OUTLOOK FORMATION PROCESS AMONG INDIVIDUALS WITH SYSTEMIC LUPUS ERYTHEMATOSUS EXPERIENCING CONCURRENT SYMPTOMS: A GROUNDED THEORY STUDY
Keywords:
chronic illness, grounded theory, systemic lupus erythematosus, qualitative, nursing, fatigueAbstract
Background: Living with a chronic illness entails adaptation, coping and understanding own life situation. There exist gaps on how individuals with SLE, as they experience fatigue and its concurrent symptoms, make sense/process all of these as they live with the condition?
Objectives: To explore the process between fatigue, the presence of concurrent symptoms and its social-psychological aspects.
Methods: Corbin and Strauss (Straussian) grounded theory (GT) approach was used in this study. Before this study's conduct, reflexivity was observed by the authors. In this study, thirteen (N=13) (13 female aged 19-58) individuals who qualified the inclusion criteria participated in the study. Three (N=3) additional female participants diagnosed with SLE validated the findings and suggestions were carried out. Individual audio-recorded telephone and videoconferencing interviews were conducted between October-December 2021. The data analysis included open, axial, and selective coding combined with a software program for qualitative data analysis. After initial purposeful sampling, theoretical sampling and constant comparative technique were used to further enrich the data.
Results: Pain (10/13) was the most frequent symptom that occurred concurrently with fatigue as reported by participants. Here we report that based on the findings, process of outlook towards their functioning was developed among participants as evident in three major categories: Reliance (justifying the experience), Passiveness (being open and accepting), and Independence (efforts to gain control) and supported in nine sub-categories. Outlook on functioning in this study refers to the individual’s appraisal, interpretation, or general attitude towards their functioning as they make sense of their condition and various forms of social interactions. Theoretical assumptions developed include: (1) individual outlook buffers the influence of social support to the outcomes, (2) the nature and source of social support influences the individual outlook, and (3) outlook on functioning is individualized and context based.
Conclusion: As reported in numerous studies that social support buffers outcomes however in this grounded theory study, the concept of outlook which refers to an individual’s critical interpretation of the various forms of social interactions exists. In other words, social support does not always buffer antecedents to outcomes but also serves as an antecedent to outlook.
Impact: Further studies to prove the theoretical assumptions should be conducted and to explore the role of outlook to outcomes. Outlook should be included when assessing symptom experience.
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