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Perspectives of patients and health professionals on the experience of living with psoriatic arthritis-related foot problems: a qualitative investigation

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Abstract

Objective

The aim of the study was to explore how foot problems impact on the lives of people with psoriatic arthritis by interviewing patients and health professionals.

Method

Participants were recruited from outpatient rheumatology clinics in Sydney, Australia, and in Auckland, New Zealand, using a convenience sampling strategy. People with psoriatic arthritis were asked questions in semi-structured interviews about their foot problems and the impact they have on daily living until qualitative data saturation. Focus groups were undertaken with health professionals to explore their understanding of the patient experience of psoriatic arthritis-related foot problems. All interviews were audio-recorded and transcribed verbatim. Constant comparative analysis was used to identify emerging themes from the data.

Results

Twenty-one people with psoriatic arthritis-related foot problems and 17 health professionals participated. Three overarching key themes were derived from patients and health professionals: (1) structural and functional foot manifestations, (2) impact on daily life leading to social withdrawal and reduced work productivity and (3) mediating factors influencing the severity of impact from foot problems on their lives such as social support, self-management strategies and experiences of health care.

Conclusion

Foot problems caused functional disability and altered self-concept, which lead to a cascade of social, economic and psychological consequences. People with foot problems contend with profound disruption to their functioning and life roles. Whilst health professionals recognised the functional and visual impact that foot problems have on daily life, the emotional burden may be under-appreciated. Future work to determine the scale and types of foot problems in psoriatic arthritis is required.

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Acknowledgments

The authors would like to thank the participating sites in the study including BJC Health, Liverpool Hospital, AUT University and North Shore Hospital.

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Authors and Affiliations

  1. Podiatry department, School of Health and Sciences, Western Sydney University, Building 24, Campbelltown Campus, Sydney, Australia

    Kate Carter, Steven Walmsley & Deborah E. Turner

  2. Department of Rheumatology, South Western Sydney Local Health District, Liverpool Hospital, Sydney, Australia

    Diana Chessman

  3. Health and Rehabilitation Research Institute, Faculty of Health and Environmental Science, AUT University, 90 Akoranga Drive, Northcote, Auckland, 0627, New Zealand

    Keith Rome

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  1. Kate Carter
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  2. Steven Walmsley
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  3. Diana Chessman
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  4. Keith Rome
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Correspondence to Kate Carter.

Ethics declarations

Ethical approval was granted by the South Western Sydney Local Health District (HREC/171/LPOOL/353), the Auckland University of Technology Ethics Committee (AUTEC 17/320) and the Waitemata District Health Board of Auckland New Zealand (RM/3907). Both participants and health professionals provided written informed consent prior to data collection.

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Carter, K., Walmsley, S., Chessman, D. et al. Perspectives of patients and health professionals on the experience of living with psoriatic arthritis-related foot problems: a qualitative investigation. Clin Rheumatol 38, 1605–1613 (2019). https://doi.org/10.1007/s10067-018-04411-2

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