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Nursing support at the onset of rheumatoid arthritis: Time and space for emotions, practicalities and self-management

Carr, M.; Carr, Maggie; Davis, Bev; Radford, Shirley; Robertson, Lindsay; Tipler, Sue; Hehir, Maggie; Hewlett, Sarah

Authors

M. Carr

Maggie Carr

Bev Davis

Shirley Radford

Lindsay Robertson

Sue Tipler

Maggie Hehir



Abstract

Background: Following a diagnosis of rheumatoid arthritis (RA), patients have to adapt to lifelong, unpredictable but repeated episodes of pain and disability, potentially leading to permanent loss of function and its consequences on their lives. We established nurse clinics with the aim of supporting newly diagnosed RA patients in adapting to and managing their long-term condition. The aim of this study was to explore the content of clinic discussions in this new clinical service, in order to ascertain patients' needs upon diagnosis. Methods: All clinic letters from the nurse to the family doctor were analyzed. Every topic mentioned was systematically coded independently by a researcher and a patient research partner, who compared and agreed codes. Codes were organized into categories, and, finally, into overarching themes. Results: Twenty-four patients had 74 appointment letters. A total of 79 codes were identified, from which ten categories emerged, and, finally, three overarching themes. The first theme related to 'Emotional support', which underpinned the other two themes and was discussed in almost all appointments. Issues included discussions about the emotional consequences of RA, needing time to adjust, frustration and fears for the future. The second theme 'Practicalities of the treatment of RA', included subordinate themes relating to the nature of RA, such as identity, cause, timeline, consequences and treatment. Medication issues were discussed and referrals to the multidisciplinary team were made. The final theme related to the 'Self-management of RA', and included discussions on physical symptoms and their management. Conclusions: The offer to attend a nurse clinic soon after diagnosis allowed RA patients to discuss a wide range of practical and self-management issues. However, most patients also took the opportunity and time to discuss emotional reactions and adaptations to diagnosis. The data suggest an unmet need for emotional support that a nurse clinic might be able to provide. Copyright © 2007 John Wiley & Sons, Ltd.

Citation

Carr, M., Hehir, M., Carr, M., Davis, B., Radford, S., Robertson, L., …Hewlett, S. (2008). Nursing support at the onset of rheumatoid arthritis: Time and space for emotions, practicalities and self-management. Musculoskeletal Care, 6(2), 124-134. https://doi.org/10.1002/msc.115

Journal Article Type Article
Publication Date Dec 11, 2008
Journal Musculoskeletal Care
Print ISSN 1478-2189
Electronic ISSN 1557-0681
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 6
Issue 2
Pages 124-134
DOI https://doi.org/10.1002/msc.115
Keywords newly diagnosed, rheumatoid arthritis, emotion, coping, nursing
Public URL https://uwe-repository.worktribe.com/output/1012051
Publisher URL http://dx.doi.org/10.1002/msc.115