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Belonging, happiness, freedom and empowerment - a qualitative study of patients' understanding of health in early rheumatoid arthritis
Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden; Department of Rheumatology, Skåne University Hospital, Lund, Sweden; Spenshult Research and Development Centre, Halmstad, Sweden.
Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden; Department of Rheumatology, Skåne University Hospital, Lund, Sweden.
Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden; Spenshult Research and Development Centre, Halmstad, Sweden; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark; Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sonderborg, Denmark.ORCID iD: 0000-0002-8081-579X
Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden; Department of Rheumatology, Skåne University Hospital, Lund, Sweden.
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2024 (English)In: BMC Rheumatology, ISSN 2520-1026, Vol. 8, no 1, article id 29Article in journal (Refereed) Published
Abstract [en]

Background: Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory joint disease, that influences patients’ health in different ways, including physical, social, emotional, and psychological aspects. The goal of rheumatology care is to achieve optimal health and personalised care and therefore, it is essential to understand what health means for patients in the early course of RA. The aim of this study was to describe the understanding of health among patients with early RA.

Methods: The study had a descriptive qualitative design with a phenomenographic approach. Phenomenography is used to analyse, describe, and understand various ways people understand or experience a phenomenon, in this study, patients’ understandings of health. Individual semi-structured interviews were conducted with 31 patients (22 women and nine men, aged (38–80) with early RA, defined as a disease duration of < 1 year, and disease-modifying anti-rheumatic drugs (DMARDs) for 3–7 months. The phenomenographic analysis was conducted in 7 steps, and the outcome space presents the variation in understanding and the interrelation among categories. In accordance with the European Alliance of Associations for Rheumatology’s (EULAR) recommendations, a patient research partner participated in all phases of the study.

Results: The analysis revealed four main descriptive categories: ‘Health as belonging’ was described as experiencing a sense of coherence. ‘Health as happiness’ was understood as feeling joy in everyday life. ‘Health as freedom’ was understood as feeling independent. ‘Health as empowerment’ was understood as feeling capable. Essential health aspects in early RA are comprised of a sense of coherence, joy, independence, and the capability to manage everyday life.

Conclusions: This study revealed that patients’ perception of health in early RA encompasses various facets, including a sense of belonging, happiness, freedom, and empowerment. It highlighted that health is multifaceted and personal, emphasizing the importance of acknowledging this diversity in providing person-centred care. The findings can guide healthcare professionals to deepen patients’ participation in treatment goals, which may lead to better treatment adherence and health outcomes. 

 © The Author(s) 2024.

Place, publisher, year, edition, pages
London: Springer Nature, 2024. Vol. 8, no 1, article id 29
Keywords [en]
Health, Interviews, Patients, Phenomenography, Rheumatoid arthritis
National Category
Clinical Medicine
Research subject
Health Innovation, IDC
Identifiers
URN: urn:nbn:se:hh:diva-54306DOI: 10.1186/s41927-024-00399-2ISI: 001258085600001PubMedID: 38937849Scopus ID: 2-s2.0-85197432530OAI: oai:DiVA.org:hh-54306DiVA, id: diva2:1883900
Funder
Region Skåne, REGSKANE-663961Swedish Rheumatism Association, R-980773, R-968996Södra sjukvårdsregionen, 181214Available from: 2024-07-12 Created: 2024-07-12 Last updated: 2025-10-01Bibliographically approved

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Bremander, AnnLarsson, Ingrid

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