FRI0740-HPR Responding resiliently to chronic disease: rheumatoid arthritis patients' discourse on coping strategies and challenges
Authors: Y. Shaw, M. Bradley, A. Dominique, K. Michaud, D. McDonald, T.A. Simon
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background:</h3> Little is known about how rheumatoid arthritis (RA) patients build and maintain resilience, or their ability to recover from, and adapt successfully to, stressful situations.<sup>1</sup> As symptoms and limitations caused by RA are often beyond patients9 control, it is important to understand how patients develop and maintain resilience throughout fluctuations in their condition. <h3>Objectives:</h3> We qualitatively explored patient narratives of coping with RA to examine their strategies for building/maintaining resilience in the context of RA. <h3>Methods:</h3> Semi-structured interviews were conducted with adult RA patients in the United States. Interviewees were asked to discuss their experiences with diagnosis, living with RA, coping with challenges, treatment, and healthcare providers. The interviews were audio-recorded and transcribed verbatim. Transcripts were analyzed to identify patients9 strategies for building/maintaining resilience (including examples, patterns in how and when strategies were used, and changes in use as patients gained experience with RA). Patients were categorized as 9high resilience9 and 9low resilience9 based on how confidently they coped with symptoms, physical limitations, the prospect of future life with RA, taking treatments, and communicating with healthcare providers. The characteristics of the high-resilience and low-resilience groups were qualitatively described. <h3>Results:</h3> Eighteen patients were interviewed, with ages of 27–80 years and RA durations of 4–40 years. Patients used 10 strategies to build/maintain resilience (table 1): perseverance, avoiding threatening thoughts, social support connection, pursuing valued activities, positive reframing, maintaining a sense of control, acceptance, humor, equanimity, and flexibility. Nine patients were categorized as high-resilience and 9 patients as low-resilience cases. High-resilience patients tended to have more years' experience of living with RA compared with low-resilience patients. Although low-resilience patients sometimes struggled to cope, they made efforts to improve their capacity to face their personal challenges. <h3>Conclusions:</h3> Participants used a combination of behavioral and emotion management strategies to build and maintain resilience when facing challenges of living with RA. Awareness of these strategies may benefit patients, healthcare providers and researchers developing behavioral interventions and social support programs in the context of RA and other chronic diseases. <h3>Reference</h3> 1. Sinclair VG, Wallston KA. Assessment2004;11:94–101. <h3>Disclosure of Interest:</h3> Y. Shaw Grant/research support from: Bristol-Myers Squibb, M. Bradley: None declared, A. Dominique Employee of: Bristol-Myers Squibb, K. Michaud Grant/research support from: Bristol-Myers Squibb, Pfizer and Rheumatology Research Foundation, Employee of: University of Nebraska Medical Center and National Data Bank for Rheumatic Diseases, D. McDonald Grant/research support from: Bristol-Myers Squibb, T. Simon Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb