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Fears and beliefs in rheumatoid arthritis and spondyloarthritis: a qualitative study.

Berenbaum F, Chauvin P, Hudry C, Mathoret-Philibert F, Poussiere M, De Chalus T, Dreuillet C, Russo-Marie F, Joubert JM, Saraux A - PLoS ONE (2014)

Bottom Line: Beliefs about the disease and apprehensions about the future tended to evolve over the course of the disease, as did treatment expectations.The physician can initiate discussion of these beliefs in order to dispel misconceptions, align treatment expectations, provide reassurance to the patient and readjust disease management.Such a dialogue would help improve standards of care in these chronic and incapacitating diseases.

View Article: PubMed Central - PubMed

Affiliation: Sorbonne Universités, UPMC Univ Paris 6, AP-HP, Hôpital Saint-Antoine, Rheumatology Department, Paris, France.

ABSTRACT

Objectives: To explore beliefs and apprehensions about disease and its treatment in patients with rheumatoid arthritis and spondyloarthritis.

Methods: 25 patients with rheumatoid arthritis and 25 with spondyloarthritis participated in semi-structured interviews about their disease and its treatment. The interviews were performed by trained interviewers in participants' homes. The interviews were recorded and the main themes identified by content analysis.

Results: Patients differentiated between the underlying cause of the disease, which was most frequently identified as a hereditary or individual predisposition. In patients with rheumatoid arthritis, the most frequently cited triggering factor for disease onset was a psychological factor or life-event, whereas patients with spondyloarthritis tended to focus more on an intrinsic vulnerability to disease. Stress and overexertion were considered important triggering factors for exacerbations, and relaxation techniques were frequently cited strategies to manage exacerbations. The unpredictability of the disease course was a common source of anxiety. Beliefs about the disease and apprehensions about the future tended to evolve over the course of the disease, as did treatment expectations.

Conclusions: Patients with rheumatoid arthritis and spondyloarthritis hold a core set of beliefs and apprehensions that reflect their level of information about their disease and are not necessarily appropriate. The physician can initiate discussion of these beliefs in order to dispel misconceptions, align treatment expectations, provide reassurance to the patient and readjust disease management. Such a dialogue would help improve standards of care in these chronic and incapacitating diseases.

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Related in: MedlinePlus

Current repercussions of disease by theme.Filled bars: patients with rheumatoid arthritis; open columns: patients with spondyloarthritis.
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pone-0114350-g001: Current repercussions of disease by theme.Filled bars: patients with rheumatoid arthritis; open columns: patients with spondyloarthritis.

Mentions: Patients reported both current repercussions of their disease as well as fears about the impact that the disease would have on their future lives. Current repercussions are grouped by theme in Fig. 1. Two particular repercussions were evoked by the majority of patients, namely impact on mood and impact on social life. With respect to mood, many patients felt depressed and fed up with the pain and fatigue, but also angry and irritated, particularly by the unpredictable onset of pain. This was accompanied by lowered self-esteem and a feeling of not being able to achieve what they wanted to do or what they could do before. Most patients also reported repercussions on their social life and leisure activities which would either cause them to adapt their activities (timing, duration or intensity) or give them up altogether. This latter situation was frequently a source of depression.


Fears and beliefs in rheumatoid arthritis and spondyloarthritis: a qualitative study.

Berenbaum F, Chauvin P, Hudry C, Mathoret-Philibert F, Poussiere M, De Chalus T, Dreuillet C, Russo-Marie F, Joubert JM, Saraux A - PLoS ONE (2014)

Current repercussions of disease by theme.Filled bars: patients with rheumatoid arthritis; open columns: patients with spondyloarthritis.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4256228&req=5

pone-0114350-g001: Current repercussions of disease by theme.Filled bars: patients with rheumatoid arthritis; open columns: patients with spondyloarthritis.
Mentions: Patients reported both current repercussions of their disease as well as fears about the impact that the disease would have on their future lives. Current repercussions are grouped by theme in Fig. 1. Two particular repercussions were evoked by the majority of patients, namely impact on mood and impact on social life. With respect to mood, many patients felt depressed and fed up with the pain and fatigue, but also angry and irritated, particularly by the unpredictable onset of pain. This was accompanied by lowered self-esteem and a feeling of not being able to achieve what they wanted to do or what they could do before. Most patients also reported repercussions on their social life and leisure activities which would either cause them to adapt their activities (timing, duration or intensity) or give them up altogether. This latter situation was frequently a source of depression.

Bottom Line: Beliefs about the disease and apprehensions about the future tended to evolve over the course of the disease, as did treatment expectations.The physician can initiate discussion of these beliefs in order to dispel misconceptions, align treatment expectations, provide reassurance to the patient and readjust disease management.Such a dialogue would help improve standards of care in these chronic and incapacitating diseases.

View Article: PubMed Central - PubMed

Affiliation: Sorbonne Universités, UPMC Univ Paris 6, AP-HP, Hôpital Saint-Antoine, Rheumatology Department, Paris, France.

ABSTRACT

Objectives: To explore beliefs and apprehensions about disease and its treatment in patients with rheumatoid arthritis and spondyloarthritis.

Methods: 25 patients with rheumatoid arthritis and 25 with spondyloarthritis participated in semi-structured interviews about their disease and its treatment. The interviews were performed by trained interviewers in participants' homes. The interviews were recorded and the main themes identified by content analysis.

Results: Patients differentiated between the underlying cause of the disease, which was most frequently identified as a hereditary or individual predisposition. In patients with rheumatoid arthritis, the most frequently cited triggering factor for disease onset was a psychological factor or life-event, whereas patients with spondyloarthritis tended to focus more on an intrinsic vulnerability to disease. Stress and overexertion were considered important triggering factors for exacerbations, and relaxation techniques were frequently cited strategies to manage exacerbations. The unpredictability of the disease course was a common source of anxiety. Beliefs about the disease and apprehensions about the future tended to evolve over the course of the disease, as did treatment expectations.

Conclusions: Patients with rheumatoid arthritis and spondyloarthritis hold a core set of beliefs and apprehensions that reflect their level of information about their disease and are not necessarily appropriate. The physician can initiate discussion of these beliefs in order to dispel misconceptions, align treatment expectations, provide reassurance to the patient and readjust disease management. Such a dialogue would help improve standards of care in these chronic and incapacitating diseases.

Show MeSH
Related in: MedlinePlus