Nurse‐led care for people with early rheumatoid arthritis: Interview study with thematic analysis

Abstract

AbstractAimsTo develop an understanding of what comprises nurse‐led care in early rheumatoid arthritis from the perspective of rheumatology nurse specialists in England.DesignQualitative study.MethodsSemi‐structured telephone interviews with rheumatology nurse specialists in England were conducted in Summer 2020. Interviews were audio‐recorded, transcribed verbatim and analysed using reflexive thematic analysis.Reporting follows the appropriate elements of consolidated criteria for reporting qualitative research.ResultsSixteen nurses were recruited and interviews lasted 30–60 min. Four themes with 14 subthemes were identified.A specialist service delivered by experienced rheumatology nursesSpecialist care is provided by experienced nurse specialists with a high degree of autonomy in the rheumatology multidisciplinary team context.Addressing patients' complex care needsCare is evidence‐based and aims to start treatment, keep in treatment, educate and support. Access to psychology expertise is needed.Care with compassion using person‐centred, holistic and empathetic approachesNurses create patient relationships and a positive therapeutic environment. Nurse‐led telephone advice lines are essential for treatment adjustment, patient support and empowerment.Continued evaluation and development of the serviceConsultations are reviewed, and patients are asked for feedback. The COVID‐19 pandemic caused disruption, but changes streamlined procedures and improved documentation and communication.ConclusionNurse‐led care in early rheumatoid arthritis is a specialist service delivered with compassion, addressing complex care needs and using person‐centred approaches. This study identifies key aspects of care in early disease from the nurse perspective.