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The Impact of Life-Long Illness on Women: A Qualitative Study of Low Socio-Economic Rheumatoid Arthritis (RA) Patients

The purpose of this qualitative, ethnographic study was to explore the impact of a chronic disease on low socio-economic women with RA in South Africa. Ten women participants with a mean age of 48 years and a mean duration of RA of 10 years were obtained through purposive sampling from a public hospital RA clinic. In-depth individual interviews were conducted as a method of data collection. The interviews were tape recorded and transcribed for the data analysis. Grounded theory analysis was used which produced 3 primary categories around the impact of RA: (1) Physical impact, (2) Social and economic impact, and (3) Psychological impact; and 5 sub-categories, namely, Pain and poor Functional Status, Change in life-style following a weakened economic position, Change in the constitution of the “Self”, Change in the constitution of the “Self” of the spouse/partner, and Depression. Depression, pain and poor functional status are well known health outcomes for RA patients. Perceived change in the psychological concept of the “Self” is less frequently reported. The value of this study is that the concept of the self is further explored in chronically ill individuals as a ‘fluid’ one, with the potential for undergoing a complete transformation as a consequence of RA.