Getting a Grip (Yes, you can!)

The last article to appear on this page, "ADED Benefits" (Advanced diagnostics lead to the early detection of joint disease), discussed the technological innovations and medical advances fueling today's (and tomorrow's) early detection efforts. In these early detection efforts, researchers are hoping to control a patient's arthritis before the onset of clinical symptoms. But what can patients do to immediately inspire their own sense of control? They're the ones with the aches and stiffness. And after all, a sense of control--that patients have "a choice amongst responses that are differentially effective", that what patients decide to do really matters--is the precursor to maintaining a good diet and staying active, both necessary to fighting arthritis.

Most crucial to the perception of control, patients need to understand the reasoning behind the decisions made on their personal health, i.e. why they're receiving a certain type of care; why they're being referred to a specialist; or why they're on one drug therapy and not another. According to a study published in the April 2005 edition of Arthritis & Rheumatism, there's a deep patient desire to learn just this. The study, which took place in Nottinghamshire, United Kingdom, analyzed survey responses from a randomly selected group of 600 RA patients. Using the certified Autonomy Preference Index, researchers found that patients were interested in becoming more assertive when figuring out their specific form of treatment. But even more so, these patients were interested in understanding the doctor's jargon and the medical factors at play in their treatment. Consistent with earlier studies, this study found that women exhibited a greater need to know and become involved, and that younger age and a greater knowledge of RA were reliable predictors for increased patient involvement.

Because of a patient's thirst for knowledge, the doctor's consultation is an important moment to learn, understand what's happening and weigh the options. As one study points out, the doctor's consultation is a time to share information on occurring symptoms and possible treatments. It's a time to bring lists of questions and observations and a time to explain leaflets. It's a time to air emotions and also a time for professional support, reassurance, and empathy. In essence, the doctor's consultation is a good time to re-imagine the doctor-patient relationship as an equal partnership in the name of good health and living well. Outside the doctor's office, grocery shopping, cooking, and exercise are clearly times to enact a sense of control over arthritis; the same study suggests joining a support group as a way of working through arthritis together.

That the "perception of control" is difficult to quantify or gauge doesn't mean it's any less important. In fact, just talking about control, focusing thought on what it means to feel in control might very well heighten that sense of control. Above all else, the perception of control that springs from a productive doctor's consultation or a nice stroll ultimately seems to be an expression of will. ("I can handle this. I will handle this.") And you know what they say, where there's a will...

Article References
Langer EJ. The psychology of control. California: Sage, 1993.

Neame R, Hammond A, Deighton C. Need for information and for involvement in decision making among patients with rheumatoid arthritis: a questionnaire survey. Arthritis Rheum. 2005 Apr 15;53(2):249-55.

Fraenkel L, Bogardus S, Concato J, Felson D. Preference for disclosure of information among patients with rheumatoid arthritis. Arthritis Rheum. 2001 Apr;45(2):136-9.

S. Ryan, A. Hassell, P. Dawes, et al. Control perceptions in patients with rheumatoid arthritis: the impact of the medical consultation. Rheumatology 2003; 42: 135-140