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  • 1.
    Östlund, Gunnel
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Björk, Mathilda
    Linköpings universitet.
    Thyberg, Ingrid
    Linköpings universitet, Sweden.
    Valtersson, Eva
    Landstinget i Östergötland, Sweden.
    Sverker, Annette
    Linköpings universitet, Sweden.
    Women’s situation-specific strategies in managing participation restrictions due to early rheumatoid arthritis: - a gender comparison.2018In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 6, no 2, p. 251-259Article in journal (Refereed)
    Abstract [en]

    Introduction:

    The present study explored how women describe their use of situation‐specific strategies when managing rheumatoid arthritis (RA). The aim was also to compare women's strategies with those of men, and see the extent to which they used the same strategies. Methods: The data were collected using semi‐structured interviews based on the critical incident technique. The sample consisted of women with early rheumatic arthritis (n = 34), and the results were compared with data reported in a previous study on men (n = 25) from the same cohort. The patient‐described participation restrictions due to RA were firstly linked to the domains of the International Classification of Functioning, Disability and Health (ICF). The different strategies used were then categorized. The study was approved by the Research Ethics Committee of the Faculty of Health Sciences, Linköping University, Sweden. Results: The study found that women used four situation‐specific strategies: adjustment, avoidance, interaction and acceptance. The same strategies had been found previously in interviews with men with RA. Women and men used these strategies to a similar extent in the ICF domains of mobility; major life arenas; domestic life; interpersonal interactions and relationships; and community, social and civic life. However, some differences were found, relating to the reported activities in self‐care and domestic life, in which women reported using strategies to a greater extent than men. Conclusions: Women and men used four types of situation‐specific strategies in managing RA; adjustment, avoidance, interaction and acceptance. These situation‐specific strategies provide useful knowledge, in terms of multidisciplinary rehabilitation and for patients' significant others

  • 2.
    Östlund, Gunnel
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Björk, Mathilda
    Linköpings universitet, Sverige.
    Valtersson, Eva
    Landstinget i Östergötland, Sverige.
    Sverker, Annette
    Linköpings universitet, Sverige.
    Lived experiences of sex life difficulties in men and women with early RA: The Swedish TIRA project.2015In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 13, no 4, p. 248-257Article in journal (Refereed)
    Abstract [en]

    Background: Men and women with rheumatoid arthritis (RA) experience restrictions in everyday life, in spite of the development of new medications. Recent research has described in detail how participation limitations are experienced in everyday life from a patient perspective. However, knowledge of how sex and intimate relationships are affected is still scarce. Objectives: The aim of the present study was to explore sex life experiences in relation to sexual function and sexual relationships in men and women with early RA. Methods: The study formed part of TIRA-2 (the Swedish acronym for the prospective multicentre early arthritis project). The data collection included 45 interviews with 21 men and 24 women, aged 20-63, which were recorded and transcribed verbatim. The critical incident technique was used to collect data, and content analysis to categorize the results. Results: Half the participants stated that RA affected their sex life. The general descriptions formed five categories: sex life and tiredness; sex life and ageing; emotional consequences of impaired sexual function; facilitators of sexual function and sexual relationships; and strain on the sexual relationship. Conclusions: Sex life is affected in early RA, in spite of new effective treatment strategies. New strategies of communication, assessment and self-managing interventions concerning the sex lives of patients with RA need to be implemented by a multidisciplinary healthcare team.

  • 3.
    Östlund, Gunnel
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Thyberg, Ingrid
    Linköpings universitet, Sverige.
    Valtersson, Eva
    Landstinget i Östergötland, Sverige.
    Björk, Mathilda
    Linköpings universitet, Sverige.
    Sverker, Annette
    Linköpings universitet, Sverige.
    The use of avoidance, adjustment, interaction and acceptance strategies to handle participation restrictions among Swedish men with early rheumatoid arthritis.2016In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 14, no 4, p. 206-218Article in journal (Refereed)
    Abstract [en]

    Objectives

    Living with a chronic disease means learning to live under new circumstances and involves a continuous adaptation to new ways of living. There is increasing knowledge about how people cope with stressful life events and adapt to new life situations. Approximately a third of patients diagnosed with rheumatoid arthritis (RA) are men; however, few studies have described the needs and experiences of men living with RA. The aim of the present study was to explore men's strategies for handling challenges related to participation in everyday life.

    Methods

    The present study was associated with the prospective Swedish multicentre early arthritis project (given the Swedish acronym TIRA), which, in 2006–2009, included patients with early RA, contemporarily treated, with a mean disease duration of three years. From this cohort, 25 men, aged 20–63 years, were recruited consecutively. Data were collected in individual interviews, using the critical incident technique. The strategies for dealing with the challenges of RA in everyday life were analysed and categorized using content analysis.

    Results

    Men with RA described four types of strategy for dealing with participation restrictions in everyday life: (i) Adjustment strategies – adjust behaviour, movements, medication, equipment and clothing to find new ways to conduct tasks or activities; (ii) Avoidance strategies – avoid activities, movements, social contacts and sometimes medication; (iii) Interaction strategies – say no, ask for help and work together to handle participation restrictions; and (iv) Acceptance strategies – learn to accept RA, with the pain, the slower work pace and the extended time needed.

    Conclusions

    According to men's lived experiences, a combination of strategies was used to deal with RA, depending on the situation and the experienced restriction. The results provided an understanding of how men with RA manage their disease, to reduce physical, social and emotional challenges. This knowledge may be used further to develop multi-professional interventions and patient education tailored to men with RA.

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