Use of self‐management behaviors to cope with rheumatoid arthritis stressors

Abstract

Objective. To examine self-management behaviors used to cope with 5 rheumatoid arthritis (RA)-related stressors (pain, fatigue, physical limitations, joint changes, and symptom unpredictability) and the relationship between use of selfmanagement behaviors and ability to perform life activities. Methods. Data were from telephone interviews of 511 persons with RA. Participants were presented with lists of self-management behaviors for each stressor and asked to indicate which they had used in the past year. Performance of life activities was assessed concurrently (baseline) and 1 year later (followup). The number of activities affected (difficulty performing or unable to perform) and the number that individuals were completely unable to perform were calculated. Multiple regression analyses were used to examine the association of perceived stressor impact and arthritis education with strategy use and the association of self-management behaviors with performance of life activities. Results. Four self-management strategies were identified: accommodation, active remediation, social, and perseverance. Greater perceived impact of stressors was associated with use of more self-management strategies in total for each stressor (␤ ‫؍‬ 0.43-0.73, all P < 0.0001) and with use of accommodation (␤ ‫؍‬ 0.26 -0.29, P < 0.0001), social (␤ ‫؍‬ 0.23-0.43, P < 0.0001), and perseverance (␤ ‫؍‬ 0.29 -0.46, P < 0.0001) strategies. Greater use of accommodation strategies at baseline was associated with an increase in the number of activities affected at followup (␤ ‫؍‬ 0.11, P < 0.05); greater use of perseverance strategies was associated with a decrease in activities unable to perform (␤ ‫؍‬ ؊0.13, P < 0.01). Conclusion. Self-management behaviors are commonly used and may help prevent loss of the ability to perform life activities.

Visual art-making as a resource for living positively with arthritis: An interpretative phenomenological analysis of older women's accounts

“…A qualitative study found that women affected by rheumatoid arthritis (within a sample aged 30-80 years old) emphasized the importance of maintaining a sense of control, through, for example, finding ways of maintaining their valued activities (McPherson, Brander, Taylor, & McNaughton, 2001). Helplessness, a willingness to accommodate to arthritis, and passive coping strategies such as resting and inactivity, seem to be associated with increased levels of depression, more functional restrictions, loss of activities, and higher levels of pain (Axford, Heron, Ross, & Victor, 2008;Katz, 2005;Ramjeet, Smith, & Adams, 2008). People with this condition who have positive attitudes and strategies (such as optimism, a willingness to re-prioritize and reframe their situation), and social support, are more likely to maintain their activity repertoires (Katz, 2005;Sinclair & Blackburn, 2008;Treharne, Kitas, Lyons & Booth, 2005;Treharne, Lyons, Booth & Kitas, 2007).…”

Use of accommodations for valued life activities: Prevalence and effects on disability scores

“…Use of other behavioral accommodations, such as limiting activities or taking more time to perform them, to improve functioning or reduce disability may be more common than use of devices or assistance (5)(6)(7)(8). In a study of self-management behaviors used to cope with the functional limitations of rheumatoid arthritis (RA), taking more time to perform activities was the most common strategy reported (by 80% of respondents), followed closely by avoiding or limiting certain activities (75% of respondents) (7).…”

“…In a study of self-management behaviors used to cope with the functional limitations of rheumatoid arthritis (RA), taking more time to perform activities was the most common strategy reported (by 80% of respondents), followed closely by avoiding or limiting certain activities (75% of respondents) (7). Asking for help was reported by ϳ60%, but use of equipment was mentioned only rarely.…”

The Pathogenetic Link Between Stress and Rheumatic Diseases

“…Moreover, in the European Research on Incapacitating Diseases and Social Support cohort of patients with early RA it was demonstrated that patients with a greater amount of specific social support or a stronger specific support network experienced less functional limitation and less psychological distress (Demange et al, 2004). Controlled studies of RA patients demonstrated that the ability of self-management behaviours (accommodation, active remediation, perseverance) can decrease impact of RA-related stressors (pain, fatigue, physical limitations, joint changes, and symptom unpredictability) to perform life activities (p < 0.01 -0.0001) (Katz et al, 2005).…”