Patients’ independence of a nurse for the administration of subcutaneous anti-TNF therapy: A phenomenographic study

摘要

Rheumatology nursing supports patients to manage their lives and live as independently as possible without pain, stiffnessnand functional restrictions.When conventional drugs fail to delay the development of the rheumatic disease, the patient maynrequire biological treatment such as self-administered subcutaneous anti-tumour necrosis factor (TNF) therapy. It isntherefore important that the patient perspective focuses on the life-changing situation caused by the administration ofnregular subcutaneous injections. The aim of this study was to describe variations in how patients with rheumatic diseasesnexperience their independence of a nurse for administration of subcutaneous anti-TNF therapy. The study had andescriptive, qualitative design with a phenomenographic approach and was carried out by means of 20 interviews. Fournways of understanding the patients’ experience of their subcutaneous anti-TNF therapy and independence of a nursenemerged: the struggling patient; the learning patient; the participating patient; the independent patient. Achievingnindependence of a nurse for subcutaneous anti-TNF injections can be understood by the patients in different ways. In theirnstrive for independence, patients progress by learning about and participating in drug treatment, after which they experiencenthat the injections make them independent.