Redefined by illness: meta-ethnography of qualitative studies on the experience of rheumatoid arthritis
G Daker-White, J Donovan… - Disability and …, 2014 - Taylor & Francis
G Daker-White, J Donovan, R Campbell
Disability and rehabilitation, 2014•Taylor & FrancisPurpose: To synthesize published qualitative studies concerning the lived experience of
rheumatoid arthritis (RA). To compare the conceptual features of qualitative studies covering
two different time periods. Methods: In 2002, 24 items published 1975–2001 were identified
in comprehensive literature searches and assessed by multiple reviewers. In 2010, the first
author found 28 articles published 2002–2009 in a simple search of the Medline database
and synthesized them alone. Articles were synthesized using meta-ethnography. Results …
rheumatoid arthritis (RA). To compare the conceptual features of qualitative studies covering
two different time periods. Methods: In 2002, 24 items published 1975–2001 were identified
in comprehensive literature searches and assessed by multiple reviewers. In 2010, the first
author found 28 articles published 2002–2009 in a simple search of the Medline database
and synthesized them alone. Articles were synthesized using meta-ethnography. Results …
Abstract
Purpose: To synthesize published qualitative studies concerning the lived experience of rheumatoid arthritis (RA). To compare the conceptual features of qualitative studies covering two different time periods. Methods: In 2002, 24 items published 1975–2001 were identified in comprehensive literature searches and assessed by multiple reviewers. In 2010, the first author found 28 articles published 2002–2009 in a simple search of the Medline database and synthesized them alone. Articles were synthesized using meta-ethnography. Results: Both syntheses found that the main symptoms of RA are variable and unpredictable. However, in the first synthesis a sociological model dominated where RA was seen as an assault on self-identity with devastating social consequences. The main concepts were biographical disruption, role incompetence and the dread of dependency on others. In the second synthesis, the findings produced a model for health care practitioners tied to perceptions of control and incorporating a career-adaptation model of the experience of RA. Conclusions: We recommend that future synthesizers and primary qualitative health researchers focus more on non-hospital based populations and non-English language articles or study participants. The implications for rehabilitation follow from reflecting the findings of the synthesis against existing psychological models of coping and adaptation in RA.
- Coping and adaptation are biographical processes, although the relative importance of active “disease mastery” versus more passive “getting used to it” is unclear.
- The uncertainty and fluctuating nature of symptoms and disease course presents existential challenges for people with RA in relation to maintaining physical functioning and social roles.
- Within a social model of disability, these findings point to potential intervention sites in society and relationships that would benefit people living with RA.
Implications for Rehabilitation
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