'It's this whole picture, this well-being': patients' understanding of 'feeling well' with rheumatoid arthritis

Chronic Illn. 2010 Sep;6(3):228-40. doi: 10.1177/1742395310377672. Epub 2010 Jul 27.

Abstract

Objectives: 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).

Discussion: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Adaptation, Psychological
  • Adult
  • Aged
  • Arthritis, Rheumatoid / psychology*
  • Arthritis, Rheumatoid / therapy
  • Cost of Illness*
  • Female
  • Health Status
  • Humans
  • Internal-External Control*
  • Male
  • Middle Aged
  • Quality of Life / psychology*
  • Self Care / methods
  • Self Concept*
  • Surveys and Questionnaires