Defining and refining nurse-led care for people with early rheumatoid arthritis

Sweeney, Anne-Marie Tetsche

Abstract

Nurse-led care in rheumatoid arthritis (RA) has been shown to be effective. However, the role of the nurse in early RA is not well-defined, and it is not known how well care needs are met in early RA nurse-led care. This PhD research aims to provide new knowledge in understanding nurse-led care in early RA and to propose a model of early RA care.

Three studies were conducted using a sequential exploratory mixed method approach: a systematic review of qualitative studies, an interview study with rheumatology nurse specialists, and a cross-sectional survey with patients in early RA. Evidence from the three studies was compared with EULAR recommendations for the role of the nurse, EULAR recommendations for management of early RA, and with an earlier model of rheumatology nursing care.

The systematic review found that patients valued nurse-led care. It was characterised by professionalism, person-centeredness, and a capacity to address holistic care needs. However, only few studies specifically included the perspective of patients with early RA. The interview study with rheumatology nurse specialists found that nurse-led care in early RA is a specialist service that is delivered with compassion and addresses complex and holistic care needs using person-centred approaches. Innovation and service improvement are part of the role. The study provided a provisional model of nurse-led care in early RA. In the patient survey, questionnaire items representing the provisional model of care were assessed as highly important. Analysis of participant comments generated themes of patient needs such as being listened to, involved, and informed.

The synthesis of evidence generated a novel model of nurse-led care in early RA with the potential to meet patients’ complex and holistic care needs. The research contributes to knowledge about rheumatology nursing and can inform practice, training, and further research.

• Thesis Type: Thesis
• Deposit Date: Oct 29, 2022
• Publicly Available Date: Apr 27, 2023
• Public URL: https://uwe-repository.worktribe.com/output/10109302
• Award Date: Apr 27, 2023