| Embitterment is an emotion that common people may experience when confronted with an uncontrollable event in which they feel treated unjustly. We expect that patients with rheumatic diseases are at risk to develop embitterment, because symptoms such as pain and fatigue are invisible and often also uncontrollable. The invisibility of symptoms may lead to invalidation (a lack of understanding from others) and the uncontrollability of symptoms to helplessness. We believe that different combinations of validation and controllability will determine how well a person adjusts psychologically to having a rheumatic disease: a combination of validation and controllability will lead to empowerment, invalidation alone will trigger anger, uncontrollability alone will cause sadness, and the combination of invalidation and uncontrollability will lead to embitterment. Patients who are characterized by embitterment may not receive needed help because they are preoccupied with perceived past injustice and may challenge offered help. Unfortunately, health care professionals may view such patients simply as ?difficult? without realizing how to work successfully with them. Yet, these patients certainly need help because they have a poor quality of life, and their relatives often suffer as well. The aim of our research is to examine whether invalidation, uncontrollability, and their combinations are important determinants of adjustment to rheumatic diseases. Two studies are proposed. First, an internet-presented questionnaire will examine the frequency of invalidation and uncontrollability and their proposed consequences: anger, sadness, empowerment, and embitterment. We will also investigate how these important variables predict adjustment (symptoms and functioning) to rheumatic disease. Our second study will be conducted in the context of assessment for work ability?a situation that often triggers feelings of invalidation and uncontrollability. Among patients with rheumatoid arthritis, osteoarthritis, or fibromyalgia, we will examine whether invalidation and uncontrollability related to work ability assessment predict patients? adjustment. |
