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Improving Self-Care for Patients with Rheumatoid Arthritis

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Introduction

Rheumatoid arthritis (RA) is a heterogeneous autoimmune disease that is chronic and acute, most likely to affect women and those between 35-50 years of age. The process of RA begins as an inflammation episode in the synovium, causes it to thicken and become edematous. Synovial inflammation results in joints that are swollen, tender, and stiff. The patient with RA may manifest symptoms of pain, morning stiffness, fatigue, weight loss, anxiety, and depression. (Chen, & Wang, 2007) Self-care abilities are affected by the clinical manifestations related to the disease process of RA.

Assessment

The health history is beneficial to identify the risk factor for those with close relatives suffering with the disease. Physical examination is reliable when assessing the joints, range of motion, and circulation. A developed multi-dimensional health assessment questionnaire that is completed by the patient at each visit in their rheumatology clinic can be scored and provide the physician a current status of their physical and psychological areas that might raise concern for poor self-care. Assessing the patients ESR, CRP levels, and rheumatoid factor provides information of the patients’ baseline laboratory values with any deviations.(Palmer, El Gaafary, & El Mideany, 2007) The nurse should assess the patients’ psychosocial aspects including, social support; knowledge; education level; and socioeconomic status due to the positive correlation with self-care. (Chen, & Wang, 2007)

Planning

With RA being a chronic disease with acute exacerbations and remissions, it has social, emotional, physical, and psychosocial complications. Impaired physical mobility is a problem associated with RA, due to the symptoms of morning s...

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...elf-care abilities with this disease.

References

Chen, s, & Wang, h. (2007). The relationship between physical function, knowledge of disease, social support and self-care behavior in patients with rheumatoid arthritis. Journal of Nursing Research, 15(3),183-92.

Makelainen , P, Vehvilainen-Julkunen, K, & Pietil, A. (2009). Change in knowledge and self-efficacy of patients with rheumatoid arthritis: a six-month follow-up study. International Journal of Nursing Practice, 15(5), 368-75.

Makelainen, P, Vehvilainen-Julkunen, K, & Pietil, A. (2007). Rheumatoid arthritis patients' education-contents and methods. Journal of Nursing & Healthcare of Chronic Illnesses, 16(11c), 258-67.

Palmer, D, El Gaafary, M, & El Mideany, Y. (2007). Rheumatology. improving patient care: measurement of outcome in rheumatoid arthritis. British Journal of Nursing, 16(16), 1010-5.
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