title: 'It's this whole picture, this well-being': patients' understanding of 'feeling well' with rheumatoid arthritis.
abstract: OBJECTIVE
  The aim of this study was to explore the meaning of 'feeling well' for people with rheumatoid arthritis (RA).
  
  
  METHODS
  In-depth interviews were conducted with 23 RA patients, purposively sampled for medication type, disease duration, disease activity, age and gender. Data were analysed using Framework, emphasizing participants' personal contexts.
  
  
  RESULTS
  Well-being was viewed as a broad concept, with 'feeling well' being the result of an on-going process to actively engage with a changing body, self and life. Four dimensions emerged: 'Living in the body', 'Being in the mind', 'Adapting to illness' and 'Being in the world'. The physical impact of RA underpinned the global perception of well-being and was clearly described as linking to the experience of psychological well-being. Physical and psychological wellness was often affected by the individual's adaptation to RA and personal context (e.g. home environment, broader social attitudes).
  
  
  CONCLUSIONS
  Well-being is a multidimensional concept that is meaningful to RA patients regardless of medication type and disease severity. Patients commonly illustrated a process of actively engaging in cognitive and behavioural adjustments to move towards wellness. Clinical practice and research must take account of the complexity of well-being in long-term conditions, in order to fulfil patients' expectations.
authors.affiliation: School of Health and Social Care, University of the West of England, Glenside Campus, Blackberry Hill, Stapleton, Bristol BS16 1DD, UK. tessa2.sanderson@uwe.ac.uk
authors.forename: T
authors.initials: T
authors.lastname: Sanderson
authors.forename: M
authors.initials: M
authors.lastname: Morris
authors.forename: M
authors.initials: M
authors.lastname: Calnan
authors.forename: P
authors.initials: P
authors.lastname: Richards
authors.forename: S
authors.initials: S
authors.lastname: Hewlett
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000523:psychology* / Q000628:therapy; D017281:Cost of Illness; D005260:Female; D006304:Health Status; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012648:Self Care / Q000379:methods; D012649:Self Concept; D011795:Surveys and Questionnaires