Romatoid Artritli Hastaların Perspektifinden Yaşam Deneyimleri: Fenomenolojik Bir Yaklaşım

Abstract

Amaç: Araştırmanın amacı, romatoid artritli hastaların perspektifinden yaşam deneyimlerinin derinlemesine aktarılmasıdır. Gereç ve Yöntem: Tanımlayıcı ve fenomenolojik olarak tasarlanan bu araştırma, 15 Temmuz- 15 Ağustos 2020 tarihleri arasında romatoloji polikliniğine muayene olmak için gelen ve en az 1 yıldır romatoid artrit tanısı olan toplam 24 birey ile tamamlanmıştır. Veriler, araştırmacılar tarafından oluşturulan “Hasta Tanıtım Formu” ve “Yarı Yapılandırılmış Görüşme Formu” ile yüz yüze görüşülerek toplanmıştır. Görüşmeler sırasında romatoid artritli hastaların ifadeleri ses kayıt cihazı ile kaydedilmiştir. Verilerin değerlendirilmesinde içerik analizi yöntemi kullanılmıştır. Bulgular: Yapılan kodlamalar sonucunda 3 tema belirlenmiştir. 1) Tanıya verilen ilk tepki, 2) Romatoid artrit semptomlarının hastalar üzerindeki etkisi, 3) Baş etme stratejileri. Romatoid artritli hastaların bir kısmı ilk tanı konulduğunda inkâr ve öfke yaşarken bir kısmı da aile üyelerinde aynı hastalık bulunduğu için kabullenmiştir. Hastalıkla birlikte yaşamları fiziksel, duygusal, emosyonel, sosyal ve ekonomik açıdan etkilenmiştir. Hastalıkla başa çıkarken tedaviye uyum sağlama, aile desteği alma, öz-yönetimlerini güçlendirme ve dine yönelme gibi yöntemleri kullandıkları belirlenmiştir. Sonuç: Bu çalışma, romatoid artritin hastaların yaşamlarını tanı konduğu andan itibaren nasıl etkilediğini ve hastalıkla nasıl baş ettiklerini ortaya koymaktadır. Sağlık profesyonellerinin hastalık yönetiminde hastanın bakış açısını dikkate alma ve holistik bir yaklaşımla tedavilerini oluşturmaları önerilmektedir.

Keywords

• Romatoid Artrit
• Yaşam Deneyimi
• Fenomenolojik Yaklaşım

Life Experiences from the Perspective of Patients with Rheumatoid Arthritis: A Phenomenological Approach

Abstract

Objective: The aim of this research is to convey in-depth life experiences from the perspective of patients with rheumatoid arthritis. Methods: This descriptive and phenomenological study was completed with a total of 24 individuals who came to the rheumatology outpatient clinic for examination between 15 July and 15 August 2020 and had rheumatoid arthritis for at least 1 year. The data were collected through face-to-face interviews with the “Patient Information Form” and “Semi-structured Interview Form” created by the researchers. During the interviews, the statements of the patients with rheumatoid arthritis were recorded with a voice recorder. Content analysis method was used in the evaluation of the data. Results: As a result of the coding, 3 themes were determined. 1) Initial response to diagnosis, 2) Impact of rheumatoid arthritis symptoms on patients, 3) Coping strategies. While some of the patients with rheumatoid arthritis experienced denial and anger when the diagnosis was first made, some of them accepted because their family members had the same disease. With the disease, their lives have been affected physically, emotionally, socially and economically. It was determined that they used methods such as adapting to treatment, receiving family support, strengthening their self-management and turning to religion when coping with the disease. Conclusion:This study reveals how rheumatoid arthritis affects patients’ lives from the moment they are diagnosed and how they cope with the disease. It is recommended that health professionals consider the patient’s point of view in disease management and create their treatment with a holistic approach.

