rheumatoid arthritis can facilitate as well as hinder participation in everyday life, even early in the disease process.It is important to include the significant others in the rehabilitation process of persons with early diagnosed rheumatoid arthritis.It is of great importance to identify when and how significant others can be facilitators of participation in everyday life for persons with early rheumatoid arthritis.To make it easier for significant others to facilitate participation, there is a need for the healthcare system to explore ways to support significant others with easily accessible information about early rheumatoid arthritis.
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Affiliation(s)
- Maria Bergström
- Division of Occupational Therapy, Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden
| | - Annette Sverker
- Department of Activity and Health, Department of Rehabilitation Medicine and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Åsa Larsson Ranada
- Division of Occupational Therapy, Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden
| | - Eva Valtersson
- Department of Activity and Health, Department of Rehabilitation Medicine and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Ingrid Thyberg
- Department of Clinical and Experimental Medicine, Linköping University, Department of Rheumatology, Heart and Medicine Center, Region Östergötland, Linköping, Sweden
| | - Gunnel Östlund
- School of Health Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden
| | - Mathilda Björk
- Division of Occupational Therapy, Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Department of Rheumatology, Heart and Medicine Center, Region Östergötland, Linköping, Sweden
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6
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Sjö AS, Bergsten U. Patients' experiences of frequent encounters with a rheumatology nurse-A tight control study including patients with rheumatoid arthritis. Musculoskeletal Care 2018; 16:305-312. [PMID: 29808592 DOI: 10.1002/msc.1348] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 04/04/2018] [Accepted: 04/06/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Rheumatoid arthritis (RA) is a chronic inflammatory disease that is treated with both pharmacological and nonpharmacological methods. The treatment works well for patients who are knowledgeable about their disease and situation. However, this may be different for others as, among other things, it depends on how well informed the patients are in relation to their condition. Available research primarily focuses on patients in remission. One way of supporting and strengthening the group who experience a lack of well-being due to their disease and providing them with increased knowledge about their situation can be to give them access to a nurse-led clinic based on person-centred care. AIM The aim of the study was to describe the experience of patients with RA attending person-centred, nurse-led clinics over a 12-month period. METHODS A qualitative method was employed to deepen the understanding of the phenomenon. Fifteen participants were interviewed, and the text of the interviews was analysed using the phenomenographic method. RESULTS The analysis resulted in three categories that described participants' experiences of their encounters with a nurse. The three categories describe a process with interrelated concepts: first, Encountering competence, followed by Experiencing a sustainable relationship and, finally, Making a personal journey. CONCLUSION Patients with RA who had frequent meetings with a nurse experienced being strengthened on several levels and having gained increased knowledge about their disease. The person-centred approach made them feel that they had been met on their own level, in accordance with their needs and level of knowledge.
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Affiliation(s)
- Ann-Sofi Sjö
- Rheumatology Department, Sahlgrenska Hospital, Gothenburg, Sweden
| | - Ulrika Bergsten
- Research and Development Department at Region Halland, Halmstad, Sweden
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7
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Geenen R, Overman CL, Christensen R, Åsenlöf P, Capela S, Huisinga KL, Husebø MEP, Köke AJA, Paskins Z, Pitsillidou IA, Savel C, Austin J, Hassett AL, Severijns G, Stoffer-Marx M, Vlaeyen JWS, Fernández-de-Las-Peñas C, Ryan SJ, Bergman S. EULAR recommendations for the health professional's approach to pain management in inflammatory arthritis and osteoarthritis. Ann Rheum Dis 2018; 77:797-807. [PMID: 29724726 DOI: 10.1136/annrheumdis-2017-212662] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 03/21/2018] [Accepted: 03/28/2018] [Indexed: 01/19/2023]
Abstract
Pain is the predominant symptom for people with inflammatory arthritis (IA) and osteoarthritis (OA) mandating the development of evidence-based recommendations for the health professional's approach to pain management. A multidisciplinary task force including professionals and patient representatives conducted a systematic literature review of systematic reviews to evaluate evidence regarding effects on pain of multiple treatment modalities. Overarching principles and recommendations regarding assessment and pain treatment were specified on the basis of reviewed evidence and expert opinion. From 2914 review studies initially identified, 186 met inclusion criteria. The task force emphasised the importance for the health professional to adopt a patient-centred framework within a biopsychosocial perspective, to have sufficient knowledge of IA and OA pathogenesis, and to be able to differentiate localised and generalised pain. Treatment is guided by scientific evidence and the assessment of patient needs, preferences and priorities; pain characteristics; previous and ongoing pain treatments; inflammation and joint damage; and psychological and other pain-related factors. Pain treatment options typically include education complemented by physical activity and exercise, orthotics, psychological and social interventions, sleep hygiene education, weight management, pharmacological and joint-specific treatment options, or interdisciplinary pain management. Effects on pain were most uniformly positive for physical activity and exercise interventions, and for psychological interventions. Effects on pain for educational interventions, orthotics, weight management and multidisciplinary treatment were shown for particular disease groups. Underpinned by available systematic reviews and meta-analyses, these recommendations enable health professionals to provide knowledgeable pain-management support for people with IA and OA.
