Assistive devices, home adjustments and external help in rheumatoid arthritis

Abstract

Purpose: To explain the determinants of adaptation with disease and self-management of patients with rheumatoid arthritis (RA) in Estonia, focusing on the use of assistive devices, home adjustments and the need for external help. Method: A random sample (n = 1259) of adult Estonian RA patients was selected from the Estonian Health Insurance Fund Database. The patients completed a self-administered questionnaire, which included information about their socio-demographic and disease characteristics, the costs of care, quality of life, use of assistive devices, home adjustments and the need for external help. Regression analysis was used to analyse the predictors of patient’s adaptation with disease and self-management. Results: Twenty-six percent of the respondents used assistive devices, 20% had made home adjustments and 37% needed external help. Disabilities and physical impairments predicted the use of assistive devices, home adjustments and the need for external help. The use of medical rehabilitation services predicted the less frequent use of assistive devices, while female gender and single status predicted a more expressed need for external help. Conclusions: Disability and physical impairment are the most important determinants of the use of various technical aids and home adjustments. These factors, along with the female gender and single status of the patient, predict help-dependence.

Implications for Rehabilitation

• Rheumatoid arthritis (RA) is a chronic progressive disease that can lead to joint damage, resulting in chronic pain, loss of function and disability.

• To reduce the difficulties and to manage their everyday lives, RA patients often require personal care, home adjustments or need to use assistive devices.

• A study based on a representative sample of Estonian RA patients demonstrated that disability and physical impairment are the most important determinants of the use of various technical aids and home adjustments.

• In RA, the female gender and single status of the patient predict a more expressed need for external help.

Keywords::

• Assistive devices
• Estonia
• quality of life
• rheumatoid arthritis

Declaration of interest: The authors report no conflict of interest. This study was funded by the Estonian Science Foundation (Grant No. 6461), the Ministry of Education and Research of Estonia (targeted financing SF0180081s07) and the Estonian Health Insurance Fund.