Caroline A. Flurey

This study aimed to investigate potential gender differences in illness acceptance and coping strategies in patients with inflammatory arthritis (IA). Furthermore, the study aimed to identify factors associated with illness acceptance and coping strategies specific to men and women. A cross-sectional nationwide survey design was applied. Illness acceptance was measured by using the Acceptance of Illness Scale and coping was measured by using the Medical Coping Modes Questionnaire. Descriptive statistics were used to explore gender differences in illness acceptance and coping strategies in patients with IA, while logistic regression analyses investigated associated factors. The study included 664 participants (85.1% women) with a mean age of 50 and median disease duration of 10 years. Diagnoses included 53.3% rheumatoid arthritis, 27.1% psoriatic arthritis, and 19.6% axial spondyloarthritis. A statistically significant difference was found between men and women in use of avoidance (P = 0.015). Higher illness acceptance was associated with tertiary education in men (OR: 3.90) and older age in women (OR: 1.35 per 10 years). Women with higher disease activity used confrontation more (OR: 1.64) than women with less activity. Men relied more on avoidance when facing psychological distress (OR: 1.29) or severe fatigue (OR: 1.31), as did women with high disease activity (OR: 2.09). Acceptance-resignation was linked to higher disability and psychological distress in men (OR: 1.32 and 1.52) and higher disease activity in women (OR: 2.09). We identified factors associated with illness acceptance and coping strategies among IA patients. Gender-sensitive approaches are needed to address specific factors influencing illness acceptance and coping in men and women.

Background: Identification of rheumatoid arthritis (RA) in primary care is challenging and often delayed. Anticyclic citrullinated peptide (anti-CCP) antibody testing of people presenting to primary care with new-onset musculoskeletal symptoms without synovitis could help address this; those testing positive are at increased risk of developing RA. Aim: To explore how primary care clinicians currently identify and refer patients with suspected RA, and the behaviours required to implement a prediction model for guiding targeted anti-CCP testing for non-specific musculoskeletal symptoms in primary care. Design and setting: A qualitative descriptive study in primary care in England. Method: Eight GPs and eight musculoskeletal First Contact Practitioners (physiotherapists) participated in semi-structured interviews to explore their experiences of identifying and/or referring patients with suspected RA, and their views of a implementation package for the anti-CCP prediction model. Data were analysed using framework analysis. Results: Variations in practice were evident across the pathway for identifying and/or referring patients with suspected RA, including in access to and use of the anti-CCP test. Implementing the anti-CCP prediction model would require clinicians to believe its benefits outweigh its risks, engagement of primary and secondary care teams, and incorporation of the prediction model within an easily accessible and useable clinical-decision support system. Participants’ views about implementing the anti-CCP prediction model varied but were mostly positive overall. Conclusion: Implementing a prediction model to guide targeted anti-CCP testing in primary care could be feasible. Further research is required to explore the potential benefits, risks, and costs of a pathway for identifying and/or managing people at risk of RA

Introduction: Sexual health, pleasure, justice (equity in sexual rights and experiences), and well‐being are crucial determinants of health and life quality, yet often overlooked in the rheumatic and musculoskeletal diseases (RMD) field. However, this topic has received more attention recently, and there is a need to map the current literature to inform the direction of future studies. Hence, this protocol outlines a scoping review to systematically map existing evidence on sexual health in people with RMD, exploring key themes and identifying evidence gaps across multiple dimensions, including sexual well‐being, justice and pleasure.Method and Analysis: This scoping review will follow the methodological guidance of the Joanna Briggs Institute and be reported using the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis extension for Scoping Reviews. The search strategy will involve PubMed, Embase, Cochrane Central, CINAHL, PsychInfo, LGBTQIA+ Source, Web of Science, and the grey literature. Identified articles will be reviewed based on the eligibility criteria. The results will be narratively synthesised and aligned with the framework proposed by Mitchel et al. (2021), identifying four pillars of comprehensive public health for sexuality: ‘Sexual Health’, ‘Sexual Pleasure’, ‘Sexual Justice’, and ‘Sexual Well‐Being’.Dissemination: The scoping review will synthesise the scientific literature published on sexual health, pleasure, justice and well‐being in people with RMD. This review will provide an understanding of how sexual health is addressed in the literature to inform future research and clinical practices. The findings will be disseminated as research publications, including peer‐reviewed article(s), conference abstract(s)/presentation(s), and plain language summaries.

Background: In the United Kingdom, 20 million individuals suffer from a musculoskeletal condition, for which physical activity (PA) is a core treatment. Minority ethnic communities experience a disproportionate impact, experiencing higher levels of pain and engaging in less PA. Research has identified various factors that affect their participation in PA, including lack of access to support, limited knowledge of resources, language barriers, fear of racial harassment while exercising, and insufficient communication/information from healthcare professionals. Methods: This project adopted a realist perspective, aiming to understand “what works, in which circumstances, and for whom?” The project had 4 steps: (1) defining review scope with stakeholders; (2) searching and extracting literature, creation of initial program theories; (3) refining/validating initial program theories with stakeholders; and (4) adopting Q-methodology to highlight priority areas. Results: 17 papers were included. Three program theories were identified: (1) Lack of initial access to health service support; (2) Nature of musculoskeletal self-management support—the importance of the therapeutic relationship and value of shared conversations; and (3) Accessible long-term support for PA engagement. The Q-sort exercise highlighted priority areas: (1) complex booking procedures and inadequate translation services, (2) time constraints impact effective patient-centered care, (3) dismissive attitudes/mismatched expectations impact shared decision making, (4) rebuilding trust to strengthen therapeutic relationships, (5) cultural relevance in developing therapeutic relationships, and (6) clinician recommended PA opportunities increase knowledge of PA. Conclusions: Our findings shed light on inequities across the UK’s musculoskeletal pathways, specifically in relation to PA engagement. This points toward priority areas for future research and interventions.