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Patients’Perceptions of Having a Good Life One Year after Arthritis Patient Education: A Qualitative Study Nested within a Randomized Controlled Trial

*Kjersti Grønning  -  Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Norway
Ola Bratås  -  Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Norway
Aslak Steinsbekk  -  Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Norway
Open Access Copyright (c) 2017 Nurse Media Journal of Nursing

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Abstract

Background: Patients with inflammatory polyarthritis have various degrees of disease-related challenges such as joint pain, stiffness, fatigue, and physical limitations. Despite these challenges, patients strive for a good life using their personal resources, often taught in patient education. The effect of patient education in polyarthritis is well studied; however, long-term studies on what patients perceive as a good life after participating in arthritis patient education are scarce.

Purpose: The aim of this study was to explore patients’ perceptions of having a good life one year after attending a nurse-led patient education intervention.

Methods: This was a qualitative study nested within a randomized controlled trial (RCT) studying the effect of nurse-led patient education. Fifteen individual semi-structured interviews were conducted among those who attended the nurse-led patient education intervention. The intervention focused on the consequences of living with chronic inflammatory arthritis. The interviews explored how and whether the intervention had made any changes in the informants perceived health, well-being, arthritis, flares, and treatment regimes. The data were analyzed thematically using systematic text condensation.

Results: The findings showed that the informants’ perceptions of having a good life were related to a stable disease with few symptoms, effective treatment regimes, discovering new opportunities and perspectives in life, as well as making choices that felt right. Creating a good life was something the informants had acquired knowledge about in the nurse-led patient education intervention, particularly in the part where they had discussed and shared experiences with each other on how they managed their arthritis in different ways and settings.

Conclusion: Participating in a nurse-led patient education intervention in arthritis helped the informants to discover new opportunities and perspectives on creating a good life, especially through exchanging experiences with fellow patients.

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Keywords: Chronic arthritis; well-being; health promotion; patient education; qualitative methodology

Article Metrics:

