ILLNESS BEHAVIOR IN PATIENTS WITH RHEUMATOID ARTHRITIS

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The primary purpose is to establish baseline data regarding illnes behavior (i.e., the prediagnosis process of symptom-recognition, help-seeking behavior, and symptom validation) in patients with a prevalent chronic condition: rheumatoid arthritis (RA). While it has long been recognized that descriptions of illness behvior in acute conditions may not apply to chronic diseases, little empirical work has been conducted to document differences in this process and to delineate implications of these differences for nursing practice or theory. The study's specific aims are to determine: (1) how patients with RA interpret initial symptoms; (2) lay consultants used regarding initial symptoms and the validating or invalidating nature of consultants' responses; (3) health professionals with whom patients consult and the validating or ivalidating nature of their responses; (4) patients' emotional reactions to consultants' responses; (5) average length of time elapsing between first experience of symptoms and establishment of diagnosis; and (6) patients' emotional responses to receiving an accurate diagnosis. The sample will be 50 adult female patients diagnosed as having RA within the past two years. The primary data collection instrument will be a semi-structured interview schedule consisting of thirteen open-ended questions focusing on patients' interpretation of initial symptoms and their actions and interactions in response to these symptoms during the prediagnosis period. Demographic data and data regarding disease stage, class, and treatment also will be obtained. The primary data analysis method will be content analysis although descriptive statistics also will be used. Data obtained from this study will permit delineationn of implications for both practice and illness behavior theory. First if human responses in the illness behavior period in RA can be specified, practicing nurses can employ therapeutic measures appropriate to these responses. Second, these data may have theoretical implications for traditional models of illness behavior with the potential of evolving a model of illness behavior specific to chronic illness.