Social interactions at the onset of rheumatoid arthritis and their influence on help-seeking behaviour: A qualitative exploration.
OBJECTIVE
To explore how social interactions at the onset of rheumatoid arthritis (RA) influence help-seeking behaviour from the perspectives of those with RA and their significant others (family and friends).


METHODS
Nineteen semi-structured qualitative interviews were undertaken with people recently diagnosed with RA and their significant others. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis.


RESULTS
Significant others' initial appraisals of symptoms led them to provide practical support with daily activities rather than advice to seek help. People with RA described difficulties in communicating the severity of their symptoms and often attempted to hide their symptoms from others. Significant others also reacted negatively, expressing disbelief and dismissing symptoms. On occasion, early symptoms were even described as the catalyst for the breakdown of relationships. On reflection, significant others expressed guilt about their initial reactions and wished that they had recognized the need for intervention earlier. When symptoms had advanced and were more obvious, significant others often strongly advised that help should be sought and, in some cases, physically escorted the patient to their medical appointment. In many instances, people with RA described significant others as the catalyst for eventually seeking help.


CONCLUSIONS
Significant others play an important role in influencing help-seeking behaviour; this has implications for theoretical models of help-seeking and the development of help-seeking interventions. A negative consequence of social interactions resulted from a lack of understanding and knowledge about RA among significant others, highlighting the need for greater public awareness about the early symptoms of RA.
Centre for Ageing Studies, University of Chester, UK.
Rumandeep
R
Tiwana
Patient Research Partner, Birmingham Rheumatology Research Patient Partnership, University of Birmingham, UK.
John
J
Rowland
Patient Research Partner, Birmingham Rheumatology Research Patient Partnership, University of Birmingham, UK.
Marie
M
Fincher
Centre for Translational Inflammation Research, University of Birmingham, UK.|Department of Rheumatology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.
Karim
K
Raza
Centre for Translational Inflammation Research, University of Birmingham, UK.|Department of Rheumatology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.
Rebecca J
RJ
Stack
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000523:psychology*; D057210:Delayed Diagnosis; D005190:Family; D005260:Female; D033062:Friends; D000066505:Help-Seeking Behavior; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012944:Social Support; D055815:Young Adult
help-seeking; patient delay; qualitative; rheumatoid arthritis; social relationships