title: Perceived benefits and barriers to joint protection among people with rheumatoid arthritis and occupational therapists. A mixed methods study.
abstract: BACKGROUND
  Deciding whether or not to perform a health behaviour is an active decision-making process which has an impact on current and future behaviour and can be influenced by the beliefs both of patients and their healthcare professionals. The aim of this study was to explore rheumatoid arthritis (RA) patients' and occupational therapists' (OTs) perceptions of the benefits of and barriers to performing joint protection (JP).
  
  
  METHODS
  A mixed methods design was used. Questionnaires applied a theoretical framework of key themes to assess the relevance of JP benefits and barriers both to people with RA and OTs. Focused interviews with people with RA then enabled data triangulation. Investigator triangulation was used to check the validity of data interpretation.
  
  
  RESULTS
  Ten people with RA and nine OTs participated. From the questionnaires, both groups agreed that highly relevant key themes for JP benefits were physical well-being, potential benefit and personal control. By contrast, the three key themes for JP barriers - negative attitude of others, negative impact on others and taking time from other things - were relevant for the majority of the OTs but not patients. The interviews enabled an understanding of the meaning behind RA patients' ratings, particularly their differences from OTs. People with RA explained JP benefits, and disease acceptance had altered some initial barriers into perceived benefits over time.
  
  
  CONCLUSIONS
  Emphasizing benefits and identifying individually relevant barriers could be an important communication strategy for OTs in understanding patients' rationale for whether or not to adopt JP methods.
authors.affiliation: Department of Rheumatology, Institute of Physical Medicine, University Hospital Zurich, Zurich, Switzerland. karin.niedermann@usz.ch
authors.forename: K
authors.initials: K
authors.lastname: Niedermann
authors.forename: A
authors.initials: A
authors.lastname: Hammond
authors.forename: A
authors.initials: A
authors.lastname: Forster
authors.forename: R
authors.initials: R
authors.lastname: de Bie
mesh_terms: D001172:Arthritis, Rheumatoid / Q000503:physiopathology / Q000517:prevention & control* / Q000523:psychology; D003144:Communication Barriers; D004185:Disability Evaluation; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D007596:Joints / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy; D010353:Patient Education as Topic; D012648:Self Care; D011795:Surveys and Questionnaires