"Are you better?" A qualitative study of the meaning of recovery

Purpose. Research into the meaning of illness has often focused on an indiv idual's transition into a state of being ill, for example the adoption of a sick role. The question "Are you better?" addresses the transition out of this state and is fundamental to the patient-clinician relationship, guidin g decisions about treatment. However, the question assumes that all patient s have the same meaning for "being better." The purpose of this study was t o explore the meaning of the concept of recovery (getting better) in a grou p of people with upper limb musculoskeletal disorders. Methods. Qualitative (grounded theory) methods were used. Individual interv iews were conducted with 24 workers with work-related musculoskeletal disor ders of the upper limb. The audiotaped interviews were transcribed and code d for content. Categories were linked, comparisons made, and a theory built about how people respond to the question "Are you better?" Results. The perception of "being better" is highly contextualized in the e xperience of the individual. Being better is not only,reflected in changes in the state of the disorder (resolution) but could be an adjustment of lif e to work around the disorder (readjustment) or an adaptation to living wit h the disorder (redefinition). The experience of the disorder can be 0 infl uenced by factors such as the perceived legitimacy of the disorder, the com parators used to define health and illness, and coping styles, which in tur n can influence being better. Conclusion. Two patients could mean very different things when saying that they are better. Some may not actually have a change in disease state as me asured by symptoms, impairments, or function.