• Plos One · Jan 2014

    Fears and beliefs in rheumatoid arthritis and spondyloarthritis: a qualitative study.

    • Francis Berenbaum, Pierre Chauvin, Christophe Hudry, Florence Mathoret-Philibert, Maud Poussiere, Thibault De Chalus, Caroline Dreuillet, Françoise Russo-Marie, Jean-Michel Joubert, and Alain Saraux.
    • Sorbonne Universités, UPMC Univ Paris 6, AP-HP, Hôpital Saint-Antoine, Rheumatology Department, Paris, France.
    • Plos One. 2014 Jan 1; 9 (12): e114350.

    ObjectivesTo explore beliefs and apprehensions about disease and its treatment in patients with rheumatoid arthritis and spondyloarthritis.Methods25 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.ResultsPatients 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.ConclusionsPatients 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.

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