Aproximació al concepte

Historically, the past studies have mainly focused on the role that psychological distress, levels of tension and depression, play with the physical problems associated with chronic health conditions. More recently, evidence has been accumulating that reveals the health protecting role that positive illness appraisal plays, as it has been linked to subjective well-

being (Diener, 2013) and positive future health prospects (Pressman & Cohen, 2005). This thesis focuses on a central theme which is the proportion for Positive Psychological Change (PPC) in people living with Rheumatoid Arthritis (RA) in the UK. The thesis has discussed a number of issues relevant to the description and assessment of PPC in people with RA by means of positive response following RA diagnosis, and includes four chapters that address the research objectives.

In Chapter One, a broad overview of the extant research on PPC is presented to examine the impact of RA and provide a comprehensive review to describe various aspects of PPC. A literature review has been conducted to discuss the key concept, PPC, followed by discussing the physiological aspects of RA before moving on to the physio-psychological elements of the illness. Having searched the literature, it is clear that PPC has been considered in numerous studies, using many different terms, and the concept has been examined through a diverse range of measurements. To examine the specific elements in this area in more detail, the literature review was extended to identify aspects of PPC in individuals with RA. To support this, some quantitative and qualitative studies have been considered. Chapter Two focuses on reviewing the survey study design and the sample derivation, and discusses some of the psychometric characteristics of the measurements employed. This is followed by a quantitative research design using quantitative methods involving correlational, multiple regression and a cross-sectional approach, to describe whether PPC occurs in people with RA. The survey study results include four research aims and the subsequent analysis shows the impact of some imperative potential psychosocial factors as well as their possible association with PPC in individuals with RA. This has been addressed in Chapter Three, before moving to the final section of the thesis in Chapter Four which discusses the main findings with respect to the conceptual issues and methodological recommendations. It concludes with a proposed bio-psychosocial model and the implications and recommendations for future studies, as well as discussing the limitations of the thesis.

This current survey study ties together and extends the growing knowledge in the positive psychology literature on people with RA, and although much remains to be learned about the validity of positive change in people with RA, the extant research has shed considerable light on this contentious issue.

This is the first time that such effects have been observed in persons with RA.The use of this topic has revealed several novels aspects of positive change and patterns of coping with

disease and disabilities that might otherwise have not been evident. Although this work is still in its infancy and much research remains to be done in this area to examine whether positive aspects of psychological well-being may be differentially related to PPC and possible illness perceptions in individuals with RA, it may therefore be a useful starting point for future psychological interventions.

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