The aim of this study was to investigate the process of coping in people living with chronic inflammatory arthritis. Semi-structured individual face-to-face interviews with 26 persons having rheumatoid arthritis, psoriatic arthritis or unspecified polyarthritis were performed. The informants were asked how they experienced to live with arthritis and how they coped with challenges due to the arthritis. The main finding was that the informants experienced the process of coping with arthritis as a dynamic, iterative, balancing process. They balanced between different states, entitled “go on as usual”, “listen to the body”, “adjustments” and “attitude towards life”. The informants preferred to be in a “go on as usual” state as this was seen as normal life. However, disease fluctuations with pain, fatigue and stiffness disturbed the balance and made the informants “listen to the body”, a state where they became aware of how the disease affected them, followed by the “adjustment” state. Adjustments were composed of different efforts to ease the arthritis influence and for regaining balance. The “attitude towards life” influenced the overall process of coping. A redefined view of what the informants considered to be normal life thus happened through longer periods of imbalance. The process of coping with arthritis was found to be a dynamic, iterative, balancing process where patients redefined what they considered as normal life through the course of the disease.
Arthritis Coping Patient perspective Qualitative study Self management
This is a preview of subscription content, log in to check access.
The authors wish to thank the informants who participated in this study.
This work was supported by a research grant from The Research Council of Norway.
Zink A, Thiele K, Huscher D, Listing J, Sieper J, Krause A et al (2006) Healthcare and burden of disease in psoriatic arthritis. A comparison with rheumatoid arthritis and ankylosing spondylitis. J Rheumatol 33:86–90PubMedGoogle Scholar
Akil M, Amos RS (1995) ABC of rheumatology. Rheumatoid arthritis–I: clinical features and diagnosis. BMJ 310:587–590PubMedGoogle Scholar
Husted JA, Gladman DD, Farewell VT, Cook RJ (2001) Health-related quality of life of patients with psoriatic arthritis: a comparison with patients with rheumatoid arthritis. Arthritis Rheum 45:151–158PubMedCrossRefGoogle Scholar
Arne M, Janson C, Janson S, Boman G, Lindqvist U, Berne C et al (2009) Physical activity and quality of life in subjects with chronic disease: chronic obstructive pulmonary disease compared with rheumatoid arthritis and diabetes mellitus. Scand J Prim Health Care 27:141–147. doi:10.1080/02813430902808643PubMedCrossRefGoogle Scholar
Lazarus RS, Folkman S (1984) Stress, appraisal and coping. Springer, New YorkGoogle Scholar
Lazarus RS (1993) Coping theory and research: past, present, and future. Psychosom Med 55:234–247PubMedGoogle Scholar
Albano MG, Giraudet-Le Quintrec JS, Crozet C, d'Ivernois JF (2010) Characteristics and development of therapeutic patient education in rheumatoid arthritis: analysis of the 2003–2008 literature. Joint Bone Spine 77:405–410PubMedCrossRefGoogle Scholar
Treharne GJ, Lyons AC, Hale ED, Goodchild CE, Booth DA, Kitas GD (2008) Predictors of fatigue over 1 year among people with rheumatoid arthritis. Psychol Health Med 13:494–504PubMedCrossRefGoogle Scholar
Stamm T, Lovelock L, Stew G, Nell V, Smolen J, Jonsson H et al (2008) I have mastered the challenge of living with a chronic disease: life stories of people with rheumatoid arthritis. Qual Health Res 18:658–669. doi:10.1177/1049732308316348PubMedCrossRefGoogle Scholar
Makelainen P, Vehvilainen-Julkunen K, Pietila AM (2009) Rheumatoid arthritis patient education: RA patients' experience. J Clin Nurs 18:2058–2065PubMedCrossRefGoogle Scholar
Kvale S (1996) Interviews: an introduction to qualitative research interviewing. Sage, Thousand OaksGoogle Scholar
Hammond A, Bryan J, Hardy A (2008) Effects of a modular behavioural arthritis education programme: a pragmatic parallel-group randomized controlled trial. Rheumatology (Oxford) 47:1712–1718CrossRefGoogle Scholar
Malterud K (1993) Shared understanding of the qualitative research process. Guidelines for the medical researcher. Fam Pract 10:201–206PubMedCrossRefGoogle Scholar
Ahlmen M, Nordenskiold U, Archenholtz B, Thyberg I, Ronnqvist R, Linden L et al (2005) Rheumatology outcomes: the patient's perspective. A multicentre focus group interview study of Swedish rheumatoid arthritis patients. Rheumatology (Oxford) 44:105–110. doi:10.1093/rheumatology/keh412CrossRefGoogle Scholar
Sanderson T, Morris M, Calnan M, Richards P, Hewlett S (2010) What outcomes from pharmacologic treatments are important to people with rheumatoid arthritis? Creating the basis of a patient core set. Arthritis Care Res (Hoboken) 62:640–646. doi:10.1002/acr.20034CrossRefGoogle Scholar
Barlow JH, Turner AP, Wright CC (1998) Long-term outcomes of an arthritis self management programme. Br J Rheumatol 37:1315–1319PubMedCrossRefGoogle Scholar
Barlow JH, Turner AP, Wright CC (2000) A randomized controlled study of the Arthritis Self-Management Programme in the UK. Health Educ Res 15:665–680PubMedCrossRefGoogle Scholar