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Physical-Activity Maintenance in Patients with Rheumatoid Arthritis Featured

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Research Summary

Leoppenthin et al. (2014) explores the physical activity maintenance experience of patients with rheumatoid arthritis. The study utilized a qualitative salutogenic-oriented interview design. The study was conducted in a rheumatoid outpatient clinic, using a sample of 16 physically active patients suffering from rheumatoid arthritis diagnosed 21 years previously on average. In terms of methods, the researchers used semi-structured guide to conduct in-depth interviews on the experience of subjects, in terms of the phenomenon of physical activity maintenance. The study used systematic text condensation to analyze information from interviews. The study concludes that patients with rheumatoid arthritis may perceive physical activity to be a tool to resist disability, feel healthy, stay healthy, and create meaningfulness to life.

Research Critique

Problem statement

The problem that led to the study is that the focus of a majority of clinical programs or interventions created to promote physical activity is on physical activity change. Only a few rheumatoid arthritis interventions include a follow-up of at least one year. The researchers explored a genuine problem. The rationale for investing time and money in the study is that exploring how the maintenance of physical activity is experienced in patients with the disease contributes to knowledge about the condition, which is essential for studies, treatment, and future research on the disease. The study explores an area of public health significance. Physical activity is a vital recommendation for patients with rheumatoid arthritis. Research done demonstrate that physical activity is associated with a decrease in illnesses and deaths from a variety of conditions and diseases. However, the problem definition provided does not include statistics. Statistics adds weight to the problem of interest to the study.

Study Purpose and Research Questions


In the article, the study purpose is given as “To describe the implicit meaning of physical activity maintenance for patients with rheumatoid arthritis." The study purpose is stated clearly and precisely. The study objectives and methods reflect the purpose of the research. The study purpose is the starting point for any research. It reflects the topic and sets the tone for the development of all sections of the study, including study questions, methods, analysis, and discussion.
Research Question

Although the research question is not stated in the article, the study objective reflects the question that the study explores. From the study objective, it can be deduced that the study question is

  • “What is the experience of physical activity maintenance in RA patients?

The study purpose and research question are related to the problem. The problem of the study was that intervention programs aimed at promoting physical activity focus on physical activity change and note physical activity maintenance. The qualitative study aimed at describing the phenomenon of physical activity maintenance experience from the point of view of patients with rheumatoid arthritis. Perhaps, the question of interest to the researchers is how persons with rheumatoid arthritis perceive the phenomenon of physical activity maintenance. The article does not state the research question. However, the study has only one objective, which can be transformed into a research question. The assumed study question reflects the study problem.

The study question can be answered best through qualitative studies. This is because experience involves perceptions (feelings and emotions) which are constructs that can only be measured accurately using qualitative studies. The researchers aimed at recruiting information-rich participants demonstrating an intense interest in physical activity.

Literature review

The study cites information from both qualitative and quantitative studies. It uses the literature review section to define the study topic and propose frameworks for observing the variables of relevance to study, in terms of responding to the research question. The article cites sources beginning from the introduction section until the discussion where the researchers discuss in relation to constructs identified from the review of the literature. Although, the article does not have a section designated for the review of the literature, the background that gives the introduction and the problem statement is based on a comprehensive literature overview.

The researchers use sources that are fairly current. A significant proportion of resources cited include resources that were published from 2010 onwards. However, it breaches the requirement of qualitative studies that requires sources to be not older than 5 years. Some of the materials cited as old as 2003. Considering that the article was published in 2014, the oldest article cited should be a publication of 2009.

In stating the problem, the researchers cite the weakness of prior studies. The researchers define the focus and recommendations for physical activity provided in earlier studies, citing the lack of a recommendation for physical activity maintenance. The researcher's review of the literature on physical activity focuses on intervention recommendations for intervention programs aimed at rheumatoid arthritis.

Although the researchers explore literature to help them identify gaps and define the problem in the application of physical activity interventions for persons with rheumatoid arthritis, the extent of literature presented appears insufficient for logical reasoning on the issue. The references listed are several, but the literature review section is a small section. Perhaps, the researchers ought to have presented a comprehensive review of relevant literature. The references listed on the references page demonstrate that an extensive literature review was done. In addition, citations within the article also support the view that sufficient literature review was done. It is only that the content presented is insufficient. However, it would have been of an additional value for the article to provide a dedicated section for an in-depth review of the literature.

Conceptual/Theoretical framework

The study is developed from the perspective that physical activity maintenance is related to knowledge and enjoyment of the body, autonomy and social belonging, and responsibility and challenges. Following a review of the literature, analysis, and discussion of findings, the researchers propose a theoretical perspective for measuring the experience or meaning of physical activity maintenance as perceived by patients with rheumatoid arthritis. The study derives themes condensed in three broad categories. The categories are: knowing and enjoying the body, responsibility and challenges, and independence and social belonging. The constructs are portrayed in the form of a table, enabling easy categorization and understanding of the connection between themes, categories, and the essential meaning of physical activity.

However, the researchers do not apply the principle of grounded theory to develop a framework. Although the theoretical framework sets the foundation for the conclusion, diagrammatic expressions or representations may suit the presentation of themes in a clear way. The bottom line is that the theoretical perspective taken is vital for future research and studies, in terms of understanding the perception of maintenance of physical activity by patients with rheumatoid arthritis. The framework is a guide for intervention programs. The themes included in each of the three categories form important variables in defining physical activity experience.

The study reflects qualitative principles of research in terms of the definition of purpose, research questions, and literature review. However, it falls short of the need for a conceptual framework as vital for qualitative studies.


Burns, N. & Grove, S. (2011). Understanding Nursing Research (5th ed.). Elsevier. ISBN-13: 9781437707502

Leoppenthin, J. et al. (2014). Physical-Activity Maintenance in Patients with Rheumatoid Arthritis: A Qualitative Study. Clinical Rehabilitation, 28(3): 289-299
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