Pathophysiology of rheumatoid arthritis: nature or nurture?
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Pathophysiology of rheumatoid arthritis: nature or nurture?

John Clancy Senior lecturer, Physiology applied to health, School of Nursing and Midwifery, University of East Anglia
Heather Hasthorpe Rheumatology nurse practitioner, Norfolk and Norwich University Hospital Trust

Rheumatoid arthritis (RA) is associated with homeostatic processes in the body and its origins have long intrigued healthcare professionals; does nature or nurture determine its development? This article explores theories associated with RA development and reviews the necessary work of nurses as they help patients to deal with the symptoms of the disease. It will discuss interactions associated with the chronic, systemic, inflammatory disease which reflects an autoimmune imbalance of cells in the synovial joints and their tissues. The work highlights that the multiple roles of the healthcare practitioner are analogous to the components that sustain homoeostasis and practitioners may be considered external agents for homeostatic control. However, because of the progressive nature of RA, the authors conclude that practitioners are limited in this control as they can only manage signs and symptoms to improve the patient’s quality of life and not restore the homeostatic status.

Primary Health Care. 21, 9, 29-36. doi: 10.7748/phc2011.


Peer review

This article has been subject to double blind peer review

Conflict of interest

None declared