Table 1 An example of an individual’s self-management behavioral development in the various self-management patterns

A consistent self-management pattern

Long-term medication

Anne takes anti-rheumatic drugs. She is concerned about the risks of side effects.

Anne takes anti-rheumatic drugs.

Anne takes anti-rheumatic drugs and has no side effects, but she is concerned about the risks and has decided to ask her physician about stopping the medication.

Anne is still taking her anti-rheumatic drugs. She has discussed the side effects with her physician and has concluded that her treatment will be life-long.

An on demand self-management pattern

Managing painful periods

Anne describes that she has to listen more carefully to her body. She uses pain medication during periods of severe pain.

Anne is less active during painful periods. She does not want to use pain medication but does occasionally when the pain becomes extreme.

When she has pain, Anne is more aware of her activities and pace, and she prioritizes more.

When she encounters severe pain, Anne describes “enduring” as her only strategy. She uses pain medication occasionally, for example, to sleep.

Seeking information

Anne read quite a lot about RA on the Internet after she received her diagnosis.

Anne reads about RA when she comes across an article, but she does not want the illness to take up too much of her life.

Anne says she knows quite a lot about RA, and she does not need to know everything.

An episodic self-management pattern

Exercise

Anne claims that exercise is more important now. She has created routines for regular swimming and walking exercises.

Anne has swum less during the last month because of more obligations at work.

Anne has mostly walked during the summer holiday. She has had a break in her swimming exercise, and gym exercise has been difficult because of increased pain.

Anne performs regular exercise, and she adapts the type of exercise to her current health status. In more painful periods, she is unable to take walks, but she can swim.

A transitional self-management pattern

Managing leisure activities, work and using self talk strategies

Anne has begun to plan for a different life. She perceives an increased need for recovery and rest. Anne has tried to change her attitudes and allow herself to slow down at home and at work. She has given up some career plans and leisure activities. She avoids thinking of the future, when she might get worse.

Anne continues to change her priorities; she saves more for her retirement but spends more on holidays. She uses self talk strategies to cope with performing less, both at work and at home. She can perform activities that lead to pain if they are valuable to her. At times, Anne allows herself to grieve over her situation.

Anne describes her health as fairly good, and she wants to focus on her abilities, not her losses. She has developed strategies to take short rests in her everyday life. Anne has taken an active part in decreasing her workload, and she has adapted some activities.

Anne wants to continue living a good and healthy life. To do so, she lives in a more scheduled, less spontaneous manner and gets more rest. She has slowed down her life and prioritizes among her activities. Anne claims that she also needs to be able to ignore her RA. She describes her transition process as a developmental process that is influenced by aging and maturation, as well as her RA.