The purpose of this qualitative research was to explore the lived experiences of 
women with Sjogren's Syndrome (SS), a chronic autoimmune syndrome in which 
invading lymphocytes attack moisture-producing glands of the body. This 
syndrome, affecting 4 million Americans, involves extreme dryness of the eyes 
and mouth and other systemic complications such as fatigue and muscle and joint 
pain. Ten women, ranging in age from 27 to 83, with SS were interviewed to 
understand their coping strategies and attitudes. This study used Strauss' 
framework to view the quality of life of the chronically ill-specifically, those 
with SS. Nine questions were asked to elicit information on limitations with 
daily living, relationships, emotions about lifestyle changes, and comparisons 
with others living with chronic disease. In addition to SS, 8 of the 10 women 
also had fibromyalgia, and 4 had other conditions such as lupus and rheumatoid 
arthritis (secondary Sjogren's). Their responses were categorized into four 
groups: helping, hindering, hoping, and hurting. This led to the development of 
the 4H Model of Chronic Autoimmune Disease with subcategories such as: 
supporting, joining, comparing, coping, health promoting, fearing, becoming a 
chronic sufferer, feeling, wishing, appearing, impeding, restricting, isolating, 
suffering, doctoring, and diagnosing. J Prof Nurs 17:194-202, 2001.