title: Health Professionals' Perceptions of the Effects of Exercise on Joint Health in Rheumatoid Arthritis Patients.
abstract: Although exercise is an important factor in the management of rheumatoid arthritis (RA), research indicates that patients perceive that health professionals (HPs) are uncertain about the place of exercise in treatment and its relationship with joint damage. The present study investigated the perceptions of HPs regarding the effects of exercise on joint health in RA patients.
  
  
  
  A questionnaire investigating perceptions of exercise and joint health was distributed via professional networks and websites. Confirmatory factor analysis (CFA) was used to analyse questionnaire data and develop a focus group interview guide. Focus groups were conducted with multidisciplinary teams (MDTs) of rheumatology HPs and analysed using framework analysis.
  
  
  
  A total of 137 rheumatology HPs (95 female; 27-65 years of age) completed questionnaires. CFA showed that a four-factor model provided a marginally acceptable fit. Analysis of four focus groups (n = 24; 19 female; 30-60 years of age) identified five themes relating to HPs' perceptions of exercise and joint health in RA patients: 'Exercise is beneficial', 'Concerns about damage to joints', 'Patients have barriers to exercise', 'HP knowledge differs' and 'Patients may think service delivery is vague'.
  
  
  
  HPs were highly aware of the benefits and importance of exercise for RA patients. However, to remove the patient perception that HPs lack certainty and clarity regarding exercise it is important to ensure: (i) consistent promotion of exercise across the whole MDT; (ii) clear provision of information regarding rest, joint protection and exercise; (iii) HP education to ensure consistent, accurate knowledge, and understanding of the potential for conflicting advice when promoting exercise as part of an MDT. Copy © 2016 John Wiley & Sons, Ltd.
authors.affiliation: School of Sport, Health and Exercise Sciences, Bangor University, Bangor, UK.|Department of Nursing and Midwifery, University of the West of England, Bristol, UK.
authors.forename: Serena
authors.initials: S
authors.lastname: Halls
authors.affiliation: School of Sport, Health and Exercise Sciences, Bangor University, Bangor, UK.|North Wales Centre for Primary Care Research, School of Healthcare Sciences, Bangor University, Bangor, UK.
authors.forename: Rebecca-Jane
authors.initials: RJ
authors.lastname: Law
authors.affiliation: School of Sport, Health and Exercise Sciences, Bangor University, Bangor, UK.|Department of Rheumatology, Betsi Cadwaladr University Health Board, UK.
authors.forename: Jeremy G
authors.initials: JG
authors.lastname: Jones
authors.affiliation: School of Sport, Health and Exercise Sciences, Bangor University, Bangor, UK.
authors.forename: David A
authors.initials: DA
authors.lastname: Markland
authors.affiliation: School of Sport, Health and Exercise Sciences, Bangor University, Bangor, UK.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Maddison
authors.affiliation: School of Sport, Health and Exercise Sciences, Bangor University, Bangor, UK.|School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Jeanette M
authors.initials: JM
authors.lastname: Thom
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid; D001291:Attitude of Health Personnel; D015444:Exercise; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D000072140:Rheumatologists / Q000523:psychology
keywords: Rheumatoid arthritis; exercise; health professional perceptions; joint health