Coping with Rheumatoid Arthritis: Is One Problem the Same as Another?

Abstract

This study examined how individuals with rheumatoid arthritis (RA) cope with illness-related problems in four different areas: daily activities, leisure activities, work, and social relationships. Eighty-five people with RA took part in the study. They participated in an in-depth interview that focused on the types of changes they had experienced in their lives as a result of their arthritis and how they had coped with these changes. Audiotapes of the interviews were transcribed and content analyzed to assess participants' coping behavior. In addition, standardized measures of psychological and physical functioning were administered shortly following the original interview and at a 4-month follow-up. Three major findings emerged. First, people relied less heavily on behavioral coping strategies when dealing with problems involving social relationships than when dealing with problems involving daily activities, leisure activities, or work. Second, there was little consistency in individuals' use of either cognitive or behavioral strategies across different problem areas. Finally, individuals who exhibited limited flexibility in their coping responses experienced poorer psychological functioning compared with more flexible copers. Implications of these findings for health education practice and future research on coping with RA are discussed.

Use of self‐management behaviors to cope with rheumatoid arthritis stressors

“…This consistency of self-management strategies across stressors contrasts with some other studies. For example, Tack (39) noted that patients reported different coping behaviors for fatigue than for other problems, and Blalock et al (8) noted little consistency in use of coping strategies for problems with daily activities, leisure activities, work, and social relationships (although Blalock et al did find that individuals were more likely to use behavioral strategies to cope with problems with functioning, i.e., daily activities, leisure activities, and work, than to cope with problems with social relationships). Previous assessments of coping have categorized coping into a variety of styles, such as active versus passive coping; problem-focused versus emotion-focused coping; and optimistic cognitions, self-control, and behavioral coping (10,19,40 -42).…”

“…Self-management behaviors would appear to fall within this definition of coping. For example, Blalock and colleagues (8) identified a number of behavioral coping strategies for problems with daily and leisure activities, work, and social relationships that might be construed as self-management behaviors, including modification (changing something about a situation or behavior), perseverance (attempting to continue despite problems), and material resources (using special equipment or devices). Two scales used to assess coping with pain, the Coping Strategies Questionnaire (9) and the Vanderbilt Pain Management Inventory (10), assess specific behaviors in addition to emotions and cognitions used to cope with pain, and van Lankveld and colleagues include behaviors in their Coping with Rheumatic Stressors scale (11).…”

Coping with arthritis: Current status and critique

“…Blalock et al (27) have taken this approach. Patients were interviewed regarding how they coped with various aspects of their disease.…”

“…Blalock and colleagues (27) suggest that flexibility in coping may be crucial to the maintenance of well-being in the face of disease activity. They found that arthritis patients who used the greatest number of different coping strategies had higher scores on tests of psychological well-being.…”

When pain remains: Appraisals and adaptation

“…Although no researcher has been able to identify the "best" coping strategy, strategies in which the individual tries to function in spite of pain are usually related to better psychological and physical functioning, whereas passive strategies like restricting activities or relying on others are linked to greater pain and emotional distress (Turk & Monarch, 2002). Further, since there is no ultimate way to cope, effective stress management may be more about flexibility, whereby a greater diversity of pain coping strategies seems to be associated with better psychological adjustment in patients with chronic pain (Blalock, DeVellis, Holt & Hahn, 1993;Haythornthwaite, Menefee, Heinberg & Clark, 1998).…”