Firth, J, Nelson, A, Briggs, M et al. (1 more author) (2013) Experiences of Healthcare Provision for Foot Ulceration Occurring in People with Rheumatoid Arthritis. Musculoskeletal Care, 11 (3). 159 - 167. ISSN 1478-2189
Abstract
Background: Participants with rheumatoid arthritis (RA) report that foot ulceration has an impact on their health-related quality of life (HRQL) across physical, social and psychological domains. What is not known is how experiences of healthcare provision influence HRQL. The present study set out to map the patent journey while integrating the impact on HRQL. Methods: A purposive sample of RA patients with open foot ulceration was recruited from podiatry clinics in West Yorkshire (UK) between May 2008 and June 2009. Patients with diabetes were excluded (the impact of foot ulceration in this group is well established). In-depth interviews were taped and transcribed. A framework approach to data management was used to facilitate a case- and theme-based analysis. Results: Twenty-three RA patients (18 female, five male; aged 45-88years) participated. Two themes and five sub-themes were identified. The patient journey theme comprised the following sub-themes: access to care; knowledge acquisition; care pathways and continuity of care. Patient-professional relationships comprised the sub-themes: therapeutic patient-professional relationships and task-orientated care. The journey took a highly variable course that was influenced by patient-specific factors (past experience of ulceration; symptomology; knowledge and self-efficacy); service-specific factors (access to care and care pathways) and professional-specific factors (knowing and trusting someone; holism). Conclusions: The present study highlights the need for clearer care pathways for patients affected by foot ulceration improved patient education and better coordination of care.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Keywords: | Foot ulcers; Rheumatoid arthritis |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Healthcare (Leeds) > Nursing Adult (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > Institute of Molecular Medicine (LIMM) (Leeds) > Section of Clinical Trials Research Unit (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 14 Mar 2014 10:21 |
Last Modified: | 14 Mar 2014 10:23 |
Published Version: | http://dx.doi.org/10.1002/msc.1036 |
Status: | Published |
Publisher: | Wiley |
Identification Number: | 10.1002/msc.1036 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:78052 |