Identify Chronic Condition and associated pathophysiology

Introduction

Rheumatoid arthritis (RA) is a chronic autoimmune disease marked by immune system dysfunction that assaults the body's joint tissues, causing discomfort, swelling, and possibly even joint degeneration (Chauhan et al., 2023).

Characteristics

The knee, hand, and wrist joints are typically affected by RA. Instability (loss of balance), pain, and deformation (misshapenness) can happen due to RA (Chauhan et al., 2023).

Pathophysiology

Immune cells, such as T-cells and B-cells, infiltrate the synovium lining the joints, causing inflammation. This inflammation is brought on by the secretion of pro-inflammatory cytokines such as TNF, IL-1, and IL-6 (Chauhan et al., 2023). Anti-citrullinated protein antibodies (ACPAs) and rheumatoid factor (RF) are two autoantibodies that target joint proteins and increase the immune response in RA. Deformities develop due to this ongoing inflammation's erosion of bone and cartilage in joints. The onset of RA can be influenced by genetic and environmental variables (Chauhan et al., 2023).

Etiology

The etiology of RA is heavily influenced by genetics. It is thought that patients' genotypes and environments interacted to cause it. Rheumatoid arthritis risk has been associated with the HLA-DRB1 family of alleles (Chauhan et al., 2023).

Psychosocial considerations/impact

First, the unpredictable nature of RA flares and the enduring pain can cause emotional discomfort, including despair and anxiety. The ability to handle these emotional aspects is essential to preserving general well-being. The disorder significantly impacts a person's quality of life because diminished physical ability, loss of independence, and decreased activity can lower the sense of fulfilment and enjoyment (Lin et al., 2021). Maintaining social connections can be challenging, resulting in social isolation, making the support of friends and family all the more critical (Brignon et al., 2020). Coping mechanisms help manage the pain and stress related to RA. These include mindfulness and relaxation exercises. The importance of self-acceptance is further emphasised by the potential effects on self-esteem and body image (Flurey et al., 2018). Lastly, critical psychological elements include patient education about available treatments related to the condition and access to high-quality healthcare (Lin et al., 2021).

References

Brignon, M., Vioulac, C., Boujut, E., Delannoy, C., Beauvais, C., Kivits, J., Poivret, D., Le Quintrec, S. G., Untas, A., & Rat, C. (2020). Patients and relatives coping with inflammatory arthritis: Care teamwork. Health Expectations : An International Journal of Public Participation in Health Care and Health Policy, 23(1), 137-147. https://doi.org/10.1111/hex.12982

Chauhan, K., Jandu, S.J., Brent, H.L., & Al-Dhahir, A.M. (2023). Rheumatoid Arthritis. In Stat Pearls [Internet]. Stat Pearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK441999/

Flurey, C. A., Hewlett, S., Rodham, K., White, A., Noddings, R., & Kirwan, J. R. (2018). Coping Strategies, Psychological Impact, and Support Preferences of Men With Rheumatoid Arthritis: A Multicenter Survey. Arthritis Care & Research, 70(6), 851-860. https://doi.org/10.1002/acr.23422

Lin, C., Tu, R., Bier, B., & Tu, P. (2021). Uncovering the Imprints of Chronic Disease on Patients’ Lives and Self-Perceptions. Journal of Personalized Medicine, 11(8). https://doi.org/10.3390/jpm11080807

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