Self‐management strategies used during flares of rheumatoid arthritis in an ethnically diverse population

Abstract

This study identified a link between causal attribution of flares and the resultant self-management strategies. A perceived trigger of the flare in some patients formed a focus for their self-management strategies, whereas those who could not identify a cause aimed mainly to alleviate symptoms. A better understanding of patients' perspective in the context of disease flares will allow the development of educational programmes to facilitate more effective self-management of this important manifestation of disease.

Facteurs psychologiques et intensité de la fatigue perçue auprès de patients souffrant d’une polyarthrite rhumatoïde : une recherche préliminaire

“…D'une part, l'aspect dynamique et subtil de l'ajustement des patients apparaît difficile à saisir lors une é valuation unique : seules des é tudes à mesures ré pé té es permettraient d'en rendre compte. D'autre part, l'usage d'une é chelle gé né ralisé e de coping [14,22] et d'une é chelle d'attributions causales ne permettent de saisir finement ni l'ajustement psychologique à cette maladie pré cise ni la mise en sens de la maladie par les patients. Le recours à des mé thodologies plus qualitatives apparaît donc né cessaire pour dé crire et comprendre, dans une perspective complé mentaire, les processus à l'oeuvre et la façon dont les patients é laborent leurs rapports à la maladie et à la fatigue [5,8,12,25].…”

Evaluation of coping strategies in established rheumatoid arthritis patients: emergence of concealment in an Asian cohort

“…10 There is yet no consensus on what the best coping strategies are, and the positive association of HRQoL and strategies such as emotional expression (where patients readily express feelings or convey distress) appear conflicting. Although there is some evidence of cultural differences in coping strategies, 15,16 the population sample consisted of adolescents 15 or Asians in the setting of a Western society instead of in Asia. Although there is some evidence of cultural differences in coping strategies, 15,16 the population sample consisted of adolescents 15 or Asians in the setting of a Western society instead of in Asia.…”

A Q-methodology study of flare help-seeking behaviours and different experiences of daily life in rheumatoid arthritis

“…One qualitative study [5] within an ethnically diverse group of RA patients found that patients who did not believe there was a cause to their flares were more likely to use strategies aimed at managing their symptoms such as using analgesics or distraction techniques. In contrast, those who believed they could identify the cause of their flare were more likely to use strategies aimed at eliminating these perceived causes such as altering their diet [5].…”

“…One qualitative study [5] within an ethnically diverse group of RA patients found that patients who did not believe there was a cause to their flares were more likely to use strategies aimed at managing their symptoms such as using analgesics or distraction techniques. In contrast, those who believed they could identify the cause of their flare were more likely to use strategies aimed at eliminating these perceived causes such as altering their diet [5]. A further qualitative study [6] with RA patients across five countries found that when in a flare, patients increase their usual level of self-management strategies by resting, pacing, applying heat or cold and escalating medications such as gluco-corticoids, often without seeking medical advice.…”

“…A further qualitative study [7] found that patients saw seeking medical help for their flares as a last resort once they had exhausted all self-management techniques. However, none of these studies explored patients’ help-seeking behaviours in depth, or whether there are common behaviour patterns [5–7]. Such understanding might help clinicians in supporting patients to self-manage their RA.…”