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Affiliation(s)
- Rinie Geenen
- Department of Psychology, Utrecht University, Utrecht, The Netherlands
| | - Cécile L Overman
- Department of Psychology, Utrecht University, Utrecht, The Netherlands
| | - Robin Christensen
- Musculoskeletal Statistics Unit, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.,Department of Rheumatology, Odense University Hospital, Odense, Denmark
| | | | - Susana Capela
- Rheumatology and Metabolic Bone Diseases Department, Hospital de Santa Maria, Lisbon, Portugal.,Rheumatology Research Unit, Faculty of Medicine, Lisbon Academic Medical Centre, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Portugal
| | - Karen L Huisinga
- Department of Rheumatology, Virginia Mason Medical Center, Seattle, Washington, USA
| | - Mai Elin P Husebø
- Norwegian National Unit for Rehabilitation for Rheumatic Patients with Special Needs, NBRR, Diakonhjemmet Hospital, Oslo, Norway
| | - Albère J A Köke
- Department of Rehabilitation Medicine, Maastricht University, Maastricht, The Netherlands
| | - Zoe Paskins
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK.,Haywood Academic Rheumatology Centre, Haywood Hospital, Stoke-on-Trent, UK
| | - Irene A Pitsillidou
- EULAR Patient Research Partner, Cyprus League Against Rheumatism, Nicosia, Cyprus
| | - Carine Savel
- Department of Rheumatology, CHU, Clermont Ferrand, Clermont Ferrand, France
| | - Judith Austin
- Department of Psychology, Utrecht University, Utrecht, The Netherlands
| | - Afton L Hassett
- Department of Anesthesiology, Division of Pain Research, Chronic Pain & Fatigue Research Center, University of Michigan Medical School, Ann Harbor, Michigan, USA
| | - Guy Severijns
- EULAR Social Leagues Patients' Representative, Leuven, Belgium
| | - Michaela Stoffer-Marx
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria.,Department of Health Sciences, University of Applied Sciences FH Campus Wien, Vienna, Austria
| | - Johan W S Vlaeyen
- Research group Health Psychology, University of Leuven, Leuven, Belgium.,Behavioral Medicine Research, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - César Fernández-de-Las-Peñas
- Department Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Sarah J Ryan
- Haywood Academic Rheumatology Centre, Haywood Hospital, Stoke-on-Trent, UK
| | - Stefan Bergman
- Department of Public Health and Community Medicine, Primary Health Care Unit, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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8
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Assessing information needs and use of online resources for disease self-management in patients with rheumatoid arthritis: a qualitative study. Clin Rheumatol 2018; 37:1791-1797. [DOI: 10.1007/s10067-018-4047-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 02/05/2018] [Accepted: 02/19/2018] [Indexed: 10/17/2022]
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9
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Larsson I. Patients' conceptions of their own influence on good treatment response to biological therapy in chronic inflammatory arthritis. Patient Prefer Adherence 2017; 11:1057-1067. [PMID: 28706444 PMCID: PMC5495133 DOI: 10.2147/ppa.s131239] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Biological therapies are common in the treatment of patients with chronic inflammatory arthritis (CIA). However, despite the fact that many patients respond well to their biological therapies, there are still a number of nonresponders. In order to design the best care for patients, it is important to understand how they conceive their own role in their treatment response. OBJECTIVE To explore how patients with CIA conceive their own influence on a good treatment response to biological therapy. METHODS This study had an exploratory and descriptive design with a phenomenographic approach. Interviews were conducted with 25 patients (11 women and 14 men) aged 17-79 years, with CIA who were undergoing biological therapy and who had low disease activity or were in remission. RESULTS Patients with CIA undergoing biological therapy conceived their own influence on good treatment response in terms of adherence, physical activity, mental attitude, social support, and self-awareness. Adherence was