title: A qualitative investigation of the barriers to help-seeking among members of the public presented with symptoms of new-onset rheumatoid arthritis.
abstract: OBJECTIVE
  Treating patients with rheumatoid arthritis (RA) within 3 months of symptom onset leads to significantly improved clinical outcomes. However, many people with RA symptoms wait a long time before seeking medical attention. To develop effective health interventions to encourage people to seek help early, it is important to understand what the general public knows about RA, how they would react to the symptoms of RA, and what might delay help-seeking.
  
  
  METHODS
  Qualitative interviews were conducted with 38 members of the general public (32 women) without any form of inflammatory arthritis about their perceptions of RA symptoms and decisions to seek help were they to experience such symptoms. The interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis.
  
  
  RESULTS
  A number of barriers and drivers to help-seeking were identified and grouped into 5 themes: perceived causes of symptoms; factors related to presentation, location, and experience of symptoms; perceived effect of symptoms on daily life; self-management of symptoms; and general practitioner-related drivers and barriers.
  
  
  CONCLUSIONS
  To our knowledge, our study is the first to investigate barriers to and drivers of help-seeking in response to the onset of RA symptoms in individuals without a diagnosis of RA. It has revealed a number of additional factors (e.g., the importance of the location of the symptoms) besides those previously identified in retrospective studies of patients with RA. Together with the data from previous research, these findings will help inform future health interventions aimed at increasing knowledge of RA and encouraging help-seeking.
authors: From the Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, The University of Birmingham; Sandwell and West Birmingham Hospitals National Health Service (NHS) Trust, Birmingham; Arthritis Research United Kingdom Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele; and the Faculty of Medical and Human Sciences, School of Nursing, University of Manchester, Manchester, UK.G. Simons, Research Fellow, PhD; R.J. Stack, Research Fellow, PhD, Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, The University of Birmingham; C.D. Mallen, Professor of General Practice Research, PhD, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; K. Kumar, National Institute for Health Research Clinical Doctoral Research Fellow, MSc, Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, The University of Birmingham, and the Faculty of Medical and Human Sciences, School of Nursing, University of Manchester; K. Raza, Professor of Clinical Rheumatology, Honorary Consultant Rheumatologist, PhD, Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, The University of Birmingham, and the Sandwell and West Birmingham Hospitals NHS Trust. g.simons@bham.ac.uk.
authors: Gwenda
authors: G
authors: Simons
authors: From the Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, The University of Birmingham; Sandwell and West Birmingham Hospitals National Health Service (NHS) Trust, Birmingham; Arthritis Research United Kingdom Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele; and the Faculty of Medical and Human Sciences, School of Nursing, University of Manchester, Manchester, UK.G. Simons, Research Fellow, PhD; R.J. Stack, Research Fellow, PhD, Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, The University of Birmingham; C.D. Mallen, Professor of General Practice Research, PhD, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; K. Kumar, National Institute for Health Research Clinical Doctoral Research Fellow, MSc, Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, The University of Birmingham, and the Faculty of Medical and Human Sciences, School of Nursing, University of Manchester; K. Raza, Professor of Clinical Rheumatology, Honorary Consultant Rheumatologist, PhD, Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, The University of Birmingham, and the Sandwell and West Birmingham Hospitals NHS Trust.
authors: Christian David
authors: CD
authors: Mallen
authors: From the Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, The University of Birmingham; Sandwell and West Birmingham Hospitals National Health Service (NHS) Trust, Birmingham; Arthritis Research United Kingdom Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele; and the Faculty of Medical and Human Sciences, School of Nursing, University of Manchester, Manchester, UK.G. Simons, Research Fellow, PhD; R.J. Stack, Research Fellow, PhD, Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, The University of Birmingham; C.D. Mallen, Professor of General Practice Research, PhD, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; K. Kumar, National Institute for Health Research Clinical Doctoral Research Fellow, MSc, Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, The University of Birmingham, and the Faculty of Medical and Human Sciences, School of Nursing, University of Manchester; K. Raza, Professor of Clinical Rheumatology, Honorary Consultant Rheumatologist, PhD, Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, The University of Birmingham, and the Sandwell and West Birmingham Hospitals NHS Trust.
