title: Fears and beliefs in rheumatoid arthritis and spondyloarthritis: a qualitative study.
abstract: OBJECTIVE
  To explore beliefs and apprehensions about disease and its treatment in patients with rheumatoid arthritis and spondyloarthritis.
  
  
  METHODS
  25 patients with rheumatoid arthritis and 25 with spondyloarthritis participated in semi-structured interviews about their disease and its treatment. The interviews were performed by trained interviewers in participants' homes. The interviews were recorded and the main themes identified by content analysis.
  
  
  RESULTS
  Patients differentiated between the underlying cause of the disease, which was most frequently identified as a hereditary or individual predisposition. In patients with rheumatoid arthritis, the most frequently cited triggering factor for disease onset was a psychological factor or life-event, whereas patients with spondyloarthritis tended to focus more on an intrinsic vulnerability to disease. Stress and overexertion were considered important triggering factors for exacerbations, and relaxation techniques were frequently cited strategies to manage exacerbations. The unpredictability of the disease course was a common source of anxiety. Beliefs about the disease and apprehensions about the future tended to evolve over the course of the disease, as did treatment expectations.
  
  
  CONCLUSIONS
  Patients with rheumatoid arthritis and spondyloarthritis hold a core set of beliefs and apprehensions that reflect their level of information about their disease and are not necessarily appropriate. The physician can initiate discussion of these beliefs in order to dispel misconceptions, align treatment expectations, provide reassurance to the patient and readjust disease management. Such a dialogue would help improve standards of care in these chronic and incapacitating diseases.
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 6, AP-HP, Hôpital Saint-Antoine, Rheumatology Department, Paris, France.
authors.forename: Francis
authors.initials: F
authors.lastname: Berenbaum
authors.affiliation: INSERM, Sorbonne Universités, UPMC Univ Paris 6, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Department of Social Epidemiology, Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Chauvin
authors.affiliation: AP-HP, Hôpital Pitié-Salpétrière, Rheumatology Department, Paris, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Hudry
authors.affiliation: AP-HP, Hôpital Cochin, Clinical Psychology Department, Paris, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Mathoret-Philibert
authors.affiliation: Independent Researcher, Paris, France.
authors.forename: Maud
authors.initials: M
authors.lastname: Poussiere
authors.affiliation: UCB Laboratoires, Colombes, France.
authors.forename: Thibault
authors.initials: T
authors.lastname: De Chalus
authors.affiliation: Arthritis Fondation Courtin, Neuilly-sur-Seine, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Dreuillet
authors.affiliation: Arthritis Fondation Courtin, Neuilly-sur-Seine, France.
authors.forename: Françoise
authors.initials: F
authors.lastname: Russo-Marie
authors.affiliation: UCB Laboratoires, Colombes, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Joubert
authors.affiliation: CHU La Cavale Blanche, Rheumatology Department, Brest, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Saraux
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000523:psychology*; D005239:Fear; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D025241:Spondylarthritis / Q000523:psychology*