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Colmenares-Roa T, Gastelum-Strozzi A, Crosley E, Fuentes-Silva Y, Reategui-Sokolova C, Elera-Fitzcarrald C, Ibañez S, Cairoli E, Pons-Estel BA, Drenkard C, Peláez-Ballestas I. Digital Narratives of Living With Lupus: Lived Experiences and Meanings for Latin American and Latino Patients and Their Families. Arthritis Care Res (Hoboken) 2023; 75:540-549. [PMID: 35188345 DOI: 10.1002/acr.24870] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/20/2022] [Accepted: 02/17/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Systemic lupus erythematosus (SLE) disproportionately affects Latin American and Latino populations, with worse outcomes compared to nonminority populations. Understanding patients' views is critical to provide culturally competent care. The objective of this research is to analyze lived experiences with SLE from comments made by Latin American and Latino patients, and their relatives and friends, on the public Facebook group "Hablemos de Lupus" (in English: "Let's Talk about Lupus"). METHODS Deidentified narratives posted as a reaction to the most popular resources shared by the page were extracted using the Facepager application. We conducted a thematic analysis under an interpretative medical anthropology framework. RESULTS Five core themes were demonstrated by social media comments: lived experiences with lupus, religious/spiritual thoughts, metaphors, heredity, and experiences of family and friends. Being diagnosed with lupus is perceived as a life-changing event. The fluctuating course of the disease causes uncertainty, and the perception of invisibility within the patient's social circle generates feelings of being misunderstood. Faith and spiritual thoughts are coping strategies. Patients use metaphors about the disease's meaning and their lived experiences (the purple butterfly, not belonging, bellicose metaphors) to communicate with others. Relatives and friends are impacted by their loved one's distress. CONCLUSION Patients perceive lupus as an unpredictable illness and use metaphors to foster empathy and communicate their experiences to others. Religion is as important as medical treatment to cope with the disease, and the experience of having lupus extends to family and friends. Findings can be used to improve physician-patient communication and lupus education campaigns in the Latin American and Latino population.
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Affiliation(s)
| | | | | | | | | | | | | | - Ernesto Cairoli
- Centro Asistencial del Sindicato Médico del Uruguay and Hospital Evangélico and Institut Pasteur de Montevideo, Montevideo, Uruguay
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2
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Tejada-Llacsa PJ, Villacorta-Landeo P, Aguilar-Buitrón E, Alarcón GS, Ugarte-Gil MF. Interest on the internet for systemic lupus erythematosus: Analysis of Google Trends in Latin American countries. Lupus 2021; 30:1342-1346. [PMID: 33874814 DOI: 10.1177/09612033211010337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND/OBJECTIVE Information available on the internet about Systemic Lupus Erythematosus (SLE) can influence the doctor-patient relationship. Therefore, the aim of this study was to identify the terms used for SLE on the internet. METHODS We analyzed the data downloaded from Google Trends, considering the term "Lupus" in a six-year web-based research. The frequency of the terms for each Pan-American country was obtained automatically from Google Trends, which reports relative search volumes or RSV (on a scale from 0 to 100) across regions. RESULTS We obtained a total of 67 registered terms in 18 countries. The terms were distributed into five categories. The categories with interest in all countries were "definition" and "symptoms". CONCLUSIONS Google Trends allows us to find useful information about SLE on the internet; once the accuracy of this information is validated, it can be used by patients, health institutions, rheumatologists and other health professionals.
