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Levensverhalen en geestelijke gezondheid bij reumatische patiënten: geslachts-, leeftijd- en welzijnsgerelateerde verschillen in levensverhalen bij reumatische patiënten met betrekking tot agency, communion, contamination, redemption en copingstrategieën

Oosterzee, Anne Fleur van (2011) Levensverhalen en geestelijke gezondheid bij reumatische patiënten: geslachts-, leeftijd- en welzijnsgerelateerde verschillen in levensverhalen bij reumatische patiënten met betrekking tot agency, communion, contamination, redemption en copingstrategieën.

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Abstract:Over 2.3 million Dutch citizens are troubled by a rheumatism-related illness. It is expected that, due to increasing body weight and the relative population shift towards older age, rheumatism will increase greatly over the years in the Dutch population. Because of the diseases’ inconsistency and detrimental effects on physical activity, social and role functioning and psyche, a patient has to make many adjustments to the acquired disease. According to the life story model of identity, experiences of the past and expectations of the future are integrated in a continuous ‘life story’, with a protagonist, plot and key scenes. The life story reflects the identity of an individual, and also how new problems – such as a chronic illness - are dealt with and integrated into one’s identity. Research indicates that patients with rheumatism experience a lower level of wellbeing and more psychological and physical ailments than their healthy counterparts. Due to the ‘patient-centered medicine‘ approach, the life story is used more and more as a starting point for individual health care. Increased understanding of the life story could greatly stimulate the wellbeing and (specific) care of this growing group of patients. Therefore, it is the central concept within the current research. Two hundred ninety-nine patients were screened for their level of wellbeing. These patients were categorized as scoring either high (flourishing) or low (languishing) on wellbeing. The twenty patients with the highest and lowest wellbeing scores were interviewed by means of the life story interview. Extra attention was paid to the occurrence of rheumatism in their life story. The transcripts of the interviews were scored on the following life story themes: agency, communion, contamination and redemption. Also, gender- and age-related differences were determined. An additional analysis was done to discover additional themes in the life stories. There is a significantly positive relationship between the level of wellbeing (flourishing versus languishing) and the number of redemption sequences. Communion and agency were unrelated to wellbeing. Age plays a non-significant role in expressing communion-related sequences. No significant gender differences were found for the four themes. The flourishing group did score significantly lower on contamination episodes, compared to the languishing group. The flourishing group also scored significantly higher on both emotion- and problem-focused coping. This indicates that a better combination of and increased flexibility between the two coping strategies might positively be associated with one’s wellbeing. The results of this research can be used for optimizing healthcare surrounding patients with rheumatism. Also, it can become the starting point for further research within this patient group, as well as other chronic illnesses. The research resulted in some additional recommendations for future research. How to integrate life stories in health care might be an interesting research paradigm with tremendous practical consequences that can greatly improve specific care. Offering a written ‘life story’ intervention might be a good way to increase individual wellbeing without further burdening the Dutch health care system. Finally, there are clues that the concepts Locus of Control and religion might play a role within the life story paradigm, which makes life story themes, coping, religion and Locus of Control interesting concepts for further research concerning rheumatism or other chronic illnesses.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:77 psychology
Programme:Psychology MSc (66604)
Link to this item:http://purl.utwente.nl/essays/61230
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