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Health professionals' perspectives on psychological distress and meeting patients' support needs in rheumatology care settings: A qualitative study

Silverthorne, Chris; Daniels, Jo; Thompson, Miles; Robson, Joanna C.; Ndosi, Mwidimi; Swales, Caroline; Wilkins, Kate; Dures, Emma


Jo Daniels

Jo Robson
Consultant Associate Professor in Rheumatology

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Dr Mwidimi Ndosi
Associate Professor in Nursing Rheumatology

Caroline Swales

Kate Wilkins

Emma Dures
Associate Professor in Rheumatology and Self-management


Background: Patients with inflammatory rheumatic diseases (IRDs) face challenges including pain, fatigue and disease flares. Evidence suggests their levels of anxiety and depression are higher compared to the general population. Rheumatology teams report psychologically distressed patients have additional support needs and require more clinical time. Little is currently known about models of support and their integration into care pathways. Aim: To understand rheumatology health professionals' perspectives on patients' psychological distress and ways to meet support needs. Methods: The study used a qualitative design, with data collected in telephone semi-structured interviews. Inductive thematic analysis was used to analyse the data. Results: Fifteen interviews were conducted. Two main themes with sub-themes represent the data: Theme 1: ‘No one shoe fits all’—the many manifestations of distress in patients (sub-themes: recognising distress, dealing with distress, dealing with life events alongside an IRD) and Theme 2: ‘If rheumatology could be interwoven with psychological principles’—the need to attend to the psychological impact of IRDs, alongside the physical impact (sub-themes: priority given to physical health, working together to help patients in distress, how should patient distress be measured?, the need for extra time and resources). Conclusion: Distress can be obvious or hidden, cause issues for patients and health professionals and lead to poor engagement with care provision. Health professionals described the powerful link between physical and mental distress. This study suggests psychological support provision should be embedded within the rheumatology team and that patients' emotional wellbeing should be given equal priority to their physical wellbeing.


Silverthorne, C., Daniels, J., Thompson, M., Robson, J. C., Ndosi, M., Swales, C., …Dures, E. (in press). Health professionals' perspectives on psychological distress and meeting patients' support needs in rheumatology care settings: A qualitative study. Musculoskeletal Care,

Journal Article Type Article
Acceptance Date Dec 31, 2022
Online Publication Date Jan 11, 2023
Deposit Date Jan 11, 2023
Publicly Available Date Jan 13, 2023
Journal Musculoskeletal Care
Print ISSN 1478-2189
Electronic ISSN 1557-0681
Publisher Wiley
Peer Reviewed Peer Reviewed
Keywords RESEARCH ARTICLE, health professionals, inflammatory rheumatic diseases, psychological distress, qualitative, support needs
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