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Affiliation(s)
- Paul J Tejada-Llacsa
- Servicio de Reumatología, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Perú.,Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú
| | - Pamela Villacorta-Landeo
- Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú.,Asociación para el Desarrollo de la Investigación Estudiantil en Ciencias de la Salud (ADIECS), Lima, Perú
| | - Eder Aguilar-Buitrón
- Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú.,Asociación para el Desarrollo de la Investigación Estudiantil en Ciencias de la Salud (ADIECS), Lima, Perú
| | - Graciela S Alarcón
- School of Medicine, The University of Alabama, Birmingham, AL, USA.,Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Manuel F Ugarte-Gil
- Servicio de Reumatología, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Perú.,Escuela de Medicina Humana, Universidad Científica del Sur, Lima, Perú
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3
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Seidlein AH, Salloch S. Illness and disease: an empirical-ethical viewpoint. BMC Med Ethics 2019; 20:5. [PMID: 30626443 PMCID: PMC6327539 DOI: 10.1186/s12910-018-0341-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 12/25/2018] [Indexed: 12/16/2022] Open
Abstract
Background The concepts of disease, illness and sickness capture fundamentally different aspects of phenomena related to human ailments and healthcare. The philosophy and theory of medicine are making manifold efforts to capture the essence and normative implications of these concepts. In parallel, socio-empirical studies on patients’ understanding of their situation have yielded a comprehensive body of knowledge regarding subjective perspectives on health-related statuses. Although both scientific fields provide varied valuable insights, they have not been strongly linked to each other. Therefore, the article aims to scrutinise the normative-ethical implications of patient perspectives in building a bridge to the empirical ethics debates. Main text Three potential fields of tension between the illness and the disease perspective are presented. Consequently, findings from empirical research examining patient perspectives on illness are displayed and the practical implications and associated ethical issues which arise are discussed. This leads to the conclusion that an explicit and elaborate empirical-ethical methodology is needed to deal appropriately with the complex interaction between patients’ views and the medico-professional view of disease. Kon’s four-stage model of normative-empirical collaboration is then applied against the background of empirical data on patient perceptions. Starting from this exemplary approach, the article suggests employing empirical-ethical frameworks for further research on the conceptual and normative issues, as they help to integrate perspectives from the philosophy of medicine with socio-empirical research. Conclusion The combination of theoretical and empirical perspectives suggested contributes to a more nuanced discussion of the normative impact of patients’ actual understanding of illness. Further empirical research in this area would profit from explicitly considering potential ethical issues to avoid naturalistic fallacies or crypto-normative conclusions that may compromise healthcare practice. Vice versa, medico-theoretical debates could be enriched by integrating subjective views of those people who are immediately affected.
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Affiliation(s)
- Anna-Henrikje Seidlein
- Institute of Ethics and History of Medicine, University Medicine Greifswald, Ellernholzstr. 1-2, 17487, Greifswald, Germany
| | - Sabine Salloch
- Institute of Ethics and History of Medicine, University Medicine Greifswald, Ellernholzstr. 1-2, 17487, Greifswald, Germany.
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4
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Grandclerc S, Spiers S, Spodenkiewicz M, Moro MR, Lachal J. The Quest for Meaning Around Self-Injurious and Suicidal Acts: A Qualitative Study Among Adolescent Girls. Front Psychiatry 2019; 10:190. [PMID: 31024356 PMCID: PMC6461024 DOI: 10.3389/fpsyt.2019.00190] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 03/15/2019] [Indexed: 01/01/2023] Open
Abstract
Introduction: Suicide and non-suicidal self-injury (NSSI) are major problems in adolescent psychiatry and share numerous clinical characteristics. The principal objective of this study is to describe the subjective experience of adolescent girls and young women who present NSSI and/or suicidal behaviors and to determine the common aspects and the specificities of each experience. Method: This exploratory study is based on a procedure that is qualitative, phenomenological, and inductive. The data were collected from two semi-structured interviews each of 18 girls and young women aged 12-21 years, who were receiving care from a psychiatrist specializing in adolescents and who at least once had harmed themselves by NSSI or attempted suicide, or both. The thematic data analysis was performed by applying the methods of interpretative phenomenological analysis. Results: The results are described around four superordinate themes: relationships with the self, with others/otherness, with the body, and with death; they are then subdivided into 13 themes. Several themes appeared common to both types of behavior, especially the relational dimension of self-harming acts. The process of separation-individuation seems complex for these youth. Conclusion: The results underline the relational aspects of the self-harming behavior (NSSI or suicidal) among adolescent girls. These aspects also appear to be expressed in the family sphere, the social sphere, in contact with peers, and also at a societal level when the community no longer addresses adolescents' difficulties. When the process of subjectification does not appear to reach completion, self-aggressive behavior is seen as an ultimate attempt to regain a feeling of autonomy.
