Use of self-management behaviors to cope with rheumatoid arthritis stressors

To examine self-management behaviors used to cope with 5 rheumatoid arthritis (RA)-related stressors (pain, fatigue, physical limitations, joint changes, and symptom unpredictability) and the relationship between use of self-management behaviors and ability to perform life activities.

Data were from telephone interviews of 511 persons with RA. Participants were presented with lists of self-management behaviors for each stressor and asked to indicate which they had used in the past year. Performance of life activities was assessed concurrently (baseline) and 1 year later (followup). The number of activities affected (difficulty performing or unable to perform) and the number that individuals were completely unable to perform were calculated. Multiple regression analyses were used to examine the association of perceived stressor impact and arthritis education with strategy use and the association of self-management behaviors with performance of life activities.

Four self-management strategies were identified: accommodation, active remediation, social, and perseverance. Greater perceived impact of stressors was associated with use of more self-management strategies in total for each stressor (beta = 0.43-0.73, all P < 0.0001) and with use of accommodation (beta = 0.26-0.29, P < 0.0001), social (beta = 0.23-0.43, P < 0.0001), and perseverance (beta = 0.29-0.46, P < 0.0001) strategies. Greater use of accommodation strategies at baseline was associated with an increase in the number of activities affected at followup (beta = 0.11, P < 0.05); greater use of perseverance strategies was associated with a decrease in activities unable to perform (beta = -0.13, P < 0.01).

Self-management behaviors are commonly used and may help prevent loss of the ability to perform life activities.