Contrasts in patients' and providers' explanations of rheumatoid arthritis.
OBJECTIVE
To investigate explanations of rheumatoid arthritis (RA) from young women's perceptions of the illness experience and providers' understanding of the disease.


METHODS
This ethnographic study included 17 women from age 26 to 40 years who were under medical care for RA, and five health care providers of these participants.


RESULTS
Two main themes were identified: (a) having RA "is a pain" and (b) it changed me. The first theme represented the participants' physical and emotional suffering, interferences in their everyday lives, and aggravations in receiving health care. The second theme represented the life and lifestyle changes the women experienced as a result of having RA. The providers' explanations included two themes: (a) functioning in a normal manner and (b) controlling the disease. The first theme was keeping the women's physical functioning as normal as possible. The second theme was the providers' goal to control the disease, which they believed would lead to the preservation of joint function and manageable pain levels. Regarding results of health care, the participants and providers had comparable beliefs about decreasing the physical pain and improving joint function but they had disparate notions about the participants' being active partners in communication and negotiation processes of their health care.


CONCLUSIONS
The findings indicated the importance of discovering potential disparities in patients' and providers' explanations of RA, and revealed the participants' desire for clinical support in becoming partners in their own health care.
Fair
Betty Samford
BS
University of Texas Health Science Center at Houston, School of Nursing, 1100 Holcombe Boulevard, Houston, TX 77030, USA. betty.s.fair@uth.tmc.edu
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D000884:Anthropology, Cultural; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000517:prevention & control* / Q000523:psychology*; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003142:Communication; D018450:Disease Progression; D005260:Female; D006801:Humans; D008016:Life Change Events; D008875:Middle Aged; D009722:Nurse Practitioners / Q000523:psychology; D015404:Nursing Methodology Research; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010358:Patient Participation; D010820:Physicians / Q000523:psychology; D012219:Rheumatology; D012649:Self Concept; D012803:Sick Role; D011795:Surveys and Questionnaires