Liv, arbete och förändring. De första åren med kronisk ledgångsreumatism

Sammanfattning: This dissertation discusses the personal implications of the early consequences of rheumatoid arthritis, how they effect the person's working life and how they are dealt with. In this qualitative study thematized interviews are used. Twenty-three persons, recently diagnosed with rheumatoid arthritis, were interviewed twice, two years apart. The study is influenced by an interactionist perspective on how the occupational role is influenced by early signs of the disease and the effect on the interplay between the person struck by the illness and other persons in his/her working life. The analysis focused on how the disease affected the body, the self-image and social roles. The interviewees described how the early symptoms threatened their self-image and gave raise to feelings of insecurity and how their former balance in life was disturbed. A majority of the interviewees experienced difficulties to live up to the occupational role when symptoms of the disease became noticeable on bodily functions. They swung between the need to defend, to change, to leave or replace their occupational role in striving to achieve balance between the body's ability and the demands of working life. The study shows that the way back to a satisfactory working situation was a complex process. This can be described as a status passage. A status passage describes different courses of events which I have named "anhalter" (halts) which the person may use to find a balance between occupational role and performance at work. This approach describes rehabilitation in working life as a model of status passage and "anhalter" and it introduces a new focus. This may help us to understand the early adjustment process in the individual case and brings a new dimension to previous research on understanding adaptation to chronic diseases. It also underlines the importance of well planned interventions at an early stage and the importance of later adjustment. The model can only describe a part of the life adjustment process that people go through to adapt to a future life with rheumatoid arthritis.