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Affiliation(s)
- Salomé Grandclerc
- Maison de Solenn, MDA Cochin, AP-HP, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,CESP, Fac. de Médecine - Univ. Paris-Sud, Fac. de Médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
| | - Solene Spiers
- Service de Pédopsychiatrie, CHU de Caen, Caen, France.,UFR de Médecine, Université Caen Normandie, Caen, France.,Université Paris 13, Villetanneuse, France
| | - Michel Spodenkiewicz
- CESP, Fac. de Médecine - Univ. Paris-Sud, Fac. de Médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.,Pôle de Santé Mentale, CHU Sud Réunion, Saint-Pierre, France.,CEPOI EA 7388, UFR Santé, Université de la Réunion, Saint-Pierre, France
| | - Marie Rose Moro
- Maison de Solenn, MDA Cochin, AP-HP, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,CESP, Fac. de Médecine - Univ. Paris-Sud, Fac. de Médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
| | - Jonathan Lachal
- Maison de Solenn, MDA Cochin, AP-HP, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,CESP, Fac. de Médecine - Univ. Paris-Sud, Fac. de Médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
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5
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Larsen JL, Hall EOC, Jacobsen S, Birkelund R. The existential experience of everyday life with systemic lupus erythematosus. J Adv Nurs 2018; 74:1170-1179. [PMID: 29350776 DOI: 10.1111/jan.13525] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2018] [Indexed: 01/19/2023]
Abstract
AIM To explore from the perspective of women the nature of basic existential conditions while living with systemic lupus erythematosus. BACKGROUND Systemic lupus erythematosus has an unpredictable disease course and is documented to cause an existential rearrangement of life. The significance of changes in existential conditions and related experiences are unclear in the context of nursing and women with systemic lupus erythematosus. DESIGN A qualitative design guided by Van Manen's hermeneutic-phenomenological methodology. METHOD Individual in-depth interviews with 15 women diagnosed with systemic lupus erythematosus and of various ages, disease durations and severities were undertaken from September 2013 - October 2015. Data were analysed following van Manen's phenomenological approach and using drawing as an interpretive tool. FINDINGS The main existential experience was interpreted as a person "moving with the waves of systemic lupus erythematosus" constituted by the themes "oscillating between presence and absence of systemic lupus erythematosus," "recognizing space and bodily possibilities and limitations" and "being enriched through relationships and activities." When systemic lupus erythematosus was flaring, well-being was threatened and a laborious time to escape the feeling of a setback-in-life persisted long after the disease was medically under control. CONCLUSION Daily life with systemic lupus erythematosus is conditioned by a prominent need to be in existential motion, related to the absence and presence of systemic lupus erythematosus. The experience of a setback-in-life by illness might challenge well-being and indicates that periods of disease flares or disturbing symptoms are critical time points to provide support.
