title: Children's experiences of living with juvenile idiopathic arthritis: a thematic synthesis of qualitative studies.
abstract: OBJECTIVE
  To describe the experiences and perspectives of children and adolescents living with juvenile idiopathic arthritis (JIA).
  
  
  METHODS
  We conducted a systematic review of qualitative studies that explored the experiences of children living with JIA. We searched electronic databases (to week 2 of July 2011) and reference lists of relevant articles.
  
  
  RESULTS
  Twenty-seven studies that reported the experiences of more than 542 participants were included. Six major themes were identified: aversion to being different (unrelenting and unpredictable pain, disablement, internal disfigurement, differential treatment, and forced dependency on others); striving for normality (preserving social identity, resourcefulness, sense of community, focus on remission, and mastery over body and pain); stigma and misunderstanding (trivialization of disease, invisible pain, and discrimination); suspension in uncertainty (control versus powerlessness, hope versus disappointment); managing treatment (benefits of taking medicines, respect and involvement in health care, and motivation for physical therapy); and desire for knowledge (medical treatment and advances, lifestyle management).
  
  
  CONCLUSIONS
  JIA disrupts a child's sense of normality and impairs his or her capacity for social participation. Children with JIA have a sense of being misunderstood and stigmatized, and they feel perpetually caught between having hope and control over their bodies and overwhelming pain and despair. To increase their confidence, the ability to manage pain, and their resourcefulness for self-management, children need ongoing information about treatments and lifestyle management, strong social support, community advocacy, and active involvement in their own health decision making.
authors.affiliation: University of Sydney, Sydney, New South Wales, Australia. allison.tong@sydney.edu.au
authors.forename: Allison
authors.initials: A
authors.lastname: Tong
authors.forename: Julie
authors.initials: J
authors.lastname: Jones
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Craig
authors.forename: Davinder
authors.initials: D
authors.lastname: Singh-Grewal
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001171:Arthritis, Juvenile / Q000150:complications / Q000523:psychology* / Q000628:therapy; D001828:Body Image; D002648:Child; D017281:Cost of Illness; D004644:Emotions; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D010146:Pain / Q000209:etiology / Q000517:prevention & control / Q000523:psychology*; D010465:Perception; D011287:Prejudice; D036301:Qualitative Research; D011788:Quality of Life; D012649:Self Concept; D012933:Social Identification; D013240:Stereotyping; D055815:Young Adult