  1. Albano, M. G., Giraudet-Le Quintrec, J. S., Crozet, C., & d'Ivernois, J. F. (2010). Characteristics and development of therapeutic patient education in rheumatoid arthritis: analysis of the 2003-2008 literature. Joint Bone Spine, 77, 405-410
  2. Anderson, R. M., & Funnell, M. M. (2010). Patient Empowerment: Myths and Misconceptions. Patient Educ Couns, 79, 277-282. doi: 10.1016/j.pec.2009.07.025
  3. Barlow, J., Turner, A., Swaby, L., Gilchrist, M., Wright, C., & Doherty, M. (2009). An 8-yr follow-up of arthritis self-management programme participants. Rheumatology (Oxford), 48, 128-133
  4. Bergsten, U., Bergman, S., Fridlund, B., & Arvidsson, B. (2011). "Striving for a good life" - the management of rheumatoid arthritis as experienced by patients. Open Nursing Journal, 5, 95-101
  5. Burton, W., Morrison, A., Maclean, R., & Ruderman, E. (2005). Systematic review of studies of productivity loss due to rheumatoid arthritis. Occupational Medicine, 56, 18-27. doi: 10.1093/occmed/kqi171
  6. Cottrell, J. E. D., Jonas, M., Bergsten, U., Blaas, E., de la Torre Aboki, J., Howse, C., . . . Bulinckx, L. (2012). The Nurse's Role in Addressing Unmet Treatment and Management Needs of Patients With Rheumatoid Arthritis: Delphi-Based Recommendations. International Journal of Nursing Knowledge, n/a-n/a. doi: 10.1111/j.2047-3095.2012.01231.x
  7. Daker-White, G., Donovan, J., & Campbell, R. (2014). Redefined by illness: meta-ethnography of qualitative studies on the experience of rheumatoid arthritis. Disabil Rehabil, 36, 1061-1071. doi:doi:10.3109/09638288.2013.829531
  8. de Ridder, D., Geenen, R., Kuijer, R., & van Middendorp, H. (2008). Psychological adjustment to chronic disease. The Lancet, 372, 246-255
  9. Dures, E., Almeida, C., Caesley, J., Peterson, A., Ambler, N., Morris, M., . . . Hewlett, S. (2016). Patient preferences for psychological support in inflammatory arthritis: a multicentre survey. Ann Rheum Dis, 75, 142-147. doi: 10.1136/annrheumdis-2014-205636
  10. Dures, E., Hewlett, S., Ambler, N., Jenkins, R., Clarke, J., & Gooberman-Hill, R. (2016). A qualitative study of patients' perspectives on collaboration to support self-management in routine rheumatology consultations. BMC Musculoskelet Disord, 17, 129. doi: 10.1186/s12891-016-0984-0
  11. Dures, E., Kitchen, K., Almeida, C., Ambler, N., Cliss, A., Hammond, A., . . . Hewlett, S. (2012). "They didn't tell us, they made us work it out ourselves": patient perspectives of a cognitive-behavioral program for rheumatoid arthritis fatigue. Arthritis Care Res (Hoboken), 64, 494-501. doi: 10.1002/acr.21562
  12. Grønning, K., Midttun, L., & Steinsbekk, A. (2016). Patients' confidence in coping with arthritis after nurse-led education; a qualitative study. BMC Nurs, 15, 28. doi: 10.1186/s12912-016-0150-x
  13. Grønning, K., Rannestad, T., Skomsvoll, J. F., Rygg, L. O., & Steinsbekk, A. (2014). Long-term effects of a nurse-led group and individual patient education programme for patients with chronic inflammatory polyarthritis - a randomised controlled trial. J Clin Nurs, 23(7-8), 1005-1017. doi: 10.1111/jocn.12353
  14. Grønning, K., Rødevand, E., & Steinsbekk, A. (2010). Paid work is associated with improved health-related quality of life in patients with rheumatoid arthritis. Clin Rheumatol. doi: DOI10.1007/s10067-010-1534-z
  15. Grønning, K., Lomundal, B., Koksvik, H. S., & Steinsbekk, A. (2011). Coping with arthritis is experienced as a dynamic balancing process. A qualitative study. Clin Rheumatol, 30, 1425-1432. doi: 10.1007/s10067-011-1836-9
  16. Grønning, K., Midttun, L., & Steinsbekk, A. (2016). Patients’ confidence in coping with arthritis after nurse-led education: a qualitative study. BMC Nursing, 15, 28. doi: 10.1186/s12912-016-0150-x
  17. Grønning, K., Rannestad, T., Skomsvoll, J. F., Rygg, L. O., & Steinsbekk, A. (2013). Long-term effects of a nurse-led group and individual patient education programme for patients with chronic inflammatory polyarthritis: a randomised controlled trial. J Clin Nurs. doi: 10.1111/jocn.12353