Keywords

• Rheumatoid Arthritis
• Life Experience
• Phenomenological Approach

References

1. Shaw Y, Bradley M, Zhang C, Dominique A, Michaud K, McDonald D, et al. Development of resilience among rheumatoid arthritis patients: a qualitative study. Arthritis Care Res. 2020;72(9):1257-1265. https://doi.org/10.1002/acr.24024
2. Lin YJ, Anzaghe M, Schülke S. Update on the pathomechanism, diagnosis, and treatment options for rheumatoid arthritis. Cells. 2020;9(4):880. https://doi.org/10.3390/cells9040880
3. Monti S, Montecucco C, Bugatti S, Caporali R. Rheumatoid arthritis treatment: the earlier the better to prevent joint damage. RMD Open. 2015;1(Suppl 1):e000057. https://doi.org/10.1136/rmdopen-2015-000057
4. Chavare S, Natu S. Life of Indian women with rheumatoid arthritis: a qualitative study. IOSR Journal of Humanities and Social Science. 2020;25(3):1-12. https://doi.org/10.9790/0837-2503050112
5. Schneider M, Manabile E, Tikly M. Social aspects of living with rheumatoid arthritis: a qualitative descriptive study in Soweto, South Africa – a low resource context. Health Qual Life Outcomes. 2008;6(54):1-11. https://doi.org/10.1186/1477-7525-6-54
6. Aundhia C, Patel S, Shah N, Parmar G, Seth A. Psychological effects and management of rheumatoid arthritis. Int J Pharm Res. 2020;12(2):2033-2039. https://doi.org/10.31838/ijpr/2020.12.02.273
7. Jain A, Aggarwal A, Adams J, Jordan JE, Sadhra S, Dubey S, et al. Work productivity loss among rheumatoid arthritis patients in India: a qualitative study. Rheumatol Adv Pract. 2019;3(2):rkz046. https://doi.org/10.1093/rap/rkz046
8. Schwind JK, Fredericks S, Metersky K, Porzuczek VG. What can be learned from patient stories about living with the chronicity of heart illness? A narrative inquiry. Contemp Nurse. 2016;52(2-3):216–229. https://doi.org/10.1080/10376178.2015.1089179

9. Kocaman N. Hastaların psikososyal tepkilerini etkileyen faktörler. Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi. 2008;11(1):101-112.
10. Kostava Z, Zufferey MC, Schulz PJ. The process of acceptance among rheumatoid arthritis patients in Switzerland: a qualitative study. Pain Res Manag. 2014;19(2):61–68. https://doi.org/10.1155/2014/168472
11. LaChapelle LD, Lavoie S, Boudreau A. The meaning and process of pain acceptance. Perceptions of women living with arthritis and fibromyalgia. Pain Res Manag. 2008;13(3):201–210. https://doi.org/10.1155/2008/258542
12. Ryan S. Psychological effects of living with rheumatoid arthritis. Nurs Stand. 2014;29(13):52-59. https://doi.org/10.7748/ns.29.13.52.e9484.
13. Akkaya F, Kıyak E. Evaluation of the loneliness, social support and quality of life in patients with rheumatoid arthritis. International Journal of Caring Sciences. 2018;11(1):457-463.
14. Baloğlu HH, Aşkın A, Yener M. Determination of the factors that affect health related quality of life in patients with rheumatoid arthritis. Acta Medica Mediterranea. 2015;31(3):687-695.
15. Sturgeon JA, Finan PH, Zautra AJ. Affective disturbance in rheumatoid arthritis: psychological and disease-related pathways. Nat Rev Rheumatol. 2016;12(9):532–542. https://dx.doi.org/10.1038%2Fnrrheum.2016.112
16. Janiszewska M, Baranska A, Kanecki K. Coping strategies observed in women with rheumatoid arthritis. Ann Agric Environ Med. 2020;27(3):401–406. https://doi.org/10.26444/aaem/110958
17. Ruppar TM, Dobbels F, Lewek P, Matyjaszczyk M, Siebens K, Geest SM. Systematic review of clinical practice guidelines for the improvement of medication adherence. Int J Behav Med. 2015;22:699-708. https://doi.org/10.1007/s12529-015-9479-x
18. Kim D, Choi JY, Cho SK, Choi CB, Bang SY, Cha HS, et al. Prevalence and associated factors for non-adherence in patients with rheumatoid arthritis. J Rheum Dis. 2018;25(1):47-57. https://doi.org/10.4078/jrd.2018.25.1.47
19. Bharthi P, Shobha V, Subramanya A. atterns of drug use and factors affecting adherence to medication in patients with rheumatoid arthritis: A prospective, observational, hospital- based study. Internet Journal of Rheumatology and Clinical Immunology. 2019;7(1):1-9. https://doi.org/10.15305/ijrci/v7i1/316
20. Arshad H, Kazmi UER. Social support and coping strategies among rheumatoid arthritis patients. Pakistan J Soc Clin Psychol. 2013;11(2):7-13.
21. Pourshahbazi M, Imani M, Sarafraz MR. Relationship between spirituality components with valued life in women with rheumatoid arthritis. J Res Relig Health. 2019;5(2):89-100. https://doi.org/10.22037/jrrh.v5i2.19017.