Perceptions of female patients, caregivers and nurses of pain and pain management in adult patients with rheumatoid arthritis, Ratchaburi Province, Thailand

The care of patients with pain associated with rheumatoid arthritis is challenging and requires a systemic approach to assessment and treatment. This study aimed to explore with female patients, caregivers, and nurses, their perceptions of pain and pain management in adult patients with rheumatoid arthritis in Ratchaburi Province, Thailand. The study involved 10 female patients, 12 caregivers, and 10 nurses. Grounded theory was used as the methodology. Each participant was interviewed for at least one hour for biographical data, and experiences of pain and pain management of rheumatoid arthritis. Interviewing was audiotaped for verbatim transcription. A manual method of thematic analysis was used to find codes and categories, and to generate a grounded theory. The results showed that patients, caregivers, and nurses perceived pain and the effects of the pain of rheumatoid arthritis in terms of degeneration, and the need for intimacy and vigilance respectively. Patients expressed their negativity to pain as dejection, and they acknowledged their solicitude and receptivity towards care. Caregivers and nurses felt close understanding and connectedness respectively. Patients emphasised attribution, and nurses focused on the difficulties associated with chronicity. Pain management was in terms of physical, mental, and spiritual dimensions for all participants.