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Spiritual Well-Being in Patients With Rheumatoid Arthritis

Lin, Wen-Chuan1; Gau, Meei-Ling2; Lin, Hui-Chen1; Lin, Hung-Ru3*

Journal of Nursing Research: March 2011 - Volume 19 - Issue 1 - p 1-12
doi: 10.1097/JNR.0b013e31820b0f8c
Original Articles

Background: Rheumatoid arthritis (RA) is a chronic, long-term, and non-life-threatening disease. Individuals with RA face various daily pressures that include physical symptoms as well as feelings of helplessness, dependency, threats to self-respect, interference with social activities, disruptions of family ties, and difficulties in continuing to work. Quality of life reflects a patient's spiritual well-being and can be used as an important indicator of adaptation to RA.

Purpose: The aim of this study was to describe the status of spiritual well-being in RA patients.

Methods: This study used meta-synthesis with Sandelowski and Barroso's qualitative meta-summary technique. A comprehensive search of Academic Search Complete, CINAHL, MEDLINE, PsycARTICA LES, and SocINDEX using relevant keywords identified primary research studies that have previously explored spiritual well-being in patients with RA. Each study was systematically evaluated on the basis of the following inclusion criteria: (a) clear descriptions of research purposes and qualitative research, sampling strategies and techniques used; (b) statement of sample size and sample variables; (c) description of data analysis methods used; and (d) quality of research finding presentation.

Results: A total of 675 articles, published between 1995 and 2009, were found. Ten met the inclusion criteria. The results revealed four consistent themes related to RA patients' spiritual well-being, namely, living with the disease, reclaiming control, reframing the situation, and bolstering courage.

Conclusions/Implications for Practice: Multifaceted resources should be used to give patients spiritual support. These resources should include establishing cognition-based education programs that provide information about the disease and programs that offer strong support for patient groups. Curricula should address how to plan family education courses. Spiritual well-being as presented in this study should be integrated into quality-of-life evaluations of RA patients and provide an evaluation tool able to assess the effectiveness of various interventions.

1RN, MS, Lecturer and Doctoral student, Department of Nursing, National Taipei University of Nursing and Health Sciences;

2RN, PhD, Professor, Graduate Institute of Nurse-Midwifery, National Taipei University of Nursing and Health Sciences;

3RN, PhD, Associate Professor and Associate of Chair, Department of Nursing, National Taipei University of Nursing and Health Sciences.

Received: May 21, 2010 Revised: November 18, 2010 Accepted: December 2, 2010

*Address correspondence to: Hung-Ru Lin, No. 365, Ming-Te Rd., Taipei 11221, Taiwan, ROC. Tel: +886 (2) 2822-7101-3197; Fax: +886 (2) 2821-3233; E-mail:

© 2011 Lippincott Williams & Wilkins, Inc.