Kontakt 2011, 13(3):287-297 | DOI: 10.32725/kont.2011.034

Role of nursing in supporting adaptation of patients with rheumatoid arthritisNursing - Review

Mária Sováriová Soósová

Lekárska fakulta Univerzity Pavla Jozefa Šafárika v Košiciach, Ústav ošetrovateľstva

The main target of the study presented here is to show the most frequently occurring problems and management of the nursing care in rheumatoid arthritis (RA) patients. An analytical-synthetic approach was chosen for the investigation of the most frequent adaptation problems in patients suffering from RA. The analysis was based primarily on original studies and secondarily on data from the literature (meta-analyses, outlining studies). Roy's adaptation model was the main theoretical framework for evaluation of physical, psychical and social impacts of RA. The author shows a great variety of responses to the disease in particular adaptation modes: particularly pain, damage to joints, tiredness in the field of the physiological adaptation, depression, negative perceiving of the body condition, anxiety, depression, reduced self-esteem in the self-concept mode, development of functional disability and altered role performance (e.g. of partner, parent or co-worker) in the role function mode as well as change of relations with significant others in the interdependence mode. In addition to the disease (the focal stimulus), the responses in particular modes were also affected by further stimuli. Biological responses (particularly pain and the physical activity) were particularly significantly affected by depression, anxiety, personal toughness and fitness, but also for example by the participation in educational programmes. The following stimuli determining the psychosocial adaptation were defined: pain, physical activity, functional disability, social support, and participation in programmes supporting health. Knowledge of the above mentioned stimuli is of importance as a starting point for the choice of approaches performed in support of the adaptation. The nurse is due to aim her attention to those, which she can affect. These are particularly the moderation of pain, improvement/maintenance of the physical activity, reduction in the tiredness and maintenance of energy equilibrium, improvement of the functional ability, reduction in the psychological distress (moderation of anxiety and depression and increase of self-esteem), enhancement of positively perceived social support and supporting the patient in his/her self-classification through the mediation of education.

Keywords: rheumatoid arthritis; Roy's adaptation model; nursing care; pain; functional disability; anxiety; depression; social support

Received: March 28, 2011; Accepted: August 30, 2011; Published: September 29, 2011  Show citation