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A survey of psychological support provision for people with inflammatory arthritis in secondary care in England

Dures, Emma; Almeida, Celia; Caesley, Judy; Peterson, Alice; Ambler, Nicholas; Morris, Marianne; Pollock, Jon; Hewlett, Sarah


Emma Dures
Associate Professor in Rheumatology and Self-management

Judy Caesley

Alice Peterson

Nicholas Ambler

Marianne Morris

Jon Pollock
Associate Professor in Epidemiology


© 2014 The Authors. Objectives: The consequences of inflammatory arthritis can include depression, anxiety and low mood, reducing patients' quality of life and increasing pressure on the healthcare system. Treatment guidelines recommend psychological support, but data are lacking on the provision available. Methods: A postal survey concerning psychological support provision was sent to rheumatology units in 143 acute trusts across England. Nurses from 73 rheumatology units (51%) responded. Results: Overall, 73% rated their unit's psychological support provision as 'inadequate' and only 4% rated it as 'good'. Few units believed that psychological support did not fall within their remit (12%), yet only 8% had a psychologist in the team. Most units (68%) did not routinely screen patients to identify psychological difficulties. Referral to other service providers was reported in 42% of units, with 3% very satisfied with this provision. Within units, services containing elements of psychological support ranged from occupational therapy (81%) to psychology/counselling (14%). Psychological approaches used by team members ranged from shared decision making (77%) to cognitive-behavioural approaches (26%). The current barriers to providing psychological support were lack of clinical time and available training (86% and 74%, respectively), and delivery costs (74%). Future facilitators included management support (74%) and availability of skills training (74%). Conclusions: Rheumatology units viewed psychological support provision as part of their remit but rated their overall provision as inadequate, despite some team members using psychological skills. To improve provision, clinicians' training needs must be addressed and organizational support generated, and further research needs to define adequate psychological support provision from the patient perspective.


Dures, E., Almeida, C., Caesley, J., Peterson, A., Ambler, N., Morris, M., …Hewlett, S. (2016). A survey of psychological support provision for people with inflammatory arthritis in secondary care in England. Musculoskeletal Care, 12(3), 173-181.

Journal Article Type Article
Publication Date Jan 1, 2016
Journal Musculoskeletal Care
Print ISSN 1478-2189
Electronic ISSN 1557-0681
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 12
Issue 3
Pages 173-181
Keywords barriers and facilitators, inflammatory arthritis, psychological support provision, resources
Public URL
Publisher URL
Additional Information Additional Information : Article first published on-line: 22 April 2014