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SAGE Open Med. 2017 Jun 7;5:2050312117713647. doi: 10.1177/2050312117713647. eCollection 2017.

Quality of life in patients with established rheumatoid arthritis: A phenomenographic study.

Malm K1,2,3,4, Bergman S1,2,5,6, Andersson ML1,2, Bremander A1,2,7, Larsson I2,5.

Author information

Section of Rheumatology, Department of Clinical Sciences, Lund University, Lund, Sweden.
Spenshult Research and Development Center, Halmstad, Sweden.
Rheumatology, Capio Movement, Halmstad, Sweden.
FoU Spenshult, Halmstad, Sweden.
School of Health and Welfare, Halmstad University, Halmstad, Sweden.
Primary Health Care Unit, Department of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
School of Business, Engineering and Science, Halmstad University, Halmstad, Sweden.



Patients with rheumatoid arthritis perceive reduced quality of life in several domains, such as physical health, level of independence, environment and personal beliefs, compared with the healthy population. There is an increasing interest in quality of life in clinical and medical interventions. Few studies have explored patients' individual conceptions of quality of life, and interviews can thus complement quantitative studies. There is a need for a deeper understanding of the patients' experiences of quality of life, with regard to living with a long-term condition such as rheumatoid arthritis. The aim of this study was to explore the variation of ways in which patients with established rheumatoid arthritis understand the concept of quality of life.


The study had a qualitative design with a phenomenographic approach, which was used to describe variations in how individuals experience their quality of life. The study is based on interviews with 22 patients with established rheumatoid arthritis enrolled in the BARFOT (better anti-rheumatic pharmacotherapy) study.


The concept of quality of life could be understood in three different ways: (1) independence in terms of physical functioning and personal finances, (2) empowerment in how to manage life and (3) participation as an experience of belonging in a social context.


The different conceptions of quality of life reflect the complexity in the concept, including physical, psychological and social aspects. This complexity is important to have in mind when health professionals support patients in enhancing their quality of life.


Rheumatology/clinical immunology; qualitative study; quality of life; rheumatoid arthritis

Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

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