| 1. |
- Feldthusen, Caroline, 1977, et al.
(författare)
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Perception, consequences, communication, and strategies for handling fatigue in persons with rheumatoid arthritis of working age—a focus group study
- 2013
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Ingår i: Clinical Rheumatology. - : Springer Science and Business Media LLC. - 0770-3198 .- 1434-9949. ; 32:5, s. 557-66
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Tidskriftsartikel (refereegranskat)abstract
- Abstract The aim of this study was to describe how persons with rheumatoid arthritis (RA) of working age experience and handle their fatigue in everyday life. Six focus group discussions were conducted focusing on experiences of fatigue in 25 persons with RA (19 women, 6 men), aged 20–60 years. The discussions were recorded, transcribed verbatim, and analyzed according to qualitative content analysis. The analyses resulted in four categories. (1) Perception of fatigue: Fatigue was experienced different from normal tiredness, unpredictable, and overwhelming. It was associated with negative emotions, changed self-image, and fears. Feelings of frustration and shame were central when the persons were forced to omit valued life activities. (2) Consequences due to fatigue: The fatigue caused changes in cognitive ability, ability to act, and overall activity pattern where the increased need for rest and sleep caused an imbalance in daily life. The participants struggled not to let the fatigue interfere with work. The fatigue also brought negative consequences for their significant others. (3) Communicating fatigue: Fatigue was difficult to gain understanding for, and the participants adjusted their communication accordingly; it was important to keep up appearances. During medical consultation, fatigue was perceived as a factor not given much consideration, and the participants expressed taking responsibility for managing their fatigue symptoms themselves. (4) Strategies to handle fatigue: Strategies comprised conscious self-care, mental strategies, planning, and prioritizing. Fatigue caused considerable health problems for persons with RA of working age: negative emotions, imbalance in daily life due to increased need for rest, and difficulties gaining understanding. This draws attention to the importance of developing new modes of care to address fatigue in RA. Person-centered care to improve balance in life may be one approach needing further investigations.
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| 2. |
- Ahlstrand, Inger, et al.
(författare)
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Smärta och dagliga aktiviteter vid Reumatoid artrit ur ett patientperspektiv
- 2011
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund: Smärta vid Reumatoid artrit (RA) ärett välkänt symtom som orsakar lidande ochaktivitetsbegränsning. Traditionellt mäts smärtainom reumatologin som smärtintensitet på enVisuell Analog Skala (VAS). Kunskapen kring hurpatienter med RA upplever smärta och dess konsekvenser är begränsad. Patientens egenbeskrivning behövs som underlag för behandlingsplanering och för att utveckla nya metoderför att beskriva problematiken.Syfte: Syftet med studien är att beskriva smärtavid RA ur ett patientperspektiv med fokus på hursmärtan påverkar dagliga aktiviteter.Metod: Patienter med diagnostiserad RA i syd-östra Sverige identifierades via Svenska Reumatologiregistret. Urvalet baserades på minst 5 årssjukdomsduration och minst 40 mm smärtintensitet på VAS vid de två senaste besöken på reumatologklinik. Sammanlagt 33 patienter, 7 män och26 kvinnor, deltog i sju fokusgrupper. Gruppernaformades utifrån kön och ålder. Intervjuguideninnehöll frågor som: Hur beskriver patienter medRA sin smärta? Vad påverkar smärtan? Vilkakonsekvenser har smärtan för aktivitetsutförande,aktivitetsbalans och undvikande av aktivitet? Enkvalitativ innehållsanalys görs.Resultat/förväntat resultat: Analyser hittills visar patienternas frustration över att inteklara det man vill eller behöver göra, beroendeav andra, minskade möjligheter till delaktigheti sociala sammanhang. Och närståendes betydelse. Analyserna visar att smärtan är relaterad till Göteborg6-8 april 201134trötthet, stress och sinnesstämning och att arbeteeller andra aktiviteter medverkar till att glömmabort smärtan och uppehålla förmåga. Analysenslutförs under hösten.Konklusion: Denna studie förväntas genererany angelägen kunskap om och förståelse försmärta.
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| 3. |
- Feldhusen, Caroline, et al.
(författare)
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I am so tired of being tired : – a focus group study of fatigue in RA
- 2011
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- BakgrundFatigue is a prominent symptom in persons with Rheumatoid Arthritis (RA)and has great impact of daily life. The knowledge about how persons with RA in working age are affected by fatigue is limited. The aim of this study was to describe how persons with RA in working age experience and handle their fatigue in everyday life.MetodSix focus group discussions were conducted in 25 persons with RA (19 women/ 6 men) age 20-60 years. The discussions were recorded, transcribed verbatim and analyzed according to qualitative content analysis which resulted in four categories: The nature of fatigue in RA, limitations due to the fatigue, communicating the fatigue and strategies to handle the fatigue.ResultatThe participants experienced their fatigue as a major symptom. Because of its persistence and unpredictable nature it caused feelings of frustration, helplessness and anger. The increased need for rest and sleep caused an imbalance in daily life when valued life activities were forced to be omitted in favor of work. They were feeling limited in everyday life when the fatigue made it impossible to fulfill their roles as expected by themselves and by others. The participants expressed difficulties in communicating about the fatigue and to gain acceptance from the social environment including family, friends and health professionals. They adjusted to whom they were talking to about their fatigue to avoid being seen as lazy, boring or whining. To handle the fatigue in everyday life, planning and prioritizing to find balance was essential. The respondents also used mental strategies to handle the fatigue such as accepting the fatigue and focusing on the possibilities.SammanfattningFatigue causes considerable consequences in persons with RA in working age, living an active life and rating a low general disability. The responsibility for managing fatigue and the struggle of finding balance between important parts in life was taken by the participants themselves because fatigue was not perceived to be a factor given much consideration during medical consultation. This draws attention to the importance for health professionals to address the fatigue and its complexity and unpredictability, even in working persons with low disability.
