Nurse‐led care for people with early rheumatoid arthritis: Interview study with thematic analysis

Sweeney, Anne Marie Tetsche; Flurey, Caroline A.; McCabe, Candy S.; Robson, Joanna C.; Richards, Pamela; Ndosi, Mwidimi

Abstract

Aims: To develop an understanding of what comprises nurse-led care in early rheumatoid arthritis from the perspective of rheumatology nurse specialists in England. Design: Qualitative study. Methods: Semi-structured telephone interviews with rheumatology nurse specialists in England were conducted in Summer 2020. Interviews were audio-recorded, transcribed verbatim and analysed using reflexive thematic analysis. Reporting follows the appropriate elements of consolidated criteria for reporting qualitative research. Results: Sixteen nurses were recruited and interviews lasted 30–60min. Four themes with 14 subthemes were identified. A specialist service delivered by experienced rheumatology nurses: Specialist care is provided by experienced nurse specialists with a high degree of autonomy in the rheumatology multidisciplinary team context. Addressing patients' complex care needs: Care is evidence-based and aims to start treatment, keep in treatment, educate and support. Access to psychology expertise is needed. Care with compassion using person-centred, holistic and empathetic approaches: Nurses create patient relationships and a positive therapeutic environment. Nurse-led telephone advice lines are essential for treatment adjustment, patient support and empowerment. Continued evaluation and development of the service: Consultations are reviewed,and patients are asked for feedback. The COVID-19 pandemic caused disruption, but changes streamlined procedures and improved documentation and communication. Conclusion: Nurse-led care in early rheumatoid arthritis is a specialist service delivered with compassion, addressing complex care needs and using person-centred approaches. This study identifies key aspects of care in early disease from the nurse perspective.

• Journal Article Type: Article
• Acceptance Date: Nov 5, 2023
• Online Publication Date: Nov 21, 2023
• Publication Date: Dec 31, 2023
• Deposit Date: Nov 13, 2023
• Publicly Available Date: Dec 13, 2023
• Journal: Musculoskeletal Care
• Print ISSN: 1478-2189
• Electronic ISSN: 1557-0681
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 21
• Issue: 4
• Pages: 1651-1661
• DOI: https://doi.org/10.1002/msc.1844
• Keywords: interview, nurse specialist, nurse‐led care, rheumatology, RA, early arthritis, qualitative
• Public URL: https://uwe-repository.worktribe.com/output/11444731
• Publisher URL: https://onlinelibrary.wiley.com/journal/15570681