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. 2013 Nov 27;65(12):1916–1926. doi: 10.1002/acr.22097

Table 2.

Summary of articles identified through the systematic search that met the criteria for the systematic synthesis and from which data were extracted*

Author, year (ref.) Country Aim Sample characteristics: 1) no., 2) sex, 3) disease duration, 4) definition and diagnosis of RA Qualitative method and analysis used Quality check
Backman et al, 2007 (35) Canada To explore the impact of chronic inflammatory arthritis on parenting and to develop a conceptual framework for subsequent study of mothering

  1. 6 participants with RA (6 participants with other inflammatory arthropathies were also sampled)

  2. 6 women

  3. Not specified for the 6 patients with RA (overall range for the 12 patients was 3–40 years)

  4. Rheumatologist's diagnosis (use of classification criteria NR)

 In-depth semistructured interviews, analyzed using grounded theory

  1. Transcripts were independently reviewed by 2 researchers

  2. Member checking was undertaken with 1 participant checking results
Bernatsky et al, 2010 (40) Canada To identify barriers to optimal care for individuals with RA

  1. 18 participants with RA (54 health care professionals also sampled)

  2. 13 women

  3. NR

  4. Rheumatologist's diagnosis (use of classification criteria NR)

 Structured focus groups analyzed using content analysis (analysis reported also to draw on grounded theory principals)

  1. Transcripts were independently coded

  2. Results were viewed by stakeholders to confirm validity
Brown and Williams, 1995 (31) UK To explore women's experiences of RA

  1. 7 participants

  2. 7 women

  3. NR

  4. Sample consisted of inpatients admitted due to symptoms of RA (use of classification criteria NR)

 Conversational interviews guided by an interview schedule; data were interpreted using narrative analysis NR
Bury, 1982 (23) and Bury, 1988 (28) UK To explore the problems of recognition and challenges in life situations and relationships occasioned by the development of RA

  1. 30 participants

  2. 25 women

  3. Participants were new referrals to secondary care (exact disease duration NR)

  4. A “definite diagnosis [of RA] was … confirmed” in 29 patients (use of classification criteria NR)

 Semistructured interviews with followup interviews; analysis informed by narrative approaches Themes uncovered were validated against theoretical models
Dildy, 1996 (36) US To explore the nature of suffering in people with RA

  1. 14 participants

  2. 9 women

  3. Range 6 months to 35 years from time of diagnosis

  4. Physician's diagnosis (use of classification criteria NR)

 Interview process was described as an “intense interview strategy” with followup interviews; analysis informed by grounded theory

  1. 2 researchers examined data to establish reliability and consistency in coding

  2. Findings were validated and confirmed with the informants through the second telephone interview
Fair, 2003 (42) US To investigate explanations of RA from women's perceptions of the illness experience and providers' understanding of disease

  1. 17 participants

  2. 17 women

  3. NR

  4. Physician's diagnosis (use of classification criteria NR)

 Semistructured interviews supported by field notes; thematic analysis and framework approaches drawn upon

  1. Member checking: participants were sent copies of the explanations of RA

  2. Dependability or reliability of the study maintained by audit trail reviewed by 4 independent researchers
Griffith and Carr, 2001 (19) UK To explore the experiences of coping with RA

  1. NR

  2. NR

  3. NR

  4. NR

 In-depth interviews; method of analysis NR NR
Hewlett et al, 2005 (41) UK To explore the concept of fatigue as experienced by RA patients

  1. 15 participants

  2. 12 women

  3. Range 1.5–30 years (mean 12.6 years) from time of diagnosis

  4. 1987 ACR classification criteria for RA fulfilled

 Face-to-face semistructured interviews, analyzed to establish themes grounded in data

  1. Interviews were transcribed individually by 2 researchers independently

  2. 5 random transcripts were analyzed independently by 2 external researchers

  3. Codes were also reviewed by a steering committee
Hwang et al, 2004 (38) South Korea To explore and describe the illness experience of women with RA

  1. 5 participants

  2. 5 women

  3. Range 4–12 years (mean 7 years)

  4. Participants were diagnosed with RA in secondary care (use of classification criteria NR)

 Informal unstructured interviews were undertaken; phenomenological analysis of data Member checking: participants checked the transcripts to ensure that an accurate representation of their experience was gathered
Kumar et al, 2010 (21) UK To assess the reasons underlying delay in consultation in RA patients from a South Asian background

  1. 10 participants

  2. 9 women

  3. Participants were newly presenting to secondary care with RA

  4. 1987 ACR classification criteria for RA fulfilled

 Face-to-face in-depth semistructured interviews, analyzed using grounded theory analysis Member checking: by providing participants with a verbal summary of the areas covered and themes identified in the interview
Lempp et al, 2006 (20) UK To explore direct personal experiences of living with RA and the impact of the illness upon patients' lives

  1. 26 patients

  2. 22 women

  3. Range 1–29 years (mean 10 years)

  4. Participants were secondary care patients with RA (use of classification criteria NR)

 Face-to-face in-depth semi-structured interviews, analyzed using content analysis Plausibility of accounts judged by authors, cross-referencing of themes with an independent researcher
Neill, 2002 (24) Australia To explore patterns in the life stories of women living with RA