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| 4. |
- Feldthusen, Caroline, et al.
(författare)
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I am so tired of being tired : – a focus group study of fatigue in RA
- 2011
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Konferensbidrag (refereegranskat)abstract
- Background: Fatigue is a prominent symptom in RA and most negative impact from fatigue seems to be experienced by younger persons. Even in individuals with RA who are able to successfully participate in a wide spectrum of demanding daily activities, fatigue has been shown to be significant. The knowledge about how younger persons with RA experience and handle their fatigue is limited.Objectives: The aims were to explore, by means of qualitative interviews, how fatigue is experienced by persons with RA in working age and to identify when fatigue is experienced as a limitation and how it is handled in everyday life.Methods: Six focus group interviews were conducted with 25 (19 women, 6 men) persons. Inclusion criteria: >30 mm fatigue on a 100 mm visual analogue scale, age between 20-60 years and fulfill classification criteria of rheumatoid arthritis. The persons were asked to discuss their fatigue related to RA as well as how fatigue affected everyday life and how fatigue was handled. Transcripts were systematically analyzed by content analysis identifying units, codes, sub categories, categories and a theme (1). The categories and theme were validated by an expert in the field and by a research partner with RA.Results: Fatigue was experienced by the respondents as a significant symptom. Because of its persistence and unpredictable nature it caused feelings of frustration, helplessness and anger. The respondents expressed difficulties in communicating about the fatigue and to get understanding from the social environment including family, friends and healthcare. They were feeling limited in everyday life when the fatigue made it impossible to fulfill the roles as expected by themselves and by others. Feelings of shame, being lazy and boring were common. Finding balance between important parts of life such as work, family, leisure time, social activities and rest was mentioned as difficult. To handle the fatigue in everyday life planning and prioritizing among activities was essential. The respondents also used mental strategies to handle the fatigue including trying to accept the fatigue and focus on the possibilities.Conclusions: The result showed that fatigue in persons with RA in working age was a symptom of great importance that needs to be more highlighted in the clinical care. Even if the patients did not report extremely high levels of fatigue the consequences were extensive. An understanding of the complexity of fatigue in RA could help the persons to find a better balance between important parts in life.
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| 5. |
- Hallert, Eva, et al.
(författare)
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Development of disease activity and disability in women and men with early rheumatoid arthritis: 8 years of follow-up from the Swedish TIRA-project
- 2010
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Previous studies have reported that disability is strongly associated with disease activity in rheumatoid arthritis (RA) and disability at time of diagnosis has also proved to be a consistent predictor of disability over time.Objectives: To investigate the course of disease activity and disability over 8 years in early RA and to analyse differences between women and men.Methods: 149 patients with disease duration <1 year were included in the Swedish early RA-cohort "TIRA". Patients were followed prospectively for 8 years from the time of diagnosis. Disease activity was assessed by DAS28. Disability was measured by pain (VAS), grip force (Grippit), 'grip ability test' (GAT), range of motion in hand, upper and lower extremity (SOFI), walking speed and Health Assessment Questionnaire (HAQ). Changes over time and differences between women and men were evaluated.Results: Disease activity decreased over time from inclusion to the 8-year follow-up for both women and men. Disability as measured by SOFI (hand, upper and lower extremity) and walking time was improved during the first year after diagnosis but at the 7 and 8 year follow-up, the level of disability was comparable to the level at inclusion. Pain, grip force and GAT were also improved during the first years but thereafter remained stable. HAQ scores were similar in men and women at inclusion. After initial improvement, HAQ remained at a stable level in men, while scores for women deteriorated from year 2 onwards and had reached back to baseline levels at 8 year follow-up. More disability in women than men was also seen in grip force whereas men had more disability than women in SOFI upper extremity. There were no significant differences between women and men in disease activity or disability as measured by VAS pain, GAT, SOFI hand or SOFI lower extremity during the 8-year follow-up.Conclusion: Although disease activity was well managed, disability deteriorated over 8 years with a less favourable course in women than men. Besides controlling disease activity, there is accordingly a need for regular assessments to detect and prevent progressing disability in RA-patients, not only in the early phase of disease, but also over the following years
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| 6. |
- Hjalmarsson Österholm, Johannes, et al.
