Article

PURPOSE: To synthesize published qualitative studies concerning the lived
experience of rheumatoid arthritis (RA). To compare the conceptual features of
qualitative studies covering two different time periods. METHODS: In 2002, 24
items published 1975-2001 were identified in comprehensive literature searches
and assessed by multiple reviewers. In 2010, the first author found 28 articles
published 2002-2009 in a simple search of the Medline database and synthesized
them alone. Articles were synthesized using meta-ethnography. RESULTS: Both
syntheses found that the main symptoms of RA are variable and unpredictable.
However, in the first synthesis a sociological model dominated where RA was seen
as an assault on self-identity with devastating social consequences. The main
concepts were biographical disruption, role incompetence and the dread of
dependency on others. In the second synthesis, the findings produced a model for
health care practitioners tied to perceptions of control and incorporating a
career-adaptation model of the experience of RA. CONCLUSIONS: We recommend that
future synthesizers and primary qualitative health researchers focus more on
non-hospital based populations and non-English language articles or study
participants. The implications for rehabilitation follow from reflecting the
findings of the synthesis against existing psychological models of coping and
adaptation in RA. Implications for Rehabilitation Coping and adaptation are
biographical processes, although the relative importance of active "disease
mastery" versus more passive "getting used to it" is unclear. The uncertainty and
fluctuating nature of symptoms and disease course presents existential challenges
for people with RA in relation to maintaining physical functioning and social
roles. Within a social model of disability, these findings point to potential
intervention sites in society and relationships that would benefit people living
with RA.

Langue : ANGLAIS