Understanding Rheumatoid Arthritis

241 Pages·1995·1.23 MB·English

by  Ray Fitzpatrick

Understanding Rheumatoid Arthritis
Rheumatoid arthritis is a major cause of disability affecting about 1 per
cent of the population. Although much effort has been expended on
research into the causes and treatment of RA, little progress has been
made in finding a cure. The focus of treatment in RA is on reducing the
disabling consequences of disease and controlling the symptoms.
Understanding Rheumatoid Arthritis examines the nature of RA and
its treatment, individuals’ experience of RA and its symptoms of pain
and stiffness. The impact of RA on quality of life is presented as well as
the role of health care professionals and encounters with the doctor, all
of which influence the individual’s behaviour towards their RA. For
instance, some sufferers appear to adapt successfully to their RA while
others appear to have difficulty. This book explores the psychological
and social aspects of RA in order to contribute to the development of a
broad based understanding of RA.
Understanding Rheumatoid Arthritis will be invaluable to all health
professionals involved in its treatment and/or interested in chronic
illness. It will also be useful to those who suffer from rheumatoid
arthritis, their families and carers.
Stanton Newman is Professor of Health Psychology at University
College Medical School, University of London; Ray Fitzpatrick is a
Fellow at Nuffield College and University Lecturer in the Department
of Public Health and Primary Care, University of Oxford; Tracey
A.Revenson is Associate Professor of Psychology at the Graduate
School and University Center, City University, New York; Suzanne
Skevington is Senior Lecturer in Psychology at the School of Social
Sciences, University of Bath; Gareth Williams is Reader in Sociology
of Health and Illness at the Institute of Social Research, University of
Salford.
Understanding
Rheumatoid Arthritis
Stanton Newman, Ray Fitzpatrick,
Tracey A.Revenson, Suzanne
Skevington and Gareth Williams
London and New York
First published 1996
by Routledge
11 New Fetter Lane, London EC4P 4EE
This edition published in the Taylor & Francis e-Library, 2005.
“To purchase your own copy of this or any of Taylor & Francis or Routledge’s
collection of thousands of eBooks please go to www.eBookstore.tandf.co.uk.”
Simultaneously published in the USA and Canada
by Routledge
29 West 35th Street, New York, NY 10001
© 1996 Stanton Newman, Ray Fitzpatrick, Tracey A.Revenson,
Suzanne Skevington and Gareth Williams
All rights reserved. No part of this book may be reprinted or
reproduced or utilized in any form or by any electronic,
mechanical, or other means, now known or hereafter
invented, including photocopying and recording, or in any
information storage or retrieval system, without permission in
writing from the publishers.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library.
Library of Congress Cataloguing in Publication Data
A catalogue record for this book has been requested
ISBN 0-203-99391-8 Master e-book ISBN
ISBN 0-415-10540-4 (Print Edition)
ISBN 0-415-10541-2 (pbk)
We would like to dedicate this book to all those
who confront arthritis and to our colleague
Rosemarie Archer who studied these issues with
us.
Contents
List of tables vi
Acknowledgements vii
List of acronyms viii
1 Introduction 1
2 The disorder and its treatment 7
3 The experience of rheumatoid arthritis 23
4 Pain and stiffness 45
5 Quality of life 61
6 Patient-physician relationships 85
7 Coping with rheumatoid arthritis 111
8 Social support and family relationships 135
9 Psychological therapies 163
References 183
Index 219
Tables
2.1 Criteria for the classification of rheumatoid arthritis 8
2.2 Core set of measures of disease activity for clinical trials in 14
RA
3.1 Rank order of causal categories amongst respondents 32
5.1 Dimensions of QoL in various samples of patients with RA as 64
indicated by SIP
5.2 Prevalence studies of depression in RA 70
5.3 The Steinbrocker criteria for classification of functional 72
impairment
6.1 Tasks of patient-physician communication 107
7.1 Coping factors in original measures and as applied to RA 117
7.2 Dimensions used in coping with pain questionnaires 124
Acknowledgements
Ideas for a book come from a variety of sources and we have all been
fortunate to have the opportunity to meet and discuss issues on the
psychological and social aspects of arthritis. These were facilitated by a
Collaborative Senior International Fellowship from the Fogarty
International Center of the US National Institute of Health (Grant no. 1
FOG TWO1663) to Tracey Revenson and Stanton Newman. In addition
Tracey Revenson was supported by a grant from the New York chapter
of the Arthritis Foundation (Fisher Foundation Bequest).
In addition we have been assisted by both our colleagues who have
commented on chapters and our collaborators in the studies reported in
this volume. Our sincere thanks to Rosemarie Archer, Michael Bury,
Barbara Felton, Heather Fields, Allan Gibofsky, Crispin Jenkinson, Ana
Abraido-Lanza, Susan Lonsdale, Deborah Majerovitz, Alastair Mowat,
Edward Seidman, Kathleen Schiaffino, Michael Shipley. We would also
like to thank Sue Garratt for manipulating the text, Sabrina Duncan and
Gail Meacham for help with literature searches and Liz Wake for
assisting with proofreading.
Acronyms
AIMS Arthritic Impact Measurement Scales
BDI Beck Depression Inventory
CES-D Centre for Epidemiological Studies—Depression
CNS central nervous system
CSQ Coping Strategies Questionnaire
DIS Diagnostic Interview Schedule
DMARD Disease modifying and reducing drugs
EA experimentally induced arthritis
EMG electromyograph
ESR erythrocyte sedimentation rate
FSI Functional Status Index
GHQ General Health Questionnaire
HAD Hospital Anxiety and Depression Scale
HAQ Health Assessment Questionnaire
MPQ McGill Pain Questionnaire
NHP Nottingham Health Profile
NSAIDs non-steroidal anti-inflammatory drugs
OA osteoarthritis
PDI Pain Disability Index
QoL quality of life
QWB Quality of Well-being
RA rheumatoid arthritis
RADAR Rapid Assessment of Disease Activity in
Rheumatology
SAARD slow-acting antirheumatic drugs
ix
SEIQoL Schedule for the Evaluation of Individual Quality of
Life
SIP Sickness Impact Profile
SNS sympathetic nervous system
VAPRS Visual Analogue of Pain Relief Scale
VAS Visual Analogue Scale
VMPMI Vanderbilt Multidimensional Pain Management
Inventory
VPCI Vanderbilt Pain Coping Inventory
WOC Ways of Coping