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THU0583 Emotions Related to Participation Restrictions Experienced by Patients with Early Rheumatoid Arthritis: A Qualitative Interview Study (The Swedish Tira Study)
  1. G. Ostlund1,
  2. M. Björk2,
  3. I. Thyberg3,4,
  4. M. Thyberg5,
  5. E. Waltersson6,
  6. B. Stenström7,
  7. A. Sverker6
  1. 1School of Health, Care and Social Welfare, Division of Social Work, Mälardalens Uinversity Eskilstuna
  2. 2Department of Rehabilitation, School of Health Sciences, Jönköping University
  3. 3Department of Clinical and Eperimental Medicine, Faculty of Healt Sciences, Rheumatology, Linköping University
  4. 4Department of Rheumatology in Östergötland, County Council of Östergötland, Linköping
  5. 5Department of Medicine and Health, Rehabilitation Medicine, Linköping University
  6. 6Rehabilitation section NSC, County Council of Östergötland, Linköping
  7. 7Patient research partner, the Swedish Rheumatism Association, Stockholm, Sweden


Background Psychological distress is a well-known complication in rheumatoid arthritis (RA). It is usually studied by questionnaires with predefined items related to mental functions, and the knowledge regarding the full spectrum of emotions and their relations to practical participation restrictions is still scarce.

Objectives The aim was to explore emotionsrelated to participation restrictions.

Methods This study is part of the Swedish TIRA-project [1]. 48 patients with early RA, age 20 – 63, were interviewed about participation restrictions with Critical Incident Technique [2]. Transcribed interviews were synthesized into dilemmas and linked to ICF activity/participation codes [3]. The emotions described by the patients have been condensed and categorized.

Results Sadness, fear, anger, and shame were expressed in relation to RA participation restrictions. Sadness was described when trying to perform daily activities such as getting up in the mornings, getting dressed, or at work when not being able to perform duties. Sadness was also experienced in relation to not being able to continue leisure activities or in caring for children. Examples of fear descriptions were found in relation to the deteriorating health and fumble fear made the individual withdraw from activities when mistrusting the body. Anger was described in relation to domestic and employed work, but also in social relations when the individual felt hindered to continue valued activities. Shame or embarrassments were described when participation restrictions became visible in public.

Conclusions Sadness, anger, fear and shame are closely related to practical participation restrictions and may be addressed by corresponding multiprofessional interventions that facilitate participation.


  1. Björk, M., Thyberg, I., Rikner, K., Balogh, I., Gerdle, B. (2009). Sick leave before and after diagnosis of rheumatoid arthritis: a report from the Swedish TIRA project. J Rheumatol;36:1170-1179.

  2. Flanagan, C. (1954). The critical incident technique. Psychological Bulletin; 51:327-358.

  3. Cieza, A., Geyh, S., Chatterji, S., Kostanjsek, N., Ustun, B., Stucki, G. (2005). ICF linking rules; an update based on lessons learned. J Rehabil Med; 37: 212-218.

Disclosure of Interest None Declared

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