(författare)
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Factors of importance for maintaining work as perceived by med with arthritis
- 2012
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Konferensbidrag (refereegranskat)abstract
- Background: Employment rates are significantly lower among individuals with arthritis compared to a generalpopulation. During the last decade new biological medications have revolutionized the treatment for many individuals witharthritis (1), reducing the disease activity and symptoms in a positive way, but also causing major direct costs since thenew medications are very expensive (2). Even though the effect is good some individuals still report disability like pain,fatigue (3) and work disability (4). This indicates that even though biological medicines generate a positive remission ofthe disease, disability such as work disability can still be present and needs to be evaluated. Previous research aboutindividuals with arthritis and their ability to work has mainly had a quantitative design focusing on what affects work andfacilitates the ability to work for women. There is, however, limited research about how men with arthritis perceive theirability to maintain working.Objectives: The aim of this study was thus to explore how men with arthritis perceive their ability to maintain working.Methods: Nine employed men with arthritis were purposively sampled. Interviews were performed and were inspired bythe central concepts of the Model of Human Occupation. The Empirical Phenomenological Psychological method wasmodified and used to analyze and interpret collected data.Results: The findings consist of six themes and fifteen sub-themes. The results showed that men with arthritis perceiveda desire to work, adjusted their activity pattern, were aware of their own capabilities, had good work conditions, hadenvironmental support and used effective medication to maintain their ability to work.Conclusions: This study has provided an understanding of how men with arthritis maintain their ability towork. In conclusion, to treat the symptoms of arthritis, in the more traditional way that for examplehand dysfunction and pain are treated, may prevent sick-leave but as found in the presentstudy the ability to work is complex and new strategies to support ability to work need to bedeveloped in the occupational aspects of rheumatology care.
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| 7. |
- Hjalmarsson Österholm, Johannes, et al.
(författare)
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Factors of importance for maintaining work as perceived by men with arthritis
- 2013
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Ingår i: Work. - : IOS PRESS. - 1051-9815 .- 1875-9270. ; 45:4, s. 439-448
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Employment rates are significantly lower among individuals with arthritis compared to a general population. There is, however, limited research about how men with arthritis perceive their ability to maintain working. The aim of this study was thus to explore their perception of this.PARTICIPANTS: Nine employed men with arthritis were purposively sampled.METHODS: Interviews were performed and were informed by the central concepts of the Model of Human Occupation. The Empirical Phenomenological Psychological method was modified and used to analyze and interpret collected data.RESULTS: The findings showed that men with arthritis perceived a desire to work, adjusted their activity pattern, were aware of their own capabilities, had good work conditions, had environmental support and used effective medication to maintain their ability to work.CONCLUSIONS: The findings suggest that health care professionals can help men with arthritis to find strategies and a balance between recreation and work. Ultimately, this knowledge could guide health care professionals to target men needing interventions to prevent sick leave.
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| 8. |
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| 9. |
- Liedberg, Gunilla, 1951-, et al.
(författare)
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Occupational therapists’ perceptions of gender – A focus group study
- 2012
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- 'Doing gender' in encounters with clients has been investigated previously in social science, but has not been explicitly researched from an occupational therapy perspective.The aim was to describe how occupational therapists perceive gender, and its importance for occupational therapy and daily work.The material was based on four focus group interviews that included 17 occupational therapists. The analysis showed two emerging themes: 'The concept of gender is tacit in occupational therapy' and 'Client encounters'. The first theme was for instance built up of the 'Client-centred approach', and 'Values'. The second theme consisted of 'Communication', 'Assessment' and 'Interventions'. Occupational therapists were unaware of the possibility that they were 'doing gender' in their encounters with clients. Implications of these findings for education and practice should include the gender perspective and its consequences for our clients, which could increase the awareness, and its relevance for health in bothmen and women.
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| 10. |
- Liedberg, Gunilla, et al.
(författare)
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Symptoms of subordinated importance in fibromyalgia when differentiating working from non-working women
- 2014
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Ingår i: Work. - : IOS Press. - 1051-9815 .- 1875-9270. ; 48:2, s. 155-164
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The aim was to identify differences in self-reported symptoms among working (W) and non-working (NW)women, and to determine the most important biopsychosocial variables in differentiating one group from the other.METHOD: A questionnaire was mailed to 524 members of a local chapter of the Swedish Rheumatology Association. A total of 362 persons responded (69%); 96% of which were women. Women older than 64 years and all men were excluded. The final study group consisted of 95 W, and 227 NW women. The questionnaire included data on demographics, employment, support, exercise, daily activities and symptoms. Data were analysed using univariate statistics and a partial least squares discriminant analysis (PLS-DA).RESULTS: The results showed that 41% of the W and 42% of the NW women were/had been employed in service,care or business. The NW women reported a significantly higher severity of symptoms compared with the W women. The most important variable when differentiating the W from the NW women wassocial support from colleagues and employers.CONCLUSION: To change prevailing attitudes and values towards persons with a work disability, a process of active intervention involving staff is needed. Educating employers as to how a disability may influence a work situation, and the importance of social support, can be improved.
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