title: Defining morning stiffness in rheumatoid arthritis.
abstract: OBJECTIVE
  Morning stiffness is a common and clinically important symptom in patients with rheumatoid arthritis (RA); however, it has not performed well as a classification criterion, perhaps due to poor definition. This qualitative study was carried out to identify the characteristics of morning stiffness through the self-reports of patients with RA in order to develop a new patient centered definition.
  
  
  METHODS
  Personal interviews with 24 patients with RA were analyzed independently by 2 reviewers using a grounded theory approach. A mail-out questionnaire was used to validate the information summarized from the interviews.
  
  
  RESULTS
  These findings resulted in the following definition of morning stiffness in RA: slowness or difficulty moving the joints when getting out of bed or after staying in one position too long, which involves both sides of the body and gets better with movement.
  
  
  CONCLUSIONS
  This new patient centered definition of morning stiffness may allow more precise classification of patients with RA.
authors.affiliation: Arthritis Community Research and Evaluation Unit, Ontario Cancer Institute/Princess Margaret Hospital, Toronto, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Lineker
authors.forename: E
authors.initials: E
authors.lastname: Badley
authors.forename: C
authors.initials: C
authors.lastname: Charles
authors.forename: L
authors.initials: L
authors.lastname: Hart
authors.forename: D
authors.initials: D
authors.lastname: Streiner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000503:physiopathology*; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D007596:Joints / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009068:Movement; D018908:Muscle Weakness / Q000209:etiology; D010146:Pain / Q000209:etiology; D009626:Terminology as Topic