described as the foundation for the patients' own influence on good treatment response. Physical activity, mental attitude, and social support reflected three essential ways of understanding patients' influence on good treatment response where the patients spoke about physical strength, mental strength, and social strength. Self-awareness reflected a comprehensive way of influencing good treatment response in which patients balanced their physical, mental, and social resources in partnership with health care professionals. CONCLUSION Patients conceived that they had a responsibility for adhering to the treatment as well as achieving balance in life in order to ensure good treatment response. Self-awareness was essential for maintaining a good treatment response, and this reflected the patients' awareness of the complexity of living their lives with a chronic illness.
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Affiliation(s)
- Ingrid Larsson
- School of Health and Welfare, Halmstad University
- Spenshult Research and Development Center, Halmstad, Sweden
- Correspondence: Ingrid Larsson, School of Health and Welfare, Halmstad University, Box 823, S-30118 Halmstad, Sweden, Tel +46 35 16 7965, Email
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10
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Aluru SV, Shweta A, Bhaskar S, Geetha K, Sivakumar RM, Utpal T, Padmanabhan P, Angayarkanni N. Tear Fluid Protein Changes in Dry Eye Syndrome Associated with Rheumatoid Arthritis: A Proteomic Approach. Ocul Surf 2017; 15:112-129. [DOI: 10.1016/j.jtos.2016.09.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 08/31/2016] [Accepted: 09/06/2016] [Indexed: 11/26/2022]
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11
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[EULAR recommendations for patient education of people with inflammatory arthritis. Translation and evaluation in Germany]. Z Rheumatol 2016; 75:187-99. [PMID: 26744185 DOI: 10.1007/s00393-015-0020-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
In 2015 EULAR published recommendations for patient education of people with inflammatory arthritis. The recommendations included two superior principles and eight recommendations based on the level of evidence and expert knowledge. The German translation of the recommendations was evaluated by 15 German experts. Experts graded the strength of the recommendations (SOR) on an 11 point numerical rating scale (from 0 = no agreement to 10 = total agreement). The mean score was 8,8 ± 0,49.
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12
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Hulen E, Ervin A, Schue A, Evans-Young G, Saha S, Yelin EH, Barton JL. Patient goals in rheumatoid arthritis care: A systematic review and qualitative synthesis. Musculoskeletal Care 2016; 15:295-303. [PMID: 27976535 DOI: 10.1002/msc.1173] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE During the clinical encounter, rheumatoid arthritis (RA) patient goals for care often go unexplored. The aim of the present systematic review was to identify needs, goals and expectations of RA patients in order better to guide systematic elicitation of patient goals in clinical encounters. METHODS An academic librarian searched MEDLINE, PsychINFO and the Cochrane Library using a specialized algorithm developed to identify articles about patient goals for RA care. Investigators screened search results according to prespecified inclusion criteria and then reviewed included articles and synthesized the evidence qualitatively, utilizing an inductive approach. RESULTS A total of 909 titles were retrieved in the literature search, of which 871 were excluded after a title/abstract screen. Of the remaining 38, 22 papers were included in the final review. Investigators identified four major themes in the literature: (a) the bodily experience of RA; (b) achieving normalcy and maintaining wellness; (c) social connectedness and support; and (d) interpersonal and healthcare system interactions. CONCLUSION Patients' goals when receiving care for RA are multidimensional and span several facets of everyday life. Goals for RA care should be collaboratively developed between patients and providers, with particular attention to the patient's life context and priorities.
