Barriers and reinforcing factors to self‐management behaviour in rheumatoid arthritis patients: A qualitative study

Abstract

Behavioural and environmental barriers, as well as social support and outcomes of SMB were the most important barriers and reinforcing factors of SMB. Therefore, considering these factors in patients may help in designing programmes that attempt to reduce barriers and increase reinforcing factors, which ultimately result in higher levels of SMB and quality of life among patients.

Health status and self‐management in patients with inflammatory arthritis—A five‐year follow‐up study after nurse‐led patient education

“…Also, knowing that higher self‐efficacy scores are associated with lesser psychological distress and tiredness, underline that talking to patients about how to balance their activities and energy according to their individual situations (Grønning et al, ) is needed to support patients to become good self‐managers, (Bech et. al, , Chaleshgar‐Kordasiabi, Enjezab, Akhlaghi, & Sabzmakan, ; Dures et al, ; Ostlund, Björk, Thyberg, Valtersson, & Sverker, ) and that men and women may have different needs (Flurey et al, , , , ; Gruszczynska & Knoll, ).…”

Renegotiating dimensions of the self: A systematic review and qualitative evidence synthesis of the lived experience of self‐managing rheumatoid arthritis

“…Social comparison was a common strategy across the studies. 30,32,34,41,[44][45][46]48,49,51,53,[55][56][57][58][59] Downward comparisons were used to compare oneself to someone in a worse situation or condition: 57(p282) .…”

“…Hopes and fears were often addressed. 30,[32][33][34][35][36][37]41,42,[44][45][46]48,49,51,52,[55][56][57][58][59][60]63 Participants were concerned how they would manage their illness in the future. Despite advances in the treatment, participants managed their illness under the perceived threat of immobilization, deformity and dependence.…”

“…30,31,[33][34][35]37,42,46,49,53,54,58,59 A small number of studies described how religious belief and practice provided hope and helped to maintain a positive outlook. [46][47][48]56,57,62 The predominant feature of the lived experience of self-managing RA related to 'the self', a broad category constructed to reflect various dimensions of self-concept (beliefs about oneself), self-esteem (self-worth and value) and self-efficacy (confidence in ability to deal with health problems). These concepts were found in 29 of the 32 studies.…”

“…32(p32) Feelings of shame, embarrassment and guilt around various aspects of self-managing the condition were described. 32,34,36,[50][51][52]55,56,59 These feelings were expressed, for example, in relation to using visible aids, guilt around not being physically or emotionally available to others, and feelings of embarrassment around asking for help.…”