Over the last 20 years, therapy strategies in RA have been dramatically reformed. Routines for early diagnosis, early aggressive medication is established and disease activity decreased. Although disability for persons treated with new medicines is reduced, the impact of disease on daily activities and participation is described as too high. Even if the disability has decreased, poorer general health is reported, which increases the needs and requirements of participation. Persons with RA are working to a greater extent, have less disability and a greater need to be able to make their own priorities. Despite a well-structured care early so continue many people with RA to report a high pain intensity. Pain has been highlighted by persons with RA as one of the most restrictive symptoms in RA.
Different methodological approach are used in this thesis in order to provide a more comprehensive understanding of the pain and participation in valued activities in persons with RA. International recommendations highlight that research should be based on the experience of those who are living with RA and the person with RA is in focus in standards of care for treatment (including rehabilitation) of RA. The personal perspective is therefore important but such descriptions of pain and perceptions of how it affects people’s everyday life are still missing in research. Patient Reported Outcome Measures (PROM) and focus group discussions are therefore used as data collection in this thesis. Participants in the studies in this thesis are both women and men depending on the previously found gender differences in RA. To what degree pain and participation have been reduced or still exist after the access to biological drugs has not been studied in detail. Consequently, there is a need to study pain and the relationship between pain and participation in daily activities to identify unmet needs for multi professional interventions in rehabilitation directed to the different needs and demands expressed by the women and men with RA today. Which means that there is a need to develop knowledge and methods in rehabilitation. The knowledge this thesis generate will provide a basis for that.
The studies are carried out in collaboration with the rheumatology units in the counties of Jönköping, Kalmar and Östergötland. Patient participation in research is undertaken here through cooperation with the Swedish Rheumatism Association trained research partners. successfully defended her dissertation The dissertation Pain and its relation to participation in valued activities in rheumatoid arthritis, was succesfully defended in september, 2015.