Background: Pain, stiffness and functional restrictions of the joints are the main problems for patients with inflammatory rheumatic diseases. When conventional drugs fail to delay the development of the disease the patient may require biological treatment such as anti-TNF therapy. Some biological drugs are administered in the form of subcutaneous injections by patients themselves. It is therefore important that the patient perspective is focused upon the life-changing situation due to the administration of regular subcutaneous injections.

Aim: The aim of this study was to describe variations in how patients with rheumatic diseases experience the self-administration of their subcutaneous anti-TNF therapy.

Methods: The study had a descriptive qualitative design with a phenomenographic approach. Twenty interviews were conducted based on a strategic sampling in order to achieve variation in conceptions of the phenomenon in terms of sex, age, marital status, education, illness duration, duration of medication, distance between home-hospital, and experience of intravenous infusions.

Results: Four descriptive categories emerged: 1. The struggling patient: The patients experienced a struggle and limitations in their lives by the self-administration of the subcutaneous injections. 2. The learning patient: Patients experienced a learning process by the self-administration of the subcutaneous injections. 3. The participating patient: Patients experienced control over their lives by themselves administers the subcutaneous injections. 4. The independent patient: Patients experienced that they could manage their lives and live as independently as possible by the self-administration of the subcutaneous injections.

The administration of regular subcutaneous anti-TNF injections is a process. The striving for independence in which patients are taking themselves further by learning and participating in drug treatment and then experience that the injection provides independence. Patients under treatment with subcutaneous anti-TNF injections are at different phases in the process of independence; this is not depending on how long they have self-administered subcutaneous injections.