  18. Grønning, K., Skomsvoll, J. F., Rannestad, T., & Steinsbekk, A. (2012). The effect of an educational programme consisting of group and individual arthritis education for patients with polyarthritis: A randomised controlled trial. Patient Educ Couns, 88, 113-120. doi: 10.1016/j.pec.2011.12.011
  19. Henderson, V. (2006). The concept of nursing. 1977. J Adv Nurs, 53(1), 21-31; discussion 32-24. doi: 10.1111/j.1365-2648.2006.03660.x
  20. Holland, P., & Collins, A. M. (2016). "Whenever I can I push myself to go to work": a qualitative study of experiences of sickness presenteeism among workers with rheumatoid arthritis. Disabil Rehabil, 1-10. doi: 10.1080/09638288.2016.1258436
  21. Lempp, H., Scott, D., & Kingsley, G. (2006). The personal impact of rheumatoid arthritis on patients' identity: a qualitative study. Chronic Illn, 2, 109-120
  22. Lindstrom, B., & Eriksson, M. (2005). Salutogenesis. J Epidemiol Community Health, 59, 440-442
  23. Malterud, K. (2001). Qualitative research: standards, challenges, and guidelines. Lancet, 358, 483-488
  24. Malterud, K. (2012). Systematic text condensation: a strategy for qualitative analysis. Scand J Public Health, 40, 795-805. doi: 10.1177/1403494812465030
  25. Poh, L. W., He, H. G., Chan, W. C., Lee, C. S., Lahiri, M., Mak, A., & Cheung, P. P. (2016). Experiences of Patients With Rheumatoid Arthritis: A Qualitative Study. Clin Nurs Res. doi: 10.1177/1054773816629897
  26. QSR, I. (2007). NVIVO (Version 9). Victoria: QSR International
  27. Ring Jacobsson, L., Milberg, A., Hjelm, K., & Friedrichsen, M. (2016). Gaining perspective on own illness - the lived experiences of a patient education programme for women with treated coeliac disease. J Clin Nurs. doi: 10.1111/jocn.13123
  28. Schulman-Green, D., Jaser, S. S., Park, C., & Whittemore, R. (2016). A meta-synthesis of factors affecting self-management of chronic illness. J Adv Nurs. doi: 10.1111/jan.12902
  29. Scott, I. C., Ibrahim, F., Lewis, C. M., Scott, D. L., & Strand, V. (2016). Impact of intensive treatment and remission on health-related quality of life in early and established rheumatoid arthritis. RMD Open, 2, e000270
  30. Sharpe, L. (2016). Psychosocial management of chronic pain in patients with rheumatoid arthritis: challenges and solutions. J Pain Res, 9, 137-146. doi: 10.2147/jpr.s83653
  31. Stenberg, U., Haaland-Overby, M., Fredriksen, K., Westermann, K. F., & Kvisvik, T. (2016). A scoping review of the literature on benefits and challenges of participating in patient education programs aimed at promoting self-management for people living with chronic illness. Patient Educ Couns. doi: 10.1016/j.pec.2016.07.027
  32. Strand, V., Rentz, A. M., Cifaldi, M. A., Chen, N., Roy, S., & Revicki, D. (2012). Health-related quality of life outcomes of adalimumab for patients with early rheumatoid arthritis: results from a randomized multicenter study. J Rheumatol, 39, 63-72. doi: 10.3899/jrheum.101161
  33. Svavarsdottir, M. H., Sigurdardottir, A. K., & Steinsbekk, A. (2015). What is a good educator? A qualitative study on the perspective of individuals with coronary heart disease. Eur J Cardiovasc Nurs. doi: 10.1177/1474515115618569
  34. van Eijk-Hustings, Y., van Tubergen, A., Bostrom, C., Braychenko, E., Buss, B., Felix, J., . . . Hill, J. (2011). EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis. Ann Rheum Dis. doi: 10.1136/annrheumdis-2011-200185
  35. van Riel, P. L., & Renskers, L. (2016). The Disease Activity Score (DAS) and the Disease Activity Score using 28 joint counts (DAS28) in the management of rheumatoid arthritis. Clin Exp Rheumatol, 34, 40-S44
  36. WHO. (1986). Ottawa Charter for Health Promotion. Paper presented at the International Conference on Health Promotion, Ontario Canada
  37. Zangi, H. A., Ndosi, M., Adams, J., Andersen, L., Bode, C., Bostrom, C., . . . van Tubergen, A. (2015). EULAR recommendations for patient education for people with inflammatory arthritis. Ann Rheum Dis. doi: 10.1136/annrheumdis-2014-206807
  38. Zuidema, R. M., Repping-Wuts, H., Evers, A. W., Van Gaal, B. G., & Van Achterberg, T. (2015). What do we know about rheumatoid arthritis patients' support needs for self-management? A scoping review. Int J Nurs Stud, 52(10), 1617-1624. doi: 10.1016/j.ijnurstu.2015.05.008

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