Chronic Illness: Managing Rheumatoid Arthritis - A Detailed Case Study

This case study analyzes the management of chronic rheumatoid arthritis in a patient, Mrs. Martin, highlighting her initial lack of awareness and the potential dangers of uncertainty about her illness. The study explores alternative treatments, including exercise, physical therapy, and dietary interventions such as zinc, copper, and herbal therapies. It addresses the patient's powerlessness due to her rural background and inadequate patient education, proposing strategies such as achieving clinical remission, preventing long-term disability, and providing education on effective DMARDs. The analysis emphasizes the importance of combining DMARDs with biological therapies, explaining the cost-effectiveness of alternative treatments, and conducting close surveillance of the patient's activities. Desklib offers this case study and many similar resources to aid students in their studies.

Running head: CHRONIC ILLNESS MANAGEMENT
Case Study analysis
Name of the Student
Name of the University
Author Note

1CHRONIC ILLNESS MANAGEMENT
Answer 1
An analysis of the case study suggests that Mrs. Martin was ignorant and lacked
awareness about the illness that she was suffering from. This uncertainty had the potential of
provoking danger, and threats in the cognitive state of the patient Mrs. Martin. In other
words, uncertainty about an illness refers to the inability in determining the meaning of all
illness associated events, which occur when the primary decision maker fails to assign
definite values to certain events or objects, or is incapable of predicting the health outcomes
in a definite manner. According to Mishel’s theory of uncertainty of illness, the antecedents
of uncertainty are composed of things or events that had occurred prior to the illness, thereby
creating an effect on the pain and perception of the patient. This is also associated with poor
adjustment and needs continuous appraisal in the form of a threat, to exert its deleterious
effects. Furthermore, this uncertainty should also be coped with activities that help in dealing
with the condition (Clayton, Dean & Mishel, 2018). Thus, Mrs. Martin’s uncertainty about
her health was a dangerous condition.
Answer 2
Upon conducting an internet search for alternative treatments for rheumatoid arthritis,
the extracted information suggested that there is no proper substitute for medications.
However, evidences supported the use of some alternative approaches such as, exercise,
physical therapy, occupational therapy, mind-body therapy, counseling, acupuncture, and hot
and cold treatment. Credibility of the information can be established by the fact that
promising evidences exist that have established a close association with the treatments and
rheumatoid arthritis (Cramp et al., 2013).
Answer 3

2CHRONIC ILLNESS MANAGEMENT
Upon conducting a search in the academic database, exhaustive information on
dietary interventions for treating rheumatoid arthritis were retrieved. The retrieved
information suggested that zinc, copper, selenium, essential fatty acids are crucial for the
treatment (Vaghef-Mehrabany et al., 2014). Furthermore, herbal therapies that involve the
use of ginger roots, bromelain, and Curcuma longa were also found effective for the chronic
illness. The credibility of the herbal treatment can be linked with their anti-inflammatory
properties (Ramadan & El‐Menshawy, 2013). Several antibiotics were also found successful
in treating RA (Ogrendik, 2014).
Answer 4
Mrs. Martin’s powerlessness can be attributed to the fact that she belonged to a rural
community, and there was not much educational attainment among her family members. The
fact that the physician who performed several diagnostic tests and drained her knee failed to
provide adequate patient education on the presenting complaints and the underlying factors
that contributed to RA, also added to her ignorance and made her display powerlessness in
managing the symptoms. Failure to gain a sound understanding of the risk factors that might
have contributed to her condition and the appropriate interventions for preventing the same
were some of the major contributing factors.
Answer 5
Some of the strategies would encompass:
 Achieving clinical remission
 Preventing long-term disability and structural damage
 Providing education on use of effective DMARDs (disease-modifying anti-
rheumatic drugs) (Ramiro et al., 2014)

3CHRONIC ILLNESS MANAGEMENT
 Combining use of DMARDs with biological therapies and steroids for better control
of the radiological progression
 Explaining the cost-effectiveness and risk: benefit ratio of the alternative treatment
approaches
 Conducting a close surveillance over her activities.

4CHRONIC ILLNESS MANAGEMENT
References
Clayton, M. F., Dean, M., & Mishel, M. (2018). Theories of Uncertainty in Illness. Middle
Range Theory for Nursing, 2017049.
Cramp, F., Hewlett, S., Almeida, C., Kirwan, J. R., Choy, E. H., Chalder, T., ... &
Christensen, R. (2013). Non‐pharmacological interventions for fatigue in rheumatoid
arthritis. The Cochrane Library., 8, 1-75.
Ogrendik, M. (2014). Antibiotics for the treatment of rheumatoid arthritis. International
journal of general medicine, 7, 43.
Ramadan, G., & El‐Menshawy, O. (2013). Protective effects of ginger‐turmeric rhizomes
mixture on joint inflammation, atherogenesis, kidney dysfunction and other
complications in a rat model of human rheumatoid arthritis. International journal of
rheumatic diseases, 16(2), 219-229.
Ramiro, S., Gaujoux-Viala, C., Nam, J. L., Smolen, J. S., Buch, M., Gossec, L., ... &
Landewé, R. (2014). Safety of synthetic and biological DMARDs: a systematic
literature review informing the 2013 update of the EULAR recommendations for
management of rheumatoid arthritis. Annals of the rheumatic diseases, 73(3), 529-
535.
Vaghef-Mehrabany, E., Alipour, B., Homayouni-Rad, A., Sharif, S. K., Asghari-Jafarabadi,
M., & Zavvari, S. (2014). Probiotic supplementation improves inflammatory status in
patients with rheumatoid arthritis. Nutrition, 30(4), 430-435.