Exploring the physical, psychological and social well-being of people with rheumatoid arthritis during the coronavirus pandemic: a single-centre, longitudinal, qualitative interview study in the UK

Brooks, M; Hassell, A; Ryan, S; Campbell, P; Paskins, Z; Hider, S; Rule, K; Manning, F

Abstract

Objective Rheumatoid arthritis (RA) is an autoimmune, inflammatory, systemic condition that requires specific drug treatment to suppress disease activity and prevent joint deformity. To manage the ongoing symptoms of joint pain and fatigue patients are encouraged to engage in self-management activities. People with RA have an increased incidence of serious illness and mortality, with the potential to impact on quality of life. This study explored patients’ experiences of living with RA on physical, psychological, and social wellbeing as well as their ability to employ self-management skills during the coronavirus pandemic. Design Qualitative, longitudinal (baseline, 16th September to 23rd November 2020 and after 2-4 months, 11th January to the 17th January 2021), semi-structured telephone interviews. Setting A rheumatology service based in a community hospital. Participants 15 adults with rheumatoid arthritis. Main Outcomes Data were analysed using interpretative phenomenological analysis. Results Five themes were identified which related to impact on i) fear: the dominant emotion, ii) social connections and work practices, iii) physical health, iv) identity and v) self-management as a coping mechanism. The overriding emotion was one of fear, which remained high throughout both interviews. The negative impact on social wellbeing increased as the pandemic progressed. Conversely, physical health was not affected at either time point, although participants reported difficulty in interpreting whether physical symptoms were attributable to their RA or COVID. Recognition of increased vulnerability led to a reassessment of self-identity, however respondents reported using previously learnt self-management techniques to cope in the context of the pandemic. Conclusions The main impact was on emotional and social wellbeing. Levels of fear and vulnerability which affected self-identity remained high throughout the pandemic and the impact on social wellbeing increased over time. Physical health remained largely unaffected. Self-management skills were used to maintain a sense of wellbeing.

Citation

Brooks, M., Hassell, A., Ryan, S., Campbell, P., Paskins, Z., Hider, S., …Manning, F. (2022). Exploring the physical, psychological and social well-being of people with rheumatoid arthritis during the coronavirus pandemic: a single-centre, longitudinal, qualitative interview study in the UK. BMJ Open, 12, Article e056555

• Acceptance Date: Dec 3, 2021
• Online Publication Date: Jul 26, 2022
• Publication Date: Jul 26, 2022
• Publicly Available Date: May 30, 2023
• Journal: BMJ Open
• Electronic ISSN: 2044-6055
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 12
• Article Number: e056555