This study’s purpose was to identify and describe common patterns of person-environment interaction in persons with rheumatoid arthritis. Newman’s propositions about pattern provided the theoretical foundation, and a combination of quantitative and qualitative techniques were used to recognize pattern. Sixty-six adults diagnosed with rheumatoid arthritis completed questionnaires that assessed characteristic ways of functioning. Iterative cluster analysis of the data identified five distinct groups of individuals with similar response profiles. Content analysis of each group’s characteristics produced a core theme representing the nature of the common pattern. The finding of multiple, distinct common patterns of person-environment interaction within the population of persons with RA is consistent with findings in other populations. Further study of the common patterns, in relation to health outcomes, has potential for increasing knowledge about the sources of different health experiences among persons with the same chronic illness.
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References
1.
Affleck, G. , Tennen, H., Urrows, S., & Higgins, P. (1993) Individual differences in the day-to-day experience of chronic pain: A prospective daily study of rheumatoid arthritis patients. Health Psychology, 10, 419-426.
2.
Aldenerder, M. S. , & Blashfield, R. K. (1984). Cluster analysis. Beverly Hills, CA: Sage.
3.
Blixen, C. E. , & Kippes, C. (1999). Depression, social support, and quality of life in older adults with osteoarthritis. Journal of Nursing Scholarship, 31, 221-226.
4.
Bolger, N. (1990). Coping as a personality process: A prospective study. Journal of Personality and Social Psychology, 59, 525-537.
5.
Bolger, N. , & Schilling, E. A. (1991). Personality and the problems of everyday life: The role of neuroticism in exposure and reactivity to daily stressors. Journal of Personality, 59, 355-386.
6.
Boyatzis, R. E. (1998). Transforming qualitative information. Thousand Oaks, CA: Sage.
7.
Brauer, D. J. (1993). Multidimensional person-environment interaction patterns and health status in persons with rheumatoid arthritis. Unpublished doctoral dissertation. University of Minnesota, Minneapolis.
8.
Brauer, D. J. (1998). Psychosocial functioning and health status in persons with rheumatoid arthritis. Utrecht, The Netherlands: Sigma Theta Tau International Nursing Research Congress.
9.
Engelman, L. , & Hartigan, R. (1985). K-means clustering. In W. J. Dixon, M. B. Brown, L. Engelman, J. W. Frane, M. A. Hill, R. I. Jennrich, & J. D. Toporek (Eds.), BMDP Statistical Software. Berkeley, CA: University of California Press.
10.
Ford-Gilboe M. , Campbell, J., & Berman, H. (1995). Stories and numbers: Coexistence without compromise. Advances in Nursing Science, 18, 14-26.
11.
Gudbjornsson, B. , Skogseid, B., Oberg, K., Wide, L., & Hallgren, R. (1996). Intact adrenocorticotropic hormone secretion but impaired cortisol response in patients with active rheumatoid arthritis. Journal of Rheumatology, 23(4), 596-602.
12.
Gunther, V. , Mur, E., Kurz, M., & Meise, U. (1994). Stable pattern of stress coping in patients with rheumatoid arthritis. Clinical & Experimental Rheumatology, 12(1), 35-43.
13.
Hart, K. E , & Chiovari, P. (1998). Inhibition of eating behavior: Negative cognitive effects of dieting. Journal of Clinical Psychology, 54, 427-430.
14.
Jalowiec, A. (1987). Jalowiec coping scale. Available: Anne Jalowiec, School of Nursing, Loyola University Medical Center, Maywood, IL.
15.
Jalowiec, A. (1991). Psychometric results on the 1987 Jalowiec coping scale. Available: Anne Jalowiec, School of Nursing, Loyola University Medical Center, Maywood, IL.
16.
Jonsdottir, H. (1998). Life patterns of people with chronic obstructive pulmonary disease: isolation and being closed in. Nursing Science Quarterly, 11(4),160-166.
17.
Jorgensen, C. , & Sany, J. (1994). Modulation of the immune response by the neuro-endocrine axis in rheumatoid arthritis. Clinical & Experimental Rheumatology, 12(4), 435-441.
18.
Keel, P. K. , Mitchell, J. E., Miller, K. B., Davis, T. L., & Crow, S. J. (1999). Long-term outcome of bulimia nervosa. Archives of General Psychiatry, 56, 63-69.
19.
Lambert, V. A. (1983). Study of factors associated with psychological well-being in rheumatoid arthritic women. Image: The Journal of Nursing Scholarship, 17, 50-53.
20.
Lamendola, F. , & Newman, M. A. (1994). The paradox of HIV/AIDS as expanding consciousness. Advances in Nursing Science, 16(3), 13-21.
21.
McCrae, R. , & Costa, P. (1986). Personality, coping, and coping effectiveness in an adult sample. Journal of Personality, 54, 385-405.
22.
