title: Patient preferences for psychological support in inflammatory arthritis: a multicentre survey.
abstract: OBJECTIVE
  Inflammatory arthritis (IA) can lead to anxiety, depression, pain and fatigue. Psychological support can improve quality of life and self-management; and European and American guidelines recommend support be offered. This study examined patient views on psychological support for their IA.
  
  
  METHODS
  A questionnaire designed by researchers, patient partners and clinicians was administered to 2280 patients with IA.
  
  
  RESULTS
  1210 patients responded (53%): 74% women; mean age 59 years (SD 12.7); patient global 5 (2.3); disease duration <5 years (41%), 5-10 (20%), >10 (39%). Only 23% reported routinely being asked about social and emotional issues by a rheumatology professional, but 46% would like the opportunity to discuss psychological impact. If offered, 66% of patients reported they would use a self-management/coping clinic (63% pain management, 60% occupational therapy, 48% peer support groups, 46% patient education, 46% psychology/counselling). Patients want support with managing the impact of pain and fatigue (82%), managing emotions (57%), work and leisure (52%), relationships (37%) and depression (34%). Preferences are for support to be delivered by the rheumatology team (nurse 74%, doctor 55%) and general practitioners (GPs) (51%). Only 6% of patients stated that social and emotional issues were not relevant.
  
  
  CONCLUSIONS
  Demand for psychological support is high; however, less than a quarter of patients reported being asked about social and emotional issues, suggesting a gap between needs and provision. The preference is for delivery from rheumatology clinicians and GPs, and research should establish whether they have the skills and resources to meet patients' needs.
authors.affiliation: Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Dures
authors.affiliation: Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.
authors.forename: Celia
authors.initials: C
authors.lastname: Almeida
authors.affiliation: Academic Rheumatology, University Hospitals Bristol, Bristol, UK.
authors.forename: Judy
authors.initials: J
authors.lastname: Caesley
authors.affiliation: Academic Rheumatology, University Hospitals Bristol, Bristol, UK.
authors.forename: Alice
authors.initials: A
authors.lastname: Peterson
authors.affiliation: Pain Management Centre, North Bristol NHS Trust, Bristol, UK.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Ambler
authors.affiliation: Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.
authors.forename: Marianne
authors.initials: M
authors.lastname: Morris
authors.affiliation: Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.
authors.forename: Jon
authors.initials: J
authors.lastname: Pollock
authors.affiliation: Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Hewlett
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000523:psychology / Q000534:rehabilitation*; D003695:Delivery of Health Care / Q000458:organization & administration; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000458:organization & administration; D057240:Patient Preference; D011788:Quality of Life; D012648:Self Care; D012944:Social Support; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Health services research; Patient perspective; Psychology