NURSING

Nursing Care and Communication for Rheumatoid Arthritis Patients

[Name of the Institute]

Nursing Care and Communication for Rheumatoid Arthritis Patients

Introduction

Rheumatoid arthritis (RA) is a chronic and systemic inflammatory disease of unknown etiology characterized by pain, swelling, tenderness, and deformity of the joints. Mounting evidence suggests that inflammation and joint and cartilage destruction result from activation of proinflammatory cells by an unknown mechanism. RA initially affects joints asymmetrically. Disease progression results in symmetrical joint involvement and deformity, including unnaturally-shaped joints and impaired range of motion. RA commonly affects extra-articular tissue, including the skin, eyes, muscles, blood vessels, heart, and lungs. Potential complications include pericarditis, pleuritis, pleural effusion, cervical spine instability, and anemia.

Patients with RA are at increased risk for cardiovascular disease (CVD), likely due to a combination of factors, including clustering of traditional risk factors, which may be exacerbated by the disease and its treatment and due to inflammation. RA is incurable and usually progressive, although some RA patients have a short and limited disease course. RA patients usually require lifelong treatment by a multispecialty team of clinicians, including specialists in rheumatology, orthopedics, infectious disease, cardiology, pulmonary, nephrology, and ophthalmology (Carr, 2001, pp. 12-14). Treatment involves pharmacotherapy, physical and professional therapy, psychosocial support, and, in some cases, surgery. Lifestyle modifications, including good nutrition, stress management, weight loss, exercise (e.g., low-impact, flexibility, stretching, yoga, tai chi), and hydrotherapy/physiotherapy (i.e., the use of heated water) may be used to manage symptoms. Using specialized devices to improve hand function is encouraged.

RA is a widespread disease. Global prevalence is about 1%, with women affected up to 3 times more often than men.

RA greatly impacts the quality of life (QOL) and the ability to perform activities of daily living (ADLs). Thirty-three percent of patients experience severe disability and are unable to work within five years of diagnosis.

Patients diagnosed with RA have arthritis in 3 or more joints (indicated by swelling, tenderness, warmth, pain, and decreased range of motion), laboratory results indicating elevated serum rheumatoid factor (RF), fatigue, and the presence of subcutaneous rheumatoid nodules (Hill, Pollard, 2004, pp. 21-29).

In patients with RA, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels become elevated, indicating systemic inflammation and increased risk for cardiovascular and other diseases. Life expectancy is 5 to 10 years shorter in patients with RA compared with other patients, attributed in part to cardiovascular, renal, gastrointestinal, and respiratory complications.

Nursing professionals are continually faced with the reality of the death of others, but we generally try to avoid the issue by ignoring it. This paper presents a reflection on the impact of nurses attitudes in the duel of patients with rheumatoid arthritis. For this review, first, research on the attitudes of professionals, then moving on to enumerate the difficulties of Nursing to overcome these negative behaviors. Finally, ended with a series of practice so that, by changing attitudes, we improve the care provided to RA patients in order to increase their quality of life. In this case, communicating with dying patients and educating them about their ailments is the ...