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“Striving for a Good Life”: The Management of Rheumatoid Arthritis as Experienced by Patients
Jönköping University, School of Health and Welfare, HHJ. Quality improvements, innovations and leadership in health care and social work.
Jönköping University, School of Health and Welfare, HHJ. Quality improvements, innovations and leadership in health care and social work. Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
2011 (English)In: Open Nursing Journal, E-ISSN 1874-4346, Vol. 5, p. 95-101Article in journal (Refereed) Published
Abstract [en]

Aim: To generate a theoretical model how patients experience their management of rheumatoid arthritis (RA) in everyday life.Method: An explorative design with the grounded theory approach was used by interviewing 16 informants with RA.Results: The generated theoretical model emerged in a core category- Striving for a good life with two categories; making use of personal resources and grasping for support from others, which formed the base of managing RA. When relating these categories together, four dimensions emerged which characterised patients’ different ways of managing RA: mastering, relying, struggling and being resigned.Discussion: The management of RA incorporated the use of personal resources and the grasping for support from others. Both self-management strategies and patients’ need of support were highlighted as aspects that were of importance when managing RA. Patients’ experiences of their need of support to manage RA give extended knowledge that is of importance for nurses and other healthcare providers. The relationship between patients and healthcare providers is always the key to a good encounter. Interventions to increase self-management in RA have to incorporate this knowledge when trying to increase patients’ self-efficacy and with their experience of support

Place, publisher, year, edition, pages
2011. Vol. 5, p. 95-101
Keywords [en]
Rheumatoid arthritis, patient perspective, grounded theory, chronic diseases
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hj:diva-16739DOI: 10.2174/1874434601105010095PubMedID: 22135717OAI: oai:DiVA.org:hj-16739DiVA, id: diva2:457367
Available from: 2011-11-17 Created: 2011-11-17 Last updated: 2024-01-17Bibliographically approved
In thesis
1. Patients' and healthcare providers' experiences of the cause, management and interaction in the care of rheumatoid arthritis
Open this publication in new window or tab >>Patients' and healthcare providers' experiences of the cause, management and interaction in the care of rheumatoid arthritis
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim of this thesis was to explore and describe patients’ and healthcare providers’ experiences of the causes, management and interaction in the care of rheumatoid arthritis (RA). Method: The thesis is based on four studies. Studies I and II contain data from an epidemiologic project involving patients who were recently diagnosed with RA. The patients answered an open-ended question about their conception of the cause of their RA (Study I). Qualitative data from 38 patients were analysed using the phenomenographic approach in order to identify variation in conceptions. The results of Study I formed the basis for categorizing the conceptions of 785 patients in the search for patterns of background factors (Study II). Study III aimed to explore how patients experienced their management of RA in everyday life. Data were collected by interviews with 16 patients and analysed according to Grounded Theory (GT). In study IV, the aim was to explore healthcare providers’ experiences of their interaction with patients’ management of RA. Data were collected by interviews with 18 providers representing different professions and analysed using GT. Findings:  Patients’ conceptions of the cause of their RA revealed new aspects from the patient perspective that can complement pathogenetic models. Two descriptive categories emerged: consequences beyond personal control and overloaded circumstances, which included six categories of conceptions (Study I). The most common conceptions of the cause of RA were unexpected effects of events followed by work and family-related stress (Study II). Background factors that influenced the conceptions of the cause were age, sex and educational level. Patient management of RA involved using personal resources together with grasping for support from others in their striving for a good life. When linking these aspects together, four ways of management emerged: mastering, struggling, relying and being resigned (Study III). Healthcare providers’ experiences of their interaction with patients’ management shed light upon the important issue of delivering knowledge and advice. The providers’ attitudes constituted one cornerstone and patients’ responses the other. The providers reported that the interaction led to different outcomes: completed delivery, adjusted delivery and failed delivery. Conclusions: The findings contribute new knowledge from both patients’ and healthcare providers’ perspectives, which could be used to develop a more person-centred approach in rheumatology care. Person-centred care involves taking patients’ beliefs and values into account in addition to creating a trusting relationship between patient and provider. A successful person-centred approach requires an organisation that supports the person-centred framework.

Place, publisher, year, edition, pages
Jönköping: School of Health Sciences, 2011. p. 77
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 23
Keywords
Rheumatoid arthritis, patient perspective, self-management, illness perception, patient-provider interaction, provider perspective, person-centred care
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-16740 (URN)978-91-85835-22-5 (ISBN)
Public defence
2011-12-09, Forum Humanum, Hälsohögskolan, Jönköping, 10:30 (Swedish)
Opponent
Supervisors
Available from: 2011-11-17 Created: 2011-11-17 Last updated: 2011-11-17Bibliographically approved

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Bergsten, UlrikaFridlund, Bengt

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