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Living life precariously with rheumatoid arthritis - a mega-ethnography of nine qualitative evidence syntheses
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Toye, F., Seers, Kate and Barker, K. (2019) Living life precariously with rheumatoid arthritis - a mega-ethnography of nine qualitative evidence syntheses. BMC Rheumatology, 3 (1). 5. doi:10.1186/s41927-018-0049-0 ISSN 2520-1026.
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WRAP-living-life-precariously-rheumatoid-arthritis-syntheses-Seers-2019.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (1023Kb) | Preview |
Official URL: https://doi.org/10.1186/s41927-018-0049-0
Abstract
Background
Rheumatoid arthritis is an autoimmune disease that causes joint inflammation. It affects around 400,000 people in the UK and 1 million adults in the USA. Given the appropriate treatment, many can have relatively few symptoms. It is therefore important to understand what it is like to live with rheumatoid arthritis and gain insight into peoples’ decisions about utilising healthcare. The aims of this study were: (1) to bring together qualitative evidence syntheses that explore patients’ experience of living with rheumatoid arthritis and (2) develop a conceptual understanding of what it is like to live with rheumatoid arthritis.
Methods
We used the methods of mega-ethnography. The innovation of mega-ethnography is to use conceptual findings from qualitative evidence syntheses as primary data. We searched four bibliographic databases from inception until September 2018 to identify qualitative evidence syntheses that explored patients’ experience of rheumatoid arthritis.
Results
We identified 373 qualitative evidence syntheses, removed 179 duplicates and screened 194 full text studies. We identified 42 qualitative evidence syntheses that explored the experience of pain or arthritis and 9 of these explored the experience of rheumatoid arthritis. We abstracted ideas into 10 conceptual categories: (1) rheumatoid arthritis is in control of my body (2) rheumatoid arthritis alters reciprocity; (3) rheumatoid arthritis is an emotional challenge; (4) rheumatoid arthritis disrupts my present and future self; (5) the challenge of balancing personal and work life; (6) I am trying to make sense of what is happening; (7) rheumatoid arthritis is variable and unpredictable; (8) rheumatoid arthritis is invisible; (9) I need a positive experience of healthcare, and (10) I need to reframe the situation. We developed a conceptual model underpinned by living life precariously with rheumatoid arthritis.
Conclusions
This is the second mega-ethnography, or synthesis of qualitative evidence syntheses using the methods of meta-ethnography. Future research should consider the proliferation of qualitative evidence synthesis in order to avoid duplication of research effort. Our model for rheumatoid arthritis has some important clinical implications that might be transferable to other musculoskeletal conditions.
| Item Type: | Journal Article | ||||||
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| Subjects: | R Medicine > RC Internal medicine | ||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Warwick Research in Nursing > Royal College of Nursing Research Institute (RCN) (- July 2017) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Rheumatoid arthritis | ||||||
| Journal or Publication Title: | BMC Rheumatology | ||||||
| Publisher: | BMC | ||||||
| ISSN: | 2520-1026 | ||||||
| Official Date: | 6 February 2019 | ||||||
| Dates: |
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| Volume: | 3 | ||||||
| Number: | 1 | ||||||
| Article Number: | 5 | ||||||
| DOI: | 10.1186/s41927-018-0049-0 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||
| Date of first compliant deposit: | 9 April 2019 | ||||||
| Date of first compliant Open Access: | 9 April 2019 | ||||||
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