Meenan, R. F. , Gertman, R. M., Mason, J. H., & Wolfe, F. (1997). C-reactive protein but not erythrocyte sedimentation rate is associated with clinical severity in patients with osteoarthritis of the knee or hip. Journal of Rheumatology, 24, 1486-1488.
23.
Meenan, R. F. , Mason, J. H, Anderson, J. J., Guccione, A. A., & Kazie, L. E. (1990). AIMS2: The content and properties of a revised and expanded Arthritis Impact Measurement Scales health status questionnaire. Arthritis & Rheumatism, 33, S15.
24.
Moch, S. D. (1990). Health within the experience of breast cancer. Journal of Advanced Nursing, 15, 1426-1435.
25.
Newman, M. A. (1987). Patterning. In M. E. Duffy & N. J. Pender (Eds.), Conceptual issues in health promotion. Indianapolis, IN: Sigma Theta Tau.
26.
Newman, M. A. (1994). Health as expanding consciousness (2nd ed.). New York: NLN.
27.
Newman, M. A. & Moch, S. D. (1991). Life patterns of persons with coronary heart disease. Nursing Science Quarterly, 4, 161-167.
28.
Newman, S. , Fitzpatrick, R., Lamb, R., & Shipley, M. (1990). Patterns of coping in rheumatoid arthritis. Psychology & Health, 4, 187-200.
29.
Parker, J. C. , Smarr, K. L., Walker, S. E., Hagglund, K. J., Anderson, S. K., Hewett, J. E., Bridges, A. J., Caldwell, C. W. (1991). Biopsychosocial parameters of disease activity in rheumatoid arthritis. Arthritis Care & Research, 4, 73-80.
30.
Potter, P. T. & Zautra, A. J. (1997) Stressful life events’ effects on rheumatoid arthritis disease activity. Journal of Consulting and Clinical Psychology, 65, 319-323.
31.
Rao, U. , Ryan, N. D., Dahl, R. E., Birmaher, B., Rao, R., Williamson, D. E., & Perel, J. M. (1999). Factors associated with the development of substance use disorder in depressed adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1109-1117.
32.
Rogers, M. (1970). An introduction to the theoretical basis of nursing. Philadelphia: Davis.
33.
Scharloo, M. , Kaptein, A. A., Weinman, J., Nazes, J. M., Willems, L.N.A., Bergman, W., & Rooijmans, H.G.M. (1998). Illness perceptions, coping and functioning in patients with rheumatoid arthritis, chronic obstructive pulmonary disease and psoriasis. Journal of Psychosomatic Research, 44(5), 573-585.
34.
Scheier, M. , & Carver, C. (1987). Dispositional optimism and physical well-being. The influence of generalized outcome expectancies on health. Journal of Personality, 55, 169-210.
35.
Schmidt, B. J. (1999). The art of everyday living with rheumatoid arthritis. Unpublished master’s thesis, University of Minnesota, Minneapolis.
36.
Tellegen, A. (1984). Structures of mood and personality and their relevance to assessing anxiety, with an emphasis on self-report. In A. H. Tuma & J. D. Maser (Eds.), Anxiety and the anxiety disorders. Hillsdale, NJ: Erlbaum.
37.
Tellegen, A. (1996). Brief manual for the Differential Personality Questionnaire. Unpublished manuscript, University of Minnesota, Minneapolis.
38.
U.S. Bureau of the Census (July 23, 1991). 1990 Census of Population and Housing (Summary Tape File 1A). Washington, DC: Author.
39.
Walker, L. O. , & Avant, K. C. (1995). Strategies for theory construction in nursing (3rd ed.). Norwalk, CT: Appleton & Lange.
40.
Watson, D. , & Clark, L. A. (1984). Negative affectivity: The disposition to experience aversive emotional states. Psychological Bulletin, 96, 465-490.
41.
Watson, D. , Clark, L., & Carey, G. (1988). Positive and negative affectivity and their relation to anxiety and depressive disorders. Journal of Abnormal Psychology, 97, 346-353.
42.
Watson, D. , & Pennebaker, J. (1989). Health complaints, stress, and distress: Exploring the central role of negative affectivity. Psychological Review, 96, 234-254.
43.
Watson, D. , & Tellegen, A. (1985). Toward a consensual structure of mood. Psychological Bulletin, 98, 219-235.
44.
Wiederman, M. W. , & Pryor, T. L. (2000). Body dissatisfaction, bulimia, and depression among women: The mediating role of drive for thinness. International Journal of Eating Disorders, 27, 90-95.
45.
Young, L. D. (1992). Psychological factors in rheumatoid arthritis. Journal of Consulting and Clinical Psychology, 60(4), 619-627.
46.
Zeldow, P. B. , & Pavlou, M. (1988). Physical and psychosocial functioning in multiple sclerosis: Descriptions, correlations, and a tentative typology. British Journal of Medical Psychology, 61, 185-195.
47.
Zvaifler, N. (1989). An introduction to rheumatoid arthritis. Arthritis Care and Research, 2(3), s17-s22.
