Developing a service for biologic therapies: a personal experience

Patients' dependence on a nurse for the administration of their intravenous anti-TNF therapy: A phenomenographic study

BACKGROUND

Pain, stiffness and functional restriction of the joints are the main problems for many patients with inflammatory rheumatic conditions. When conventional drugs fail to delay the development of the disease, the patient may require biological treatment such as anti-TNF therapy. Some biological drugs are administered in the form of intravenous infusions and thus the patient is obliged to attend a clinic in order to receive his/her medication, which can affect everyday life as well as independence. It is therefore important to focus on the patient perspective.

AIM

The aim of this study was to describe variations in how patients with rheumatic conditions conceive their dependence on a nurse for the administration of their intravenous anti-TNF therapy.

METHOD

The study had a descriptive qualitative design with a phenomenographic approach. Interviews were conducted with 20 patients.

RESULT

Three descriptive categories and seven sub-categories emerged: Dependence that affords security (encountering continuity, encountering competence and obtaining information); Dependence that creates involvement (being allowed influence and being given freedom); Dependence that invigorates (obtaining relaxation and encountering the environment).

CONCLUSION

The patients had not reflected on the fact that they were dependent on a nurse for the administration of their intravenous anti-TNF therapy, which may be due to their possibility to influence the treatment. The patients' needs should constitute the basis for the nurse's role in the provision of care.

An exploration of patients' experiences of anti-TNF therapy

OBJECTIVE

To explore the experience of rheumatoid arthritis patients receiving anti-tumour necrosis factor (anti-TNF) therapy on physical, psychological and social well-being.

METHOD

Seven patients with rheumatoid arthritis (RA) who received six months of infliximab were interviewed in depth by one researcher to identify their experiences of this treatment. The interviews were tape-recorded and analysed using Colaizzi's procedural steps.

RESULTS

Four main categories were identified from the interview relating to the patient's experience of anti-TNF therapy. These included: The impact of living with RA on physical, psychological and social function. The influence of anti-TNF therapy on physical, psychological and social function. The experience of attending for treatment. The impact of discontinuing anti-TNF treatment.

CONCLUSION

All seven patients experienced benefits from receiving anti-TNF therapy. These benefits were not maintained once the treatment period was completed.