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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

Ryan, Sarah; Campbell, Paul; Paskins, Zoe; Hider, Samantha; Manning, Fay; Rule, Katrina; Brooks, Michael; Hassell, Andrew

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 Thumbnail


Authors

Sarah Ryan

Fay Manning

Katrina Rule

Michael Brooks



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 well-being as well as their ability to employ self-management skills during the coronavirus pandemic. DESIGN: Qualitative, longitudinal (baseline, 16 September to 23 November 2020 and after 2-4 months, 11 January to the 17 January 2021), semistructured telephone interviews. SETTING: A rheumatology service based in a community hospital. PARTICIPANTS: 15 adults with RA. MAIN OUTCOMES: Data were analysed using interpretative phenomenological analysis. RESULTS: Five themes were identified that related to impact on (1) fear: the dominant emotion, (2) social connections and work practices, (3) physical health, (4) identity and (5) self-management as a coping mechanism. The overriding emotion was one of fear, which remained high throughout both interviews. The negative impact on social well-being 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-19. 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 well-being. Levels of fear and vulnerability which affected self-identity remained high throughout the pandemic and the impact on social well-being increased over time. Physical health remained largely unaffected. Self-management skills were used to maintain a sense of well-being.

Journal Article Type Article
Acceptance Date Dec 3, 2021
Online Publication Date Jul 26, 2022
Publication Date Jul 27, 2022
Publicly Available Date May 30, 2023
Journal BMJ Open
Publisher BMJ Publishing Group
Volume 12
Issue 7
Article Number e056555
DOI https://doi.org/10.1136/bmjopen-2021-056555
Keywords COVID-19, QUALITATIVE RESEARCH, RHEUMATOLOGY
Public URL https://keele-repository.worktribe.com/output/424054
Publisher URL https://bmjopen.bmj.com/content/12/7/e056555

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