authors: Kanta
authors: K
authors: Kumar
authors: From the Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, The University of Birmingham; Sandwell and West Birmingham Hospitals National Health Service (NHS) Trust, Birmingham; Arthritis Research United Kingdom Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele; and the Faculty of Medical and Human Sciences, School of Nursing, University of Manchester, Manchester, UK.G. Simons, Research Fellow, PhD; R.J. Stack, Research Fellow, PhD, Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, The University of Birmingham; C.D. Mallen, Professor of General Practice Research, PhD, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; K. Kumar, National Institute for Health Research Clinical Doctoral Research Fellow, MSc, Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, The University of Birmingham, and the Faculty of Medical and Human Sciences, School of Nursing, University of Manchester; K. Raza, Professor of Clinical Rheumatology, Honorary Consultant Rheumatologist, PhD, Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, The University of Birmingham, and the Sandwell and West Birmingham Hospitals NHS Trust.
authors: Rebecca Jayne
authors: RJ
authors: Stack
authors: From the Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, The University of Birmingham; Sandwell and West Birmingham Hospitals National Health Service (NHS) Trust, Birmingham; Arthritis Research United Kingdom Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele; and the Faculty of Medical and Human Sciences, School of Nursing, University of Manchester, Manchester, UK.G. Simons, Research Fellow, PhD; R.J. Stack, Research Fellow, PhD, Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, The University of Birmingham; C.D. Mallen, Professor of General Practice Research, PhD, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; K. Kumar, National Institute for Health Research Clinical Doctoral Research Fellow, MSc, Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, The University of Birmingham, and the Faculty of Medical and Human Sciences, School of Nursing, University of Manchester; K. Raza, Professor of Clinical Rheumatology, Honorary Consultant Rheumatologist, PhD, Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, The University of Birmingham, and the Sandwell and West Birmingham Hospitals NHS Trust.
authors: Karim
authors: K
authors: Raza
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility; D000066505:Help-Seeking Behavior; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D036301:Qualitative Research; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
keywords: GENERAL PUBLIC; HELP-SEEKING; KNOWLEDGE; PERCEPTIONS; RHEUMATOID ARTHRITIS
references: BMJ Open. 2013 Feb 13;3(2):null
references: 23408077
references: Rheumatology (Oxford). 2010 May;49(5):1005-12
references: 20189950
references: Health Psychol. 1986;5(2):95-114
references: 3732230
references: Ann Rheum Dis. 2012 Dec;71(12):1921-3
references: 22941769
references: Health Qual Life Outcomes. 2008;6:54
references: 18651986
references: J Adv Nurs. 2005 Mar;49(6):616-23
references: 15737222
references: Rheumatology (Oxford). 2013 Mar;52(3):452-9
references: 22949726
references: Arthritis Rheum. 2010 Dec;62(12):3537-46
references: 20722031
references: Arthritis Care Res (Hoboken). 2013 Dec;65(12):1916-26
references: 23926091
references: Chronic Illn. 2014 Dec;10(4):259-72
references: 24567194
references: Rheumatology (Oxford). 2014 Sep;53(9):1646-53
references: 24729397
references: Rheumatology (Oxford). 2008 Oct;47(10):1577-82
references: 18713769
references: Arthritis Rheum. 2006 Dec 15;55(6):864-72
references: 17139662
references: Best Pract Res Clin Rheumatol. 2006 Oct;20(5):849-63
references: 16980210
references: Ann Rheum Dis. 2013 Aug;72(8):1302-7
references: 22956597
references: Ann Rheum Dis. 2012 Apr;71(4):493-7
references: 22121128
references: Patient Educ Couns. 2001 Feb;42(2):145-57
references: 11118780
references: Ann Rheum Dis. 2013 Jan;72(1):13-22
references: 22532640
references: Chronic Illn. 2010 Sep;6(3):171-82
references: 20610465
references: Rheumatology (Oxford). 2007 Sep;46(9):1438-40
references: 17578850
references: Arthritis Rheum. 2008 Apr 15;59(4):575-82
references: 18383399
references: Sociol Health Illn. 1982 Jul;4(2):167-82
references: 10260456
references: Scand J Prim Health Care. 2014 Mar;32(1):37-43
references: 24635577
references: Health Psychol. 1993 May;12(3):171-9
references: 8500446
references: Musculoskeletal Care. 2008 Dec;6(4):247-66
references: 18785194
references: Lancet. 2005 Sep 3-9;366(9488):825-31
references: 16139657