Challenges reported by women and men with SpA related to their reproductive roles in coping with the disease.
| Categories | Codes | Examples of Responses |
|---|---|---|
| Theme 1: Family transition | ||
| Mood and isolation from family and partner | Mood swings change relationships | “I took it out on her [his wife], everything has an effect. It was too much for both of us.” Man 11, age: 39 y/o, DD: 9 yrs, BASDAI: 7.1, BASFI: 3.9. Normal radiograph, heel enthesitis. “I am anxious, nervous; I am very touchy around my family and my partner. My head thinks I can do something, but my body says no.” Woman 9, age: 46 y/o, DD: 1 yrs, BASDAI: 5.9, BASFI: 3.7. Normal radiograph, ultrasound with heel enthesitis. |
| Problems in sexual relations and loss of partner | Loss of sexual relations | “Difficulties with mobility affect sexual relations.” Man 12, age: 68 y/o, DD: 6 yrs, BASDAI: 0.3, BASFI: 1. Bilateral sacroiliitis III/IV and syndesmophytes in lumbar spine. “In sexual relations, because I get very tired and my hips hurt.” Woman 10, age: 51 y/o, DD: 23 yrs, BASDAI: 7.8, BASFI: 6.2. Bilateral sacroiliitis II/IV and peripheral affection. |
| Separation from partner | “We coped badly, and I left, partly because of this [referring to a change in character].” Man 13, age: 43 y/o, DD: 7 yrs, BASDAI: 2, BASFI: 3.9. Unilateral sacroiliitis III/IV. “I left because of that, because it was impossible in bed [sexual relations].” Woman 11, age: 66 y/o, DD: 58 yrs, BASDAI: 5.3, BASFI: 6.3. Bilateral sacroiliitis II/IV and peripheral affection. | |
| Loss of family project of having a partner and children | “I’m single; the pain doesn’t allow me to maintain a relationship because it limits me.” Man 14, age: 44 y/o, DD: 22 yrs, BASDAI: 2, BASFI: 5. Bilateral sacroiliitis III/IV and knee and heel enthesitis. “The disease has prevented me from having a partner.” Woman 12, age: 66 y/o, DD: 39 yrs, BASDAI: 6.3, BASFI: 8.1. Syndesmophytes in cervical spine. | |
| Theme 2. Response to post-SpA gender conflict | ||
| Rethinking limitations | Taking responsibility | “To put my shoes on, to wash up, to pick things up; I cannot do a thorough clean... because it hurts. I manage; I have switched to cleaning products in smaller containers so that I can pick them up...” Woman 10, age: 51 y/o, DD: 23 yrs, BASDAI: 7.8, BASFI: 6.2. Bilateral sacroiliitis II/IV and peripheral affection. “I could not be 100% with my children. I knew I had to do things, but I could not.” Woman 13, age: 55 y/o, DD: 35 yrs, BASDAI: 3, BASFI: 0.2. Bilateral sacroiliitis III/IV and lumbar squaring. |
| Turning a blind eye | “I’m limited as regards [to] domestic activities such as painting or lifting heavy objects.” Man 15, age: 60 y/o, DD: 9 yrs, BASDAI: 5.8, BASFI: 6.8. Bilateral sacroiliitis IV/IV and syndesmophytes in cervical spine. “I could not play with my children. I hurt everywhere they touched me.” Man 16, age: 65 y/o, DD: 35 yrs, BASDAI: 3.9, BASFI: 4.7. Bilateral sacroiliitis IV/IV and lumbar fusion. | |
| Feelings of incapacity with children | “I’m limited in the care I can provide for my children.” Man 11, age: 39 y/o, DD: 9 yrs, BASDAI: 7.1, BASFI: 3.9. Normal radiograph, heel enthesitis. | |
SpA: spondyloarthritis; y/o: years old; DD: disease duration; BASDAI: Bath Ankylosing Spondylitis Disease Activity Index; BASFI: Bath Ankylosing Spondylitis Functional Index.