Case study report: that led to the acquisition of self-management ability for RA symptoms using a notebook

Abstract

  This case was a 37-year-old woman, who was a non-working mother. She was diagnosed with rheumatoid arthritis（RA）and had difficulty doing her hobbies due to painful symptoms. To give the patient the ability to self-manage her symptoms, we suggested the self-evaluation of her daily activities using a notebook. The RA was diagnosed in 2007, and symptoms worsened in 2015. In 2016, abatacept was started, and occupational therapy was started at our outpatient rehabilitation center. In addition to the range-of-motion exercises and the life-style guidance reducing the stress of wrist joints, we had the patient use the self-management method of recording her daily activities in her notebook. Following this method, she wrote down the severity of the symptoms and consulted us about the way in which she increased or decreased the intensity of her daily activities, based on the results recorded in the notebook. One year after the intervention, the wrist pain both at rest and in motion disappeared. Although malaise accompanied by menstrual period only remained, she could cope with the symptoms and restarted her hobbies. Thus, we suggest that the use of a notebook enables patients to gain the ability to self-manage RA symptoms.