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Affiliation(s)
- Elizabeth Hulen
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, USA
| | - Ayla Ervin
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, USA
| | - Allison Schue
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, USA
| | | | - Somnath Saha
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, USA.,Oregon Health & Science University, USA
| | | | - Jennifer L Barton
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, USA.,Oregon Health & Science University, USA
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13
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Poh LW, He HG, Chan WCS, Lee CSC, Lahiri M, Mak A, Cheung PP. Experiences of Patients With Rheumatoid Arthritis: A Qualitative Study. Clin Nurs Res 2016; 26:373-393. [PMID: 26862118 DOI: 10.1177/1054773816629897] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that greatly impacts one's physical and psychosocial well-being. The purpose of this study was to explore the experiences and support needs of adult patients living with RA. A descriptive qualitative study was conducted, and 16 adults with RA were interviewed from October 2013 to January 2014. The transcribed data were analyzed using thematic analysis. Five themes were identified: altered physical capacity and well-being, psychological and emotional challenges, changes in social life, coping strategies, and support received and further support needs. This study provided insights into the experiences and support needs of patients with RA in Singapore. Physical and psychosocial challenges experienced by patients affected their daily and social activities. Patients' needs for variety of support should be addressed.
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Affiliation(s)
| | - Hong-Gu He
- 2 National University of Singapore, Singapore; National University Health System, Singapore
| | | | - Ching Siang Cindy Lee
- 2 National University of Singapore, Singapore; National University Health System, Singapore
| | - Manjari Lahiri
- 4 National University Hospital, Singapore; National University Health System, Singapore
| | - Anselm Mak
- 4 National University Hospital, Singapore; National University Health System, Singapore
| | - Peter P Cheung
- 4 National University Hospital, Singapore; National University Health System, Singapore
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14
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Grønning K, Bratås O, Steinsbekk A. Which Factors Influence Self-Efficacy in Patients with Chronic Inflammatory Polyarthritis? Musculoskeletal Care 2015; 14:77-86. [PMID: 26311320 DOI: 10.1002/msc.1114] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) or unspecified polyarthritis (UA) deal with several symptoms such as joint stiffness, pain, physical limitations and fatigue. Self-efficacy is about patients' beliefs and abilities to handle the symptoms and implications of having arthritis. Patients' self-efficacy is also a phenomenon that nurses may affect through patient education. Therefore, the aim of the present study was to investigate the factors that predict self-efficacy in patients with chronic inflammatory polyarthritis. METHODS The participants (n = 132) were recruited from St Olavs University Hospital in central Norway from 2008 to 2010, and consisted of adult patients with RA, PsA or UA. We performed secondary analyses on data collected in a randomized controlled trial studying the long-term effects of nurse-led patient education. We carried out bivariate and multivariate linear regression analyses. The predictor variables consisted of baseline data on demographics, disease characteristics (diagnosis, disease duration, disease activity, use of disease-modifying anti-rheumatic drugs, pain and tiredness) and psychological variables (well-being, psychological distress and patient activation). The dependent variables were self-efficacy over other symptoms and self-efficacy over for pain after one year. RESULTS The analyses showed that female gender and patient activation predicted higher self-efficacy over other symptoms, whereas female gender and better well-being predicted higher self-efficacy over pain. CONCLUSION To strengthen arthritis patients' self-efficacy, nurses need to focus on patients' well-being and activation. Nurses also need to be aware of possible gender differences regarding patients' self-efficacy. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Kjersti Grønning
