“It is about taking grips and not let myself be ravaged by my body”: A qualitative study of outcomes from in-patient multidisciplinary rehabilitation for patients with chronic rheumatic diseases

Abstract

Purpose: To explore how patients experience the process and personal impact of deriving outcomes from a rheumatological rehabilitation program. Methods: Semi-structured interviews were conducted with 23 patients with inflammatory rheumatic diseases approximately 2 months after a 4-week hospital based multidisciplinary rehabilitation program. A thematic analysis was applied. Results: Overarching themes were increased dignity and self-respect. Initial uncertainty regarding illness management was exchanged with confident coping and of becoming an active agent in ones own life. Strategies and coping tools tried out during the rehabilitation stay, do by their experienced effect become primary sources of gained insight into illness and symptom manifestation. Both elements give a sense of control and influence self-confidence and motivation to engage in self-management. The process from gained insight and experienced effect of coping tools, to active self management, is however, not automatic. Psychological factors play a key role, and there is a need to take individual psychological themes into account and tailor interventions accordingly. Conclusions: Specialized multidisciplinary rehabilitation is an ongoing active process, in which psychological factors play a key role and must be accounted for. Well targeted rehabilitation has the potential to create outcomes of major personal impact.

Implications for Rehabilitation

• Well targeted multidisciplinary rehabilitation has the potential to create outcomes of major personal impact

• Rehabilitation interventions should be tailored according to the patient’s subjective perception of challenges.

• A secure and supportive environment where patients are met with respect and interest represents a crucial element in rehabilitation.

Keywords::

• Coping
• psychological factors
• psychosocial
• rheumatic disease
• rheumatology

Declaration of Interest: This project has been financed with the aid of EXTRA funds from the Norwegian Foundation for Health and Rehabilitation.