  1. 3 participants

  2. 3 women

  3. Range 19–38 years (symptom duration)

  4. NR

 4 face-to-face unstructured interviews with each participant, supported by photos, field notes, and telephone calls; analysis drew on pattern and theoretical analysis techniques Repeated interviewing to explore concepts in depth and validate initial interpretations
Nyman and Lützen, 1999 (30) Sweden To identify the caring needs of women with RA undergoing acupuncture treatment

  1. 6 participants

  2. 6 women

  3. Range 4–26 years (median 11 years) from time of diagnosis

  4. Rheumatologist diagnosis (use of classification criteria NR)

 20 semistructured interviews over a period of 11 weeks, conducted during acupuncture sessions; data analyzed using content analysis Authors suggested that data were validated, but the method of validation was not explained
Oliver et al, 2008 (22) UK To explore the experiences of those with RA in order to understand the impact on the individual and on health care resources

  1. 22 participants

  2. 16 women

  3. ≤3 years from time of diagnosis

  4. Participants were asked to confirm with a health care professional that they had seropositive RA (use of classification criteria NR)

 Telephone semistructured interviews, analyzed using thematic analysis

  1. Process maps were transcribed into individual participant maps and returned to the participant for verification and alteration

  2. Themes reviewed by research team
Sakalys, 1997 (29) US To explore prediagnostic illness behavior in RA

  1. 50 participants

  2. 20 women

  3. ≤2 years from time of diagnosis

  4. 1987 ACR classification criteria for RA fulfilled

 Structured interviews; data were analyzed using content analysis Intercoder agreement was checked periodically
Sheppard et al, 2008 (25) UK To explore people's beliefs, feelings, and actions at the onset of RA to gain insights into the factors that influenced their decision to consult

  1. 24 participants

  2. 10 women

  3. ≤14 months from time of diagnosis

  4. 1987 ACR classification criteria for RA fulfilled

 In-depth semistructured interviews; analysis followed a grounded theory approach Blind and independent codingSelf-selecting participants were sent a summary of the interview
Schneider et al, 2008 (27) South Africa To explore a range of experiences, including onset of disease, treatment, environmental barriers and facilitators, employment, and social inclusion

  1. 60 participants

  2. 60 women

  3. Range 1–26 years (or more) since time of diagnosis

  4. 1987 ACR classification criteria for RA fulfilled

 Semistructured in-depth interviews, analyzed using a thematic analysis approach NR
Shaul, 1995 (17) US To explore how women manage RA and the demands of their everyday lives

  1. 30 participants

  2. 30 women

  3. ≤18 years from time of diagnosis

  4. “Definite, classical or probable RA” as assessed by a rheumatologist

 Semistructured interviews, analyzed using constant comparative methods

  1. Interview guide assessed for face validity by 2 women with RA

  2. Independet coding of a sample of transcripts
Shaul, 1997 (33) US To explore the transition of women experiencing RA

  1. 30 participants

  2. 30 women

  3. ≤18 years from time of diagnosis

  4. “Definite, classical or probable RA” as assessed by a rheumatologist

 Semistructured interviews, analyzed using constant comparative methods

  1. Interview guide assessing for face validity by 2 women with RA

  2. Independent coding of a sample of transcripts
Stamm et al, 2008 (39) Austria To explore the life story of people diagnosed with RA

  1. 10 participants

  2. 8 women

  3. NR

  4. Attendees at a rheumatology outpatient clinic (use of classification criteria NR)

 Repeated narrative interviews were analyzed using a narrative biographical method Self-reflection and debriefing were undertaken and findings were discussed with coauthors
Townsend et al, 2010 (26) Canada To identify ethical challenges in the early RA experience

  1. 8 participants

  2. NR

  3. ≤12 months from time of diagnosis

  4. Physician's diagnosis (use of classification criteria NR)

 In-depth interviews, including followup interviews; constant comparisons and thematic analysis Blind and independent coding of transcripts
Wiener, 1975 (34) US To explore the management of pain in RA

  1. 21 participants

  2. NR

  3. NR

  4. NR

 Interviews and observational data were collected; analysis informed by grounded theory NR
Williams, 1984 (18) UK To explore the way in which beliefs about the etiology of arthritis can be understood in terms of narrative reconstruction

  1. 30 participants

  2. 19 women

  3. ≥5 years

  4. NR

 In-depth semistructured interviews; analysis informed by narrative approaches Themes uncovered were validated against theoretical models
Williams and Graham, 2012 (37) UK To explore patients' experiences of foot problems associated with RA

  1. 22 participants

  2. 16 women

  3. Mean 15 years for women and 13 years for men

  4. RA according to 1987 ACR classification criteria

 Focus groups facilitated by a researcher; analysis of data informed by thematic analysis Transcripts were read and verified by 1 participant from each focus group
Yoshida, 1996 (32) Canada To explore various forms of uncertainty among people with RA

  1. 46 participants

  2. 32 women

  3. Range 18 months to 53 years (mean 13.5 years)

  4. Particiants were members of the consultation and therapy service of the arthritis society (use of classification criteria NR)

 In-depth semistructured interviews; data were analyzed using a constant comparative approach and grounded theory methods Coding scheme was developed and refined by 2 researchers

*RA = rheumatoid arthritis; NR = not reported; ACR = American College of Rheumatology.