To explore prediagnostic illness behavior in rheumatoid arthritis (RA).
In this descriptive study, interview and medical records data from 50 female patients were analyzed using quantitative and qualitative techniques.
Findings revealed a high incidence of symptom normalization, self-treatment, symptom comparison, and prolonged time to diagnosis with multiple misdiagnoses and physicians consulted. Most subjects reported invalidation of initial symptoms, multifaceted emotional distress, and relief upon accurate diagnosis. Significant associations were found between (a) illness-related symptom attributions and fewer physicians consulted (P < 0.05) and less invalidation (P < 0.05); (b) life stress events and fewer physicians consulted (P < 0.05) and shorter time to diagnosis (P < 0.05); (c) remissions and time to diagnosis (P < 0.05), number of physicians consulted (P < 0.001), and number of misdiagnoses (P < 0.001).
Illness behavior in RA is prolonged, convoluted, and accompanied by personal and social stress. Invalidation of reported symptoms and relief upon definitive diagnosis are prominent features of the process.