Johns Hopkins University, Baltimore, Maryland.
Arthritis Care Res (Hoboken). 2014 Nov;66(11):1662-72. doi: 10.1002/acr.22374.
Stiffness is a well-recognized symptom of rheumatoid arthritis (RA). It is frequently queried during clinic visits as an indicator of disease activity and was included in the 1961 and 1987 RA classification criteria. Little is known about how people with RA experience stiffness and its impact on their lives.
We conducted 4 focus groups including 20 people with RA (4-6 participants per group) from 1 academic clinical practice and 1 private practice to generate accounts of stiffness experiences. Qualitative inductive thematic data analysis was conducted.
Five overarching themes were identified: relationship of stiffness with other symptoms, exacerbating or alleviating factors and self-management, stiffness timing and location, individual meanings of stiffness experiences, and impact of stiffness on daily life.
Focus group discussions revealed individual stiffness experiences as diverse and complex. Several stiffness features were endorsed by a majority of participants, but few, if any, were universally experienced; thus, the significance of stiffness as an expression of the disease varied widely. Discussions yielded descriptions of how individual limits imposed by RA in general and stiffness in particular may change over time and were intertwined with adaptations to preserve participation in valued life activities. These results concerning the diversity of the stiffness experience, consequential adaptations, and its impact suggest that a more individualized approach to stiffness measurement may be needed to improve stiffness assessments.
僵硬是类风湿关节炎（RA）的一种公认症状。在就诊时经常会询问它，作为疾病活动的指标，并被纳入 1961 年和 1987 年的 RA 分类标准。人们对 RA 患者的僵硬体验及其对生活的影响知之甚少。
我们进行了 4 个焦点小组，包括来自 1 个学术临床实践和 1 个私人实践的 20 名 RA 患者（每组 4-6 名参与者），以生成僵硬体验的描述。采用定性归纳主题数据分析。
确定了 5 个总体主题：僵硬与其他症状的关系、加重或缓解因素和自我管理、僵硬的时间和位置、僵硬体验的个体意义以及僵硬对日常生活的影响。
焦点小组讨论揭示了个体僵硬体验的多样性和复杂性。大多数参与者都认可一些僵硬特征，但很少有（如果有的话）是普遍经历的；因此，僵硬作为疾病表现的意义差异很大。讨论产生了关于 RA 一般和僵硬特别对个体限制的描述，这些限制可能随着时间的推移而变化，并与为了保持参与有价值的生活活动而进行的适应相互交织。这些关于僵硬体验的多样性、随之而来的适应及其影响的结果表明，可能需要更个性化的僵硬测量方法来改善僵硬评估。