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Affiliation(s)
- Janni Lisander Larsen
- Nursing Section, Department of Public Health, Aarhus University, Aarhus, Denmark.,Copenhagen Lupus and Vasculitis Clinic, Rheumatology and Spine Diseases Centre, Rigshospitalet, Copenhagen, Denmark
| | - Elisabeth O C Hall
- Nursing Section, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Søren Jacobsen
- Copenhagen Lupus and Vasculitis Clinic, Rheumatology and Spine Diseases Centre, Rigshospitalet, Copenhagen, Denmark
| | - Regner Birkelund
- Denmark & Lillebaelt Hospital, Institute of Regional Health Research, University of Southern, Vejle, Denmark
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6
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Rutter S, Kiemle G. Exploring the social and interpersonal experiences of South Asian women with a diagnosis of Systemic Lupus Erythematosus. Psychol Health 2014; 30:318-35. [DOI: 10.1080/08870446.2014.972397] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- S.J. Rutter
- Department of Clinical Psychology, North Manchester General Hospital, Manchester, UK
| | - G. Kiemle
- Doctorate in Clinical Psychology, The University of Liverpool, Liverpool, UK
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7
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Grayson PC, Amudala NA, McAlear CA, Leduc RL, Shereff D, Richesson R, Fraenkel L, Merkel PA. Causal attributions about disease onset and relapse in patients with systemic vasculitis. J Rheumatol 2014; 41:923-30. [PMID: 24634202 DOI: 10.3899/jrheum.131096] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Patients vary in their beliefs related to the cause of serious illness. The effect of these beliefs among patients with systemic vasculitis is not known. Our study aimed to describe causal attributions about disease onset and relapse in systemic vasculitis and to examine whether causal beliefs differ by type of vasculitis or are associated with negative health outcomes. METHODS Patients with vasculitis were recruited to complete an online questionnaire. Categories of causal beliefs were assessed with the Revised Illness Perception Questionnaire (IPQ-R). Differences in beliefs about disease onset versus relapse were compared across different forms of vasculitis. Causal beliefs were assessed in association with several health outcomes including fatigue, functional impairments, and personal understanding of the condition. RESULTS The questionnaire was completed by 692 patients representing 9 forms of vasculitis. The majority (90%) of patients had beliefs about the cause of their illness. Causal attributions were highly variable, but altered immunity and stress were the most commonly agreed-upon causal beliefs. Frequencies of causal beliefs were strikingly similar across different forms of vasculitis, with a few notable exceptions primarily in Behçet disease. Beliefs differed about causes of disease onset versus relapse. Specific beliefs about disease onset and relapse were weakly associated with fatigue, functional impairments, and understanding of the condition. CONCLUSION Patient beliefs related to the cause of systemic vasculitis are highly variable. Patterns of causal beliefs are associated with important negative health outcomes. Clinicians who care for patients with vasculitis should be mindful of these associations and consider asking about patients' causal beliefs.
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Affiliation(s)
- Peter C Grayson
- From the US National Institutes of Health (NIH), National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), Bethesda, Maryland; The Vasculitis Center, Section of Rheumatology, and the Clinical Epidemiology Unit, Boston University School of Medicine, Boston, Massachusetts; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania; University of South Florida, Tampa, Florida; School of Nursing, Duke University, Durham, North Carolina; Division of Rheumatology, Yale University, New Haven, Connecticut, USA
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8
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Sutanto B, Singh-Grewal D, McNeil HP, O'Neill S, Craig JC, Jones J, Tong A. Experiences and Perspectives of Adults Living With Systemic Lupus Erythematosus: Thematic Synthesis of Qualitative Studies. Arthritis Care Res (Hoboken) 2013; 65:1752-65. [DOI: 10.1002/acr.22032] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 04/03/2013] [Accepted: 04/10/2013] [Indexed: 11/09/2022]
Affiliation(s)
- Bernadet Sutanto
- University of Sydney and The Children's Hospital at Westmead; Sydney, New South Wales Australia
| | - Davinder Singh-Grewal
- University of Sydney, The Children's Hospital at Westmead, University of New South Wales, and Liverpool Hospital; Sydney, New South Wales Australia
| | - H. Patrick McNeil
- University of New South Wales and Liverpool Hospital; Sydney, New South Wales Australia
| | - Sean O'Neill
- University of New South Wales and Liverpool Hospital; Sydney, New South Wales Australia
| | - Jonathan C. Craig
- University of Sydney and The Children's Hospital at Westmead; Sydney, New South Wales Australia
| | - Julie Jones
- University of Sydney; Sydney, New South Wales Australia
| | - Allison Tong
- University of Sydney and The Children's Hospital at Westmead; Sydney, New South Wales Australia
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9
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Abstract
This paper considers the experiences of people with lupus in comparison with those with diabetes, and discusses the impact of lupus specialist nurses in information-giving and education under the guise of 'just in case' vs. 'just in time'. Now recognized as a difficult condition to diagnose, lupus can lead to significant worry and distress especially during delays to diagnosis and times of high disease activity. Providing appropriate, individualized information to people with lupus is embedded in specialist nursing practice and enables individuals to use the tools of self-management approaches in gaining control over everyday symptoms.