- Sør-Trøndelag University College, Faculty of Nursing & Center for Health Promotion Research, Trondheim, Norway
| | - Ola Bratås
- Sør-Trøndelag University College, Faculty of Nursing & Center for Health Promotion Research, Trondheim, Norway
| | - Aslak Steinsbekk
- Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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15
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Zangi HA, Ndosi M, Adams J, Andersen L, Bode C, Boström C, van Eijk-Hustings Y, Gossec L, Korandová J, Mendes G, Niedermann K, Primdahl J, Stoffer M, Voshaar M, van Tubergen A. EULAR recommendations for patient education for people with inflammatory arthritis. Ann Rheum Dis 2015; 74:954-62. [DOI: 10.1136/annrheumdis-2014-206807] [Citation(s) in RCA: 205] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 02/10/2015] [Indexed: 01/30/2023]
Abstract
ObjectivesThe task force aimed to: (1) develop evidence-based recommendations for patient education (PE) for people with inflammatory arthritis, (2) identify the need for further research on PE and (3) determine health professionals’ educational needs in order to provide evidence-based PE.MethodsA multidisciplinary task force, representing 10 European countries, formulated a definition for PE and 10 research questions that guided a systematic literature review (SLR). The results from the SLR were discussed and used as a basis for developing the recommendations, a research agenda and an educational agenda. The recommendations were categorised according to level and strength of evidence graded from A (highest) to D (lowest). Task force members rated their agreement with each recommendation from 0 (total disagreement) to 10 (total agreement).ResultsBased on the SLR and expert opinions, eight recommendations were developed, four with strength A evidence. The recommendations addressed when and by whom PE should be offered, modes and methods of delivery, theoretical framework, outcomes and evaluation. A high level of agreement was achieved for all recommendations (mean range 9.4–9.8). The task force proposed a research agenda and an educational agenda.ConclusionsThe eight evidence-based and expert opinion-based recommendations for PE for people with inflammatory arthritis are intended to provide a core framework for the delivery of PE and training for health professionals in delivering PE across Europe.
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16
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Dwarswaard J, Bakker EJM, van Staa A, Boeije HR. Self-management support from the perspective of patients with a chronic condition: a thematic synthesis of qualitative studies. Health Expect 2015; 19:194-208. [PMID: 25619975 DOI: 10.1111/hex.12346] [Citation(s) in RCA: 145] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2015] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Receiving adequate support seems to be crucial to the success of self-management. Although different empirical studies separately examined patients' preferences for self-management support (SMS), an overview is lacking. OBJECTIVE The aim of this qualitative review was to identify patients' needs with respect to SMS and to explore by whom this support is preferably provided. SEARCH STRATEGY Qualitative studies were identified from Embase, MEDLINE OvidSP, Web of science, PubMed publisher, Cochrane central, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO. INCLUSION CRITERIA Articles needed to meet all of the following criteria: (i) focuses on self-management, (ii) concerns adult patients with rheumatic diseases (rheumatoid arthritis and fibromyalgia), a variant of cancer or chronic kidney disease, (iii) explores support needs from the patients' perspective, (iv) uses qualitative methods and (v) published in English. DATA EXTRACTION AND SYNTHESIS A thematic synthesis, developed by Thomas and Harden, was conducted of the 37 included studies. MAIN RESULTS Chronic patients need instrumental support, psychosocial support and relational support from health-care professionals, family/friends and fellow patients to manage the chronic condition. Relational support is at the centre of the support needs and fuels all other types of support. DISCUSSION AND CONCLUSIONS Patients do not self-manage on their own. Patients expect health-care professionals to fulfil a comprehensive role. Support needs can be knitted together only when patients and professionals work together on the basis of collaborative partnership. Dynamics in support needs make it important to regularly assess patient needs.
