Background/Purpose: Patients with rheumatoid arthritis (RA) face a number of challenges which adversely affect their quality of life. The objective was to qualitatively evaluate content of online discussions on their perceived physical challenges posted by patients with RA.

Methods: Participants were adults 18 years or older, living the United States or Canada, diagnosed with RA and enrolled in a trial assessing the effects of social networking on chronic disease management in RA, using a private patient support group on Facebook. Different topics for discussion were posted weekly by a moderator. We collected the discussions posted by the participants on their perceived physical challenges and compiled them into a database. The data was coded using Dedoose, an online application for qualitative data analysis. We used a grounded theory approach and thematic content analysis to synthetize and categorized the codes into major themes.

Results: The group had 92 registered members. Sixty-four members comprising 60 females and 4 males participated actively by contributing to the discussion. They ranged in age from 24 to 71 years, 93.8% were non-Hispanic white, 68.8% were married or living with a significant other or partner and 61% had a Bachelor’s degree or higher educational level. Participants had been diagnosed with RA between 1 and 9 years prior to the study. A total of 356 posts were found including 25 by the moderator. Number of posts per active participant ranged between 1 and 60. The major themes identified included: i) Perceived physical challenges, ii) Psychological manifestations, iii) Social effects of living with RA, and iv) Coping mechanisms.

Specific physical challenges commonly identified by participants included fatigue, pain, stiffness and inability or difficulty in carrying out simple daily tasks. Psychological manifestations included insomnia, brain fog, frustrations particularly from being misunderstood, and depression. Social effects included disruptions in their social engagements, family lives, difficulty in keeping up with friends and demands of work life. Coping mechanisms included use of medical therapies including pharmacotherapy and surgery, attitudinal changes, lifestyle modifications such as going slowly in the mornings, getting up a bit early and not scheduling appointments before 10 am, and using social support.

Conclusion: Patients with RA face a myriad of physical challenges which may take a toll on their social lives and mental states. Our evidence suggests a beneficial effect for interventions designed to increase education or conversation between patients and their health care providers to address the identified issues.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/physical-challenges-in-ra-a-qualitative-study-of-an-online-patient-support-group/