Characteristics of refractory disease and persistent symptoms in inflammatory arthritis: Qualitative framework analysis of interviews with patients and health care professionals

IF 3.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology Pub Date : 2025-01-08 DOI:10.1111/bjhp.12780

Hema Chaplin, Carol Simpson, Kate Wilkins, Jessica Meehan, Nora Ng, James Galloway, Ian C. Scott, Debajit Sen, Rachel Tattersall, Rona Moss-Morris, Heidi Lempp, Sam Norton

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引用次数: 0

Abstract

Objectives

This study aims to explore patients' and clinicians' understanding and experiences of refractory disease (RD) and persistent physical and emotional symptoms (PPES) in patients with inflammatory arthritis (IA), namely rheumatoid arthritis or polyarticular juvenile idiopathic arthritis from their perspectives through interviews and/or focus groups.

Design

A qualitative study was conducted, following a pragmatic epistemology approach with framework analysis employed.

Methods

Semi-structured interviews or focus groups with IA patients (n = 25) and multi-disciplinary rheumatology HCPs (n = 32) were conducted at one time point to obtain participants respective understanding and experiences of managing RD/PPES, and its impact on the patient-professional relationship.

Results

Three key themes were identified from both patients and professionals' experiences of RD/PPES: (1) relevant treatment experiences, (2) symptoms (with or without inflammation) and (3) impact: physical, psychological and social. These themes included 28 specific categories that would be considered as components characterizing RD/PPES, most common to both patients and HCPs with six being patient-specific and only one HCP-specific. The specific biopsychosocial symptoms and impacts of RD/PPES pertain to pain, fatigue, stiffness, joint involvement and physical, psychological and social functioning and quality of life, covering disease-related distress, mobility and independence. Wider influential factors such as comorbidities, non-adherence, health/medication beliefs and behaviours and social support were also identified.

Conclusion

Common persistent symptoms that have both mental and physical impact characterize RD/PPES in IA and therefore a more integrated holistic approach to treatment is needed from multi-disciplinary HCPs, including health psychologists.

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炎症性关节炎难治性疾病和持续性症状的特征：对患者和卫生保健专业人员访谈的定性框架分析。

目的：本研究旨在通过访谈和/或焦点小组，从患者和临床医生的角度探讨炎症性关节炎（IA）患者（即类风湿关节炎或多关节幼年特发性关节炎）的难治性疾病（RD）和持续性身体和情绪症状（PPES）的理解和经验。设计：进行了一项定性研究，采用了框架分析的语用认识论方法。方法：在同一时间点对IA患者（n = 25）和多学科风湿病HCPs （n = 32）进行半结构化访谈或焦点小组，以获得参与者各自对RD/PPES管理的理解和经验，及其对患者-专业关系的影响。结果：从RD/PPES患者和专业人员的经历中确定了三个关键主题：(1)相关的治疗经历，(2)症状（有无炎症）和(3)影响：身体，心理和社会。这些主题包括28个特定类别，将被视为表征RD/PPES的组成部分，在患者和hcp中最常见，其中6个是患者特异性的，只有1个是hcp特异性的。RD/PPES的特定生物心理社会症状和影响涉及疼痛、疲劳、僵硬、关节受累以及身体、心理和社会功能和生活质量，包括与疾病相关的痛苦、活动能力和独立性。还确定了更广泛的影响因素，如合并症、不遵医嘱、健康/药物信念和行为以及社会支持。结论：具有精神和身体影响的常见持续性症状是IA RD/PPES的特征，因此需要包括健康心理学家在内的多学科HCPs采用更综合的整体治疗方法。

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来源期刊

British Journal of Health Psychology PSYCHOLOGY, CLINICAL-

CiteScore

14.10

自引率

1.30%

发文量

期刊介绍： The focus of the British Journal of Health Psychology is to publish original research on various aspects of psychology that are related to health, health-related behavior, and illness throughout a person's life. The journal specifically seeks articles that are based on health psychology theory or discuss theoretical matters within the field.