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Affiliation(s)
- Jolanda Dwarswaard
- Research Centre Innovations of Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.,Department of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Ellen J M Bakker
- Research Centre Innovations of Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - AnneLoes van Staa
- Research Centre Innovations of Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.,Department of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Hennie R Boeije
- Department of Methodology and Statistics, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands
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17
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Poh L, He HG, Lee C, Cheung P, Chan WC. An integrative review of experiences of patients with rheumatoid arthritis. Int Nurs Rev 2015; 62:231-47. [DOI: 10.1111/inr.12166] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- L.W. Poh
- Division of Nursing; Khoo Teck Puat Hospital; Singapore
| | - H.-G. He
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
| | - C.S.C. Lee
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
| | - P.P. Cheung
- Division of Rheumatology; National University Hospital; Singapore
| | - W.-C.S. Chan
- School of Nursing and Midwifery; Faculty of Health and Medicine; The University of Newcastle; Newcastle Australia
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18
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Bergsten U, Andrey AM, Bottner L, Nylander M, Persson G, Petersson E, Bergman S. Patient-initiated research in rheumatic diseases in Sweden--dignity, identity and quality of life in focus when patients set the research agenda. Musculoskeletal Care 2014; 12:194-7. [PMID: 24782268 PMCID: PMC4282434 DOI: 10.1002/msc.1073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- U Bergsten
- Spenshult Hospital for Rheumatic diseasesOskarström, Sweden
- Sahlgrenska University HospitalGothenburg, Sweden
- * Correspondence: Ulrika Bergsten, Sahlgrenska University Hospital, Rheumatology Department, Gröna stråket 14, 413 45 Gothenburg, Sweden. Tel: +46 733 345117; Fax: +46 31 3418395., ;
| | - A-M Andrey
- Swedish Rheumatism AssociationStockholm, Sweden
| | - L Bottner
- Swedish Rheumatism AssociationStockholm, Sweden
| | - M Nylander
- Swedish Rheumatism AssociationStockholm, Sweden
| | - G Persson
- Swedish Rheumatism AssociationStockholm, Sweden
| | - E Petersson
- Swedish Rheumatism AssociationStockholm, Sweden
| | - S Bergman
- Spenshult Hospital for Rheumatic diseasesOskarström, Sweden
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19
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Cottrell JED, Jonas M, Bergsten U, Blaas E, de la Torre Aboki J, Howse C, Korandova J, Löfman P, Logtenberg C, Lupton T, Mallon C, Oliver S, Pickles D, Bulinckx L. The nurse's role in addressing unmet treatment and management needs of patients with rheumatoid arthritis: Delphi-based recommendations. Int J Nurs Knowl 2013; 24:66-76. [PMID: 23750901 DOI: 10.1111/j.2047-3095.2013.01231.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE Evaluate nurse's role in management of patients with rheumatoid arthritis (RA). METHODS Modified Delphi with two rounds of questionnaires, followed by in-person meeting. International group of 12 nurses experienced with RA patients receiving biologic therapy. FINDINGS Nurses often spend more time with patients than doctors do. Nurse is in unique position to explore patient needs; educate about treatment, administration, product storage, and self-injection technique; determine readiness for and understanding of treatment; monitor safety and progress; and coordinate care within multidisciplinary setting. CONCLUSIONS Nurse's role is complex and vitally important to optimal RA patient care. Additional nurse involvement may address unmet needs. IMPLICATIONS FOR NURSING PRACTICE Rheumatology nurses can address unmet patient needs by expanding current roles and by adopting additional functions.