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Affiliation(s)
- S Brown
- Royal National Hospital for Rheumatic Diseases NHS Foundation Trust, Bath, UK
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10
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Waldron N, Brown SJ, Hewlett S, Elliott B, McHugh N, McCabe CS. 'To suddenly have a name for this thing… was wonderful': the patient's experience of receiving a diagnosis of systemic lupus erythematosus. Musculoskeletal Care 2012; 10:135-141. [PMID: 22514146 DOI: 10.1002/msc.1010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVES The aim of this study was to explore the patient's perception of receiving a diagnosis of systemic lupus erythematosus (lupus) and reports on their experience of the period between onset of symptoms and receiving a definitive diagnosis. METHODS Focus groups were conducted in seven rheumatology centres. Forty-three participants were purposively selected and data were subjected to thematic deductive analysis. RESULTS Focus group data generated three major themes. 'Diagnostic uncertainty and misdiagnosis' describes the frustration for many of experiencing years of often debilitating symptoms that have gone unacknowledged by health professionals and misunderstood by themselves. Some experienced the trauma of being misdiagnosed, which impacted on how they adjusted to their final diagnosis of lupus. 'Consequences of receiving a diagnosis' highlights the feelings of relief for participants at finally having a diagnosis, despite its implications. However, the manner in which this knowledge was delivered was often inappropriate and unsupported, affecting how they adjusted to future management of their condition. 'Impact on individuals' lives' explores how many felt empowered by finally receiving recognition for their symptoms, but the diagnosis of a relatively unknown condition with often invisible symptoms impacted on the response and support they received from those around them. CONCLUSION It is essential health professionals have a greater understanding of the patient experience prior to receiving a diagnosis of lupus. The individual experience from symptom onset to diagnosis has a direct impact on the patient's subsequent acceptance of their diagnosis and response to management and therefore justifies the need for further research in this field.
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Affiliation(s)
- Nicola Waldron
- The Royal National Hospital for Rheumatic Diseases, Bath, UK.
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11
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Mattsson M, Möller B, Stamm T, Gard G, Boström C. Uncertainty and opportunities in patients with established systemic lupus erythematosus: a qualitative study. Musculoskeletal Care 2012; 10:1-12. [PMID: 22009870 DOI: 10.1002/msc.220] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
UNLABELLED Systemic lupus erythematosus (SLE) is a chronic disease which can affect any organ, and the impact of the condition will affect each person differently. There are few qualitative studies including the experiences of both women and men with a diagnosis of SLE corresponding to the American College of Rheumatology (ACR) criteria where both negative and positive impacts of the disease have been presented. PURPOSE The aim was to describe how patients with established SLE experience their illness in everyday life, including both negative and positive aspects. METHOD Four focus group interviews were conducted with 16 women and three men with SLE according to ACR criteria, with varied disease activity and no or little organ damage. The interviews were tape recorded, transcribed verbatim and analysed using qualitative content analysis. RESULTS Two themes emerged: multifaceted uncertainty contained the categories 'an unreliable body', 'obtrusive pain and incomprehensible fatigue', 'mood changes and worries', 'reliance on medication and health care'; Focus on health and opportunities included 'learning process implying personal strength', 'limitations and possibilities in activities and work', 'a challenge to explain and receive support' and 'living an ordinary life incorporating meaningful occupations'. CONCLUSIONS While we expected to find a mainly negative impact, positive aspects were also described. Our findings were complex and showed that patients with established SLE can experience both uncertainty and opportunities. This highlights the importance for healthcare professionals of gaining a better understanding of patients' uncertainty, to enable them to support patients, allowing them to focus on health and opportunities. Measurement instruments that capture different aspects of uncertainty and opportunities needs to be developed.
