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AB1221-HPR Adjustment, Avoidance, Interaction, and Acceptance Strategies Where Used by Men with Participation Restrictions Due to Early RA
  1. G. Ostlund1,
  2. M. Björk2,3,
  3. I. Thyberg4,
  4. E. Valtersson5,
  5. A. Sverker6,7
  1. 1School of Health, Care and Social Welfare, Mälardalens University, Eskilstuna
  2. 2Rehabilitation Center and Department of Medical and Health Sciences, Linköpings University, Linköping
  3. 3Department of Rehabilitation, School of Health Sciences, Jönköping University, Jönköping
  4. 4Rheumatology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University
  5. 5Department of Rheumatology in Östergötland, County Council of Östergötland
  6. 6Faculty of Arts and Sciences, Department of Social and Welfare Studies, Social Work
  7. 7Department of Rehabilitation and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden


Background Approximately 1/3 of patients diagnosed with the chronic disease Rheumatoid Arthritis (RA) are men, however few studies describe experiences and strategies to handle daily activities [2]. Daily life with a chronic disease means learning to live under new circumstances. This also foresee a continuous adaptation to new ways of living. The process of coping in which the individual change the perceived cause of stress as in problem-focused coping or when managing the emotions of stress, as in emotion-focused coping where first mentioned by Lazarus and Folkman [1]. Coping is described as an individual style to handle stressful events that might be changed over time.

Objectives The aim was to explore men's strategies for dealing with participation restrictions in everyday life due to early RA.

Methods This study is associated with the prospective multi-centre early arthritis project under the Swedish acronym “TIRA-2” [3]. Participants were 25 males of which 22 were work active, mean age 53 years, contemporary treated with mean disease duration of 3 years. Individual interviews were done using the Critical Incident Technique (CIT) [4]. The verbatim transcribed text were analyzed and categorized using content analysis. The study has been approved by the Ethics Committee.

Results The men experienced that RA partly required a changed life style and most of them used a combination of strategies to deal with the participation restrictions in relation to RA. In the adjustment strategy new behaviors and tools were used to solve participation restrictions. The avoidance strategy included deliberate avoidance of possible participation restrictions, such as staying at home in the evenings and avoiding socializing with friends. The interaction strategy included to verbally express needs and give demands in relation to others both at work and in the family and ask for help when needed. The acceptance strategy was identified by the wordings used when talking about the experienced participation restrictions as “I accept that everything takes longer time”.

Conclusions The interviewed men with early RA were contemporary treated and active in the work force, still, all of them had to deal with some participation restrictions. Moreover, this study claims that most men used a combination of strategies to deal with the experienced participation restriction.


  1. Lazarus, R. S., Folkman, S. Stress, Appraisal and Coping 1984, New york: Springer Publishing Company.

  2. Shuttleworth, RP (2004). Disabled masculinity; Expanding the masculine repertoire. In Smith BG, Hutchinson B (Eds). Gendering disability, New Brunswick, NJ; Rutgers University Press.

  3. Thyberg I, Dahlstrom O, Björk M, Arvidsson P, Thyberg M. Potential of the HAQ score as clinical indicator suggesting comprehensive multidisciplinary assessments: the Swedish TIRA cohort 8 years after diagnosis of RA. Clin Rheumatol 2012; 31(5):775-83.

  4. Flanagan C. The critical incident technique. Psychol Bull 1954; 51:327–358.

Disclosure of Interest None declared

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