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Affiliation(s)
- Jane E D Cottrell
- Rebecca MacDonald Centre for Arthritis & Autoimmunity, Toronto, Ontario, Canada
| | | | - Ulrika Bergsten
- Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden
| | | | | | - Catriona Howse
- South London Healthcare NHS Trust-Queen Mary's, Sidcup, Kent, United Kingdom
| | | | - Päivi Löfman
- Saimaa University of Applied Sciences, Lappeenranta, Finland
| | | | - Terri Lupton
- University of Calgary Medical Clinics, Calgary, Alberta, Canada
| | - Catherine Mallon
- University of Alberta, RAPPORT Centre, Edmonton, Alberta, Canada
| | | | | | - Leeanna Bulinckx
- PerCuro Clinical Research Ltd., Victoria, British Columbia, Canada
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20
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Rodham K, McCabe C, Pilkington M, Regan L. Coping with chronic complex regional pain syndrome: advice from patients for patients. Chronic Illn 2013; 9:29-42. [PMID: 22659350 DOI: 10.1177/1742395312450178] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To explore what advice people currently living with chronic complex regional pain syndrome would offer to another person coming to terms with a diagnosis of chronic complex regional pain syndrome. METHODS Semi-structured interviews with 21 adults (5 male) living with chronic complex regional pain syndrome who had completed a complex regional pain syndrome rehabilitation programme were conducted. RESULTS Effectively self-managing complex regional pain syndrome required individuals to play an active role. This could only be achieved if they felt they had sufficient control. Means of attaining control involved attaining a level of acceptance, becoming well-informed and accessing the right kind of support. The advice offered by patients for patients largely reflected that offered by healthcare professionals. One area where there was a conflict concerned sleep hygiene. CONCLUSIONS Our study provides support both for the argument put forward by Redman that without appropriate preparation and support, self-management is ineffective, and that by Skuladottir and Hallsdottir that the main challenge of the chronic pain trajectory is that of retaining a sense of control. The clinical implications of this are discussed.
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Affiliation(s)
- Karen Rodham
- Department of Psychology, University of Bath, Bath, UK.
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21
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Cottrell JED, Jonas M, Bergsten U, Blaas E, de la Torre Aboki J, Howse C, Korandova J, Löfman P, Logtenberg C, Lupton T, Mallon C, Oliver S, Pickles D, Bulinckx L. The Nurse's Role in Addressing Unmet Treatment and Management Needs of Patients With Rheumatoid Arthritis: Delphi-Based Recommendations. Int J Nurs Knowl 2012:n/a-n/a. [PMID: 23206315 DOI: 10.1111/j.2047-3095.2012.01231.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE Evaluate nurse's role in management of patients with rheumatoid arthritis (RA). METHODS Modified Delphi with two rounds of questionnaires, followed by in-person meeting. International group of 12 nurses experienced with RA patients receiving biologic therapy. FINDINGS Nurses often spend more time with patients than doctors do. Nurse is in unique position to explore patient needs; educate about treatment, administration, product storage, and self-injection technique; determine readiness for and understanding of treatment; monitor safety and progress; and coordinate care within multidisciplinary setting. CONCLUSIONS Nurse's role is complex and vitally important to optimal RA patient care. Additional nurse involvement may address unmet needs. IMPLICATIONS FOR NURSING PRACTICE Rheumatology nurses can address unmet patient needs by expanding current roles and by adopting additional functions.
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Affiliation(s)
- Jane E D Cottrell
- Rebecca MacDonald Centre for Arthritis & Autoimmunity, Toronto, Ontario, Canada
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22
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Kristiansen TM, Primdahl J, Antoft R, Hørslev-Petersen K. It means everything: continuing normality of everyday life for people with rheumatoid arthritis in early remission. Musculoskeletal Care 2012; 10:162-170. [PMID: 22628091 DOI: 10.1002/msc.1013] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE The aim of this follow-up study was twofold: firstly, to explore how people who were clinically regarded to be in a state of remission experienced their everyday lives with rheumatoid arthritis (RA); secondly, to explore the experiences of people in early remission with healthcare provision and their perceived support needs. METHODS Two focus group interviews were conducted with 11 participants in total. Interview data were analysed using content analysis methods. RESULTS All participants felt that they were able to continue their normal everyday activities at home, at leisure and at work. They were also able to maintain their normal roles. Continuing the normality of everyday life seemed to be the most important defining variable for experiencing being in remission. Support needs were directly related to the participants' positive experiences of actual support from the healthcare providers and were related to the continuity of the care provider, coherence, being taken care of, having a personal and trusting relationship with the health professionals and being properly informed about RA and how to manage it. CONCLUSION The participants wanted to concentrate on wellness and tended to avoid thinking of possible side effects, being chronic ill and the development of RA in the future.
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Affiliation(s)
- T M Kristiansen
- King Christian X' Hospital for Rheumatic Diseases, Graasten, Denmark.
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