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Affiliation(s)
- M Mattsson
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden.
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12
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Roussou E, Iacovou C, Weerakoon A, Ahmed K. Stress as a trigger of disease flares in SLE. Rheumatol Int 2011; 33:1367-70. [PMID: 22193224 DOI: 10.1007/s00296-011-2292-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2011] [Accepted: 12/10/2011] [Indexed: 11/29/2022]
Abstract
Patients with systemic lupus erythematosus were asked to report their perceptions as to whether stress can trigger disease flares. A total of 54 patients treated at two District General Hospitals in Essex were included in the analysis. They were 4 males and 50 females and were 20 Caucasians, 22 Asians, and 12 Africans/Afro-Caribbean. Thirty-three of 54 patients (61.1%) reported stress to be a trigger for disease flares. Although most (85%) of the Caucasian patients reported that stress triggered their disease flares, only 50% of the African/Afro-Caribbean patients and 45.4% of the Asian patients reported stress as a trigger for disease flares. No correlation was found between reported number of flares per year and characteristics such as age (P = 0.4), age at diagnosis (P = 0.8), age at disease onset (P = 0.6), or disease duration (P = 0.2). A trend towards a significant correlation was observed between the number of reported flares per year and the number of children a patient has (P = 0.07).
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Affiliation(s)
- E Roussou
- Department of Rheumatology and Rehabilitation, Barking Havering and Redbridge University Hospitals NHS Trust, King George Hospital, Barley Lanes, Goodmayes, Ilford, Essex, IG3 8YB, UK.
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13
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Waldron N, Brown S, Hewlett S, Elliott B, McHugh N, McCabe C. 'It's more scary not to know': a qualitative study exploring the information needs of patients with systemic lupus erythematosus at the time of diagnosis. Musculoskeletal Care 2011; 9:228-238. [PMID: 21993962 DOI: 10.1002/msc.221] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVES To identify the information needs of patients newly diagnosed with systemic lupus erythematosus (lupus), to inform the design of a future education package. METHODS Focus groups were conducted in seven rheumatology centres in the UK with 43 purposively selected participants. Data were subjected to thematic inductive analysis. RESULTS The first major theme, 'Impact of early information', describes how for many individuals information was scant and, as most had little prior knowledge of lupus, the information was difficult to absorb, leaving them with feelings of fear and confusion. 'Information received versus information sought' (theme 2) describes how few participants felt they had received clear, consistent information. For most, information was felt to be insufficient, forcing them to seek it elsewhere, which, if unsuitable, resulted in further distress. 'Early education needs' (theme 3) reflects that patients would rather be informed of potential problems than remain naïve. Patients felt that receiving a comprehensive information pack as an adjunct to verbal information from their clinician would be helpful, along with rapid access to knowledgeable professionals when they were ready to ask questions about their lupus. CONCLUSIONS Participants stated information and support currently provided at diagnosis is inadequate for their needs. They would like detailed information, provided through a variety of formats. Crucially this should be supported by professionals and available at whatever point in the patient's journey they want to access such discussions .The challenge is for health professionals to meet these needs in the most beneficial and cost effective way.
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Affiliation(s)
- Nicola Waldron
- The Royal National Hospital for Rheumatic Diseases, Bath, UK.
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