Self-helplessness in arthritis: an important but overlooked index

Br J Nurs. 2010;19(15):965, 968-71. doi: 10.12968/bjon.2010.19.15.77692.


The recent introduction of patient-reported outcome measures (PROMs) assessment into rheumatology practice has changed the way patients suffering from inflammatory arthritis are assessed. This article describes a cross-sectional study of 102 rheumatoid arthritis (RA) patients that was undertaken to evaluate the construct of helplessness in patients with RA, its correlation with other disease activity parameters, and its sensitivity to change following biologic therapy. The study also set out to explore the possibility of including a self-helplessness measurement, using the modified Rheumatology Attitude Index (mRAI), as part of the holistic patient assessment in standard clinical practice. Assessment of self-helplessness was shown to be significantly correlated with both psychological as well as functional status measures. The mRAI index is a highly useful and predictive tool for clinical use that is responsive to change in the patients' clinical condition. As part of the PROMs questionnaire, this scale can be applied in a manner similar to other indicators of disease activity status, and is as easy to administer and interpret in standard clinical practice.

MeSH terms

  • Activities of Daily Living
  • Adaptation, Psychological
  • Arthritis, Rheumatoid / nursing
  • Arthritis, Rheumatoid / psychology*
  • Case-Control Studies
  • Cross-Sectional Studies
  • Female
  • Helplessness, Learned*
  • Humans
  • Male
  • Middle Aged
  • Nursing Assessment*
  • Quality of Life
  • Self Care / psychology*
